Of all the back pain diagnoses that get missed or misdiagnosed, sacroiliac (SI) joint dysfunction or Sacroiliac (SI) Joint Pain may be the most common. Patients often spend months — sometimes years — being treated for a disc problem or sciatica that never quite resolves, when the real source of pain is actually a joint most people have never heard of. At Chattanooga Non-Surgical Orthopedics, identifying and correctly treating SI joint pain is one of Dr. Jeff Hall’s specialties.

What Is the SI Joint, and Why Does It Cause So Much Confusion?

The sacroiliac joints connect your sacrum (the triangular bone at the base of your spine) to your pelvis on each side. These joints don’t move much — but the small amount of motion they do allow is critical for absorbing shock as force travels between your spine and legs. When an SI joint becomes too mobile (hypermobile) or, conversely, too restricted (hypomobile), the result is pain that can be remarkably difficult to pin down.

That’s because SI joint pain frequently mimics — and gets confused with — other conditions:

• It’s often felt just below the beltline on one side, similar to lower left-sided or right-sided low back pain
• It can refer pain into the buttock and back of the thigh, mimicking sciatica
• It frequently worsens with activities like standing on one leg, climbing stairs, or rolling over in bed — patterns that overlap with hip and lumbar disc pain

Because of this overlap, SI joint dysfunction is one of the most commonly misdiagnosed sources of low back and buttock pain in orthopedic and chiropractic practice.

Common Causes of SI Joint Dysfunction

• Pregnancy and childbirth, during which hormonal changes loosen the SI ligaments, sometimes leading to lasting hypermobility
• Traumatic injury, such as a fall directly onto the buttocks or a car accident
• Leg length discrepancy or gait abnormalities, which place uneven, repetitive stress on one SI joint
• Prior lumbar fusion surgery, which shifts additional mechanical load onto the SI joints below the fused segment
• Repetitive asymmetric activity, such as always carrying a child or bag on the same side, or certain running and golf mechanics

How CNS Orthopedics Diagnoses and Treats SI Joint Pain

Because SI joint pain mimics so many other conditions, accurate diagnosis starts with specific orthopedic provocation tests and a thorough history — not just imaging, since SI joint dysfunction frequently doesn’t show up clearly on a standard X-ray or MRI.

Chiropractic Adjustments — For a restricted or malpositioned SI joint, targeted adjustments restore normal joint mechanics and immediately reduce abnormal stress on the surrounding ligaments and muscles.

Prolotherapy — For patients with SI joint hypermobility or ligament laxity (common after pregnancy or injury), prolotherapy strengthens the surrounding ligaments, restoring the joint’s natural stability — something adjustments alone can’t fully address.

PRP Therapy — In cases involving ligament or joint tissue damage, PRP injections can accelerate healing and reduce chronic inflammation within the joint.

Clinical Exercise — Targeted glute, core, and hip stabilization exercises are essential for keeping the SI joint properly supported and preventing the dysfunction from returning.

If Sciatica Treatment Hasn’t Worked, This Might Be Why

If you’ve already tried treatment for “sciatica” or a disc problem without lasting relief, an unaddressed SI joint may be the real culprit. This is an incredibly common pattern we see at CNS Orthopedics, and it’s exactly why a precise, hands-on diagnosis matters before treatment begins.