Sacroiliac Joint Dysfunction: A Hidden Cause of Hip Pain

Name: Blue Heron Chiropractic & Healing Arts Center in NE Portland
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An image of the hip and pelvis showing SI joint pain

This patient believes he has Hip Pain which is actually his SI joint.

Many patients report persistent hip pain without realizing that the true source may lie in the sacroiliac (SI) joint. The SI joints, located where the sacrum meets the pelvis, are essential for stability and weight transfer between the upper body and legs. However, dysfunction or inflammation in these joints can mimic hip pain, leading to misdiagnosis.

The Confusion Between Hip and SI Joint Pain

There are two SI joints, one on either side of the triangular Sacrum bone at the bottom of your spine. The SI joint connects the Ilia or wings of the pelvis, to the Sacrum. Since the Ilia make up what is often described as part of the hip (it’s really the Pelvis), SI joint issues are often misinterpreted as hip pain due to the proximity of the joint to the hip region. Pain is usually felt on one or both sides of the buttocks, but not in the center. It can also radiate up the back muscles, down the back of the thigh, or into the hip and groin. Sacroiliac (SI) joint dysfunction is a condition that causes pain in the lower back and buttocks due to abnormal movement in the sacroiliac joints.

When the Pelvis is rotated on the SI joint, it is described as dysfunctional. Symptoms from SI joint dysfunction can radiate along the pelvis, groin, buttock, or even down the leg, much like those from hip or lower back disorders. Since the pain can manifest in areas typically associated with hip problems, including the outer hip or upper thigh, it can mislead both patients and practitioners

Several factors can trigger SI joint dysfunction. These

Causes of SI Joint Dysfunction

include:

Injury or trauma, such as from falls or motor vehicle accidents.
Work Injuries, including ladders or stairs, carrying, lifting, stepping off a curb.
Pregnancy, as the joint becomes more mobile to prepare for childbirth.
Degeneration or arthritis, which can wear down the cartilage and irritate the joint.

Certain biomechanical issues, such as leg length discrepancies or muscle imbalances, can also contribute to SI joint stress, further complicating diagnosis. Sharp radiating pain is also often confused with Sciatica or nerve pain, while actually it is Sacroiliitis, or irritation of the SI joint.

Diagnosis and Treatment

Misdiagnosing SI joint dysfunction as hip pain can delay effective treatment. A proper diagnosis often involves a combination of physical examinations, patient history, and diagnostic imaging. Chiropractic care can play a crucial role in managing SI joint dysfunction, using manual adjustments, soft tissue work, and corrective exercises to relieve pain and restore proper function.

Dr. Sibilla will palpate your SI joints and determine the extent of pain and injury. Hip range of motion and side-to-side comparisons will be made. Since the pelvis rotates with an SI dysfunction, shortening one leg, we will do a Leg length measurement. Leg Length Analysis is made possible with our gravity-dependent lift table to get a true postural reading. Additionally, we may order an X-ray to measure an exact discrepancy in millimeters.

Manual adjustments can counter-rotate an oblique (rotated) pelvis, and SOT blocking techniques are often be applied. Occasionally, with an anatomical leg length discrepancy, we may fit you for a heel lift to be worn inside the shoe.

Not True Hip Pain

Understanding that SI joint dysfunction can masquerade as hip pain helps patients get the right treatment earlier, improving outcomes and preventing chronic discomfort. If you are experiencing persistent “hip” pain, it may be worthwhile to consult with an orthopedic or chiropractic specialist to evaluate your SI joints.

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