SI Joint Dysfunction in College Station, TX: Buttock and Hip Pain

You have two sacroiliac joints, one on each side, right where the bottom of your spine meets your pelvis. They connect the sacrum, the bone just above your tailbone, to the ilium, the broad bone at the top of each side of your pelvis. Put your thumbs on the two dimples at the top of your buttocks and you’re very close to them.

“Dysfunction” is a broad word. It usually means one of three things: the joint isn’t moving as well as it should, it’s moving more than it should, or it’s irritated and inflamed. All three can feel similar, which is part of why the exam matters.

These joints carry load between your upper body and your legs with every step, every stair, and every time you stand up from a chair. When one gets irritated or stops moving well, you feel it in ordinary moments, not just during a workout.

SI joint pain usually sits low. According to Mayo Clinic, it most often shows up in the buttocks and lower back, and it can travel into the groin and down one or both thighs. Many people can point to the exact spot with one finger, just below and inside that dimple. Common patterns include:

• A deep ache in the low back and buttock, on one side or both
• Pain that spreads into the hip or down the back of the thigh
• A sharp catch when you get up from sitting, climb stairs, or turn over in bed
• Trouble sitting or standing in one place for long
• Soreness when you sleep on the painful side, or with walking, twisting, or stooping

In plain words, people tell us “it hurts to sit for long periods” or “I can’t stand longer than 30 minutes without pain.” Rolling over at night can be the worst part, because it wakes you up just as you settle in. Getting out of the car after a long drive is another classic moment.

This isn’t a rare problem. StatPearls, a clinical reference hosted by the National Library of Medicine, notes that up to 25% of low back pain may come from the sacroiliac joint. It’s easy to overlook.

SI joint pain can travel down the back or side of the thigh, and sometimes past the knee, which looks a lot like nerve pain coming from the spine. Researchers writing in Reumatologia describe the SI joints as one of the most common sources of pain that imitates a pinched nerve, and they note that telling the two apart from symptoms alone is close to impossible. Mayo Clinic makes a similar point: SI problems can be hard to diagnose because they look like other causes of low back pain.

That’s why people with SI joint dysfunction are often told they have sciatica, or they assume they have a herniated disc. Sometimes that’s true. Other times the nerve is fine and the joint is the problem. It’s common for people to spend weeks stretching their hamstrings or treating a “pinched nerve” while the joint keeps getting irritated. And groin pain can point to the hip joint itself, which is why we check the hip as a separate possibility. Sorting out the source matters, because each one calls for a different plan.

Several things are known to set SI joint pain off:

• Pregnancy, when hormones loosen the ligaments, the joints stretch to prepare for childbirth, and extra weight deepens the curve of the low back
• The strain of delivery itself, which can leave the joints irritated afterward
• A fall onto the buttock, or a sudden heavy lift with a twist
• Unequal leg lengths or scoliosis, which change how the pelvis carries load
• Wear-and-tear changes in the joint over time

Long hours on your feet can also make an irritated SI joint much worse, since standing or sitting for a long time and climbing stairs are known aggravators. That’s familiar to Texas A&M professors who lecture standing up, to anyone from Bryan to Navasota working a long shift on concrete floors, and to fans after a long Saturday in the stands at Kyle Field.

We don’t assume a sore buttock means an SI joint. Like every first visit with us in our College Station office, it starts with a detailed history and a hands-on exam. Dr. Hansen checks how your lower back, pelvis, and hips move, feels the joint and the tissue around it, and runs neurologic tests (strength, reflexes, and sensation) to see whether a nerve root is involved.

Then come provocation tests. These gently stress the SI joint from different angles, such as pressing through a bent thigh, compressing the pelvis while you lie on your side, or bringing your leg into a figure-four position, to see whether your familiar pain shows up. No single test settles it. StatPearls notes that three or more positive tests together make the picture far more reliable, and that’s how we read them. Digital X-rays are taken in-house only when the exam calls for them, for example to look at wear in the joint or rule out a fracture after a fall.

If Dr. Hansen believes he can help, he’ll say so plainly and show you on a spine model. Our sciatica and low back pain relief care follows three steps. Prime uses guided breathing to help your body settle before the adjustment. Facilitate is a gentle, specific adjustment of the SI joint and the areas around it, and the pop is not the goal. Integrate is what happens between visits, including stabilizing and stretching exercises, which the same clinical reference lists as a first step in care alongside chiropractic adjustments. We may add soft tissue work for the muscles that guard the area.

Some low back and buttock pain isn’t a joint problem at all and needs medical care first. Get emergency care right away if you have:

• Trouble controlling your bladder or bowels
• Numbness in the groin, inner thighs, or buttocks, where a saddle would sit
• Leg weakness that keeps getting worse
• Severe pain after a hard fall, where a fracture is possible

We would not adjust with any of those signs present. If none of them fit, schedule your first appointment and we’ll find out what’s really going on.

What’s the most common mistake with SI joint pain?

Assuming it’s sciatica or tight hamstrings and stretching the wrong area for weeks. Because SI joint pain can travel down the back of the thigh, it’s easy to mistake for a nerve problem, and researchers describe telling the two apart from symptoms alone as nearly impossible. An exam that combines SI provocation tests with strength, reflex, and sensation testing points you to the right area, so your time at home goes toward the right exercises.

Why does my SI joint hurt during or after pregnancy?

Pregnancy changes how your pelvis carries load. Hormones loosen the ligaments, the joints stretch to make room for childbirth, the extra weight adds strain, and the curve of your low back deepens. Delivery itself can also strain these joints. Together, those changes can leave the SI joint irritated during pregnancy and in the months afterward. A support belt may help some women, and our prenatal chiropractic care is gentle and specific to how the joint is moving.

Can SI joint dysfunction cause groin or thigh pain?

Yes, it can. SI joint pain most often sits in the buttock and low back, but it can spread into the groin and down the back or side of the thigh, sometimes past the knee. Groin pain can also come from the hip joint itself, so we test both. If a figure-four hip test brings on groin pain rather than pain over the SI joint, that points us toward the hip instead.

Will I need an X-ray or MRI for SI joint pain?

Not necessarily. A good history and physical exam usually tell us the most. Digital X-rays are taken in-house only when your exam calls for them, for example to check for wear in the joint or rule out a fracture after a fall. If your symptoms point to something an X-ray can’t show, or you aren’t improving as expected, Dr. Hansen will refer you to an imaging center for an MRI or CT.

What can I do for SI joint pain between visits?

Movement and a few targeted exercises are usually the first step. Stabilizing and stretching exercises are a common starting point in care, and our therapeutic exercise program includes a handful that match your exam findings so you aren’t guessing. It also helps to notice what flares the joint, such as long stretches of sitting, standing, or stairs, and break those up when you can. Write down what makes it better or worse so we can adjust your plan.

Can a game day at Kyle Field flare up SI joint pain?

It can. Hours of standing, then sitting on a bleacher, plus plenty of stairs make a tough combination for an irritated SI joint, since standing or sitting for a long time and climbing stairs are known to make the pain worse. If you notice your low back and buttock hurt more the day after a home game, mention that pattern at your exam. It’s useful information for building your plan.