Pain Symptom
SI Joint Pain
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
The pain sits right over the dimple at the back of your pelvis, usually on one side. It flares when you climb stairs, get out of the car, roll over in bed or stand on one leg. You might feel it in your buttock or groin too. The sacroiliac joint barely moves, and the muscles that control it often determine whether it hurts.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding SI Joint Pain
The sacroiliac joints connect the sacrum, the triangular bone at the base of the spine, to the two halves of the pelvis. They move only slightly, but they transfer the weight of your upper body to your legs with every step.
SI joint pain happens when the joint is irritated by uneven loading, too much or too little movement, or inflammation. It is common during and after pregnancy, after falls onto the buttock, with leg length differences, and in runners and athletes. The gluteal muscles, piriformis, pelvic floor, hamstrings and deep abdominal muscles all help stabilize the joint. When some are tight and others underactive, the joint takes uneven stress.
Inflammatory conditions such as ankylosing spondylitis should be ruled out by your physician when appropriate. Dr. Gordon treats the muscles around the joint so it can carry load comfortably again.
SI Joint Pain at a Glance
Also called
Sacroiliac joint dysfunction
Where it is felt
Low back dimple on one side, buttock, sometimes the groin or back of the thigh
Who it affects
Pregnant and postpartum women, runners, people after falls, people with leg length differences
Common aggravators
Stairs, getting out of a car, rolling in bed, standing on one leg, long walks
Key muscles
Gluteals, piriformis, pelvic floor, hamstrings, deep abdominals
The Gap in Care
What Tests Check, and What They Can Miss
SI joint pain often looks normal on imaging. The problem is usually how the joint is loaded, which is a muscle and movement issue.
What routine testing is looking for
- Inflammatory arthritis
- Fracture after a fall
- Disc or spinal problems
- Hip joint disease
What often keeps symptoms going
- Gluteal and piriformis trigger points
- Uneven muscle support around the joint
- Pelvic floor guarding that alters stability
- Hamstring tension pulling on the pelvis
- Asymmetric movement habits
These are found with hands-on and load testing, which is how Dr. Gordon approaches SI joint pain.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Pain at the low back dimple
One-sided pain at the back of the pelvis.
Pain with stairs
Pain climbing stairs or stepping up.
Pain rolling in bed
Sharp pain turning over.
Pain getting out of the car
Pain with twisting and stepping out.
Buttock or groin pain
Pain spreading into the buttock or groin.
Pain standing on one leg
Pain dressing or standing on the affected side.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Uneven load
When the pelvis is not stabilized evenly, the joint takes extra stress.
Gluteal and piriformis trigger points
These muscles attach near the joint and refer pain to it.
Pelvic floor involvement
The pelvic floor helps stabilize the pelvis from below.
Hamstring and hip tension
Tight hamstrings and hip muscles pull unevenly on the pelvis.
Your First Visit
How Dr. Gordon Evaluates SI Joint Pain
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
- 1
Records and history review
Dr. Gordon reviews your imaging, physician or physical therapy notes, medications and past treatments so he knows what has been ruled out and what has already been tried.
- 2
Joint provocation testing
Specific tests to confirm whether the SI joint is the source of your pain.
- 3
Load transfer testing
Single-leg, stair and walking tests to see how your pelvis handles load.
- 4
Muscle mapping
Hands-on assessment of the gluteals, piriformis, hamstrings and low back.
- 5
Plan and coordination
A clear plan, plus communication with your physician, orthopedist or physical therapist when that helps your care.
When to see a physician first
- New weakness, numbness or tingling that is spreading or getting worse
- Numbness in the saddle area or loss of bladder or bowel control
- Back pain with fever, chills or unexplained weight loss
- Pain after a significant fall or accident
- Back pain with a history of cancer
- Severe pain at night that does not change with position
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for SI joint pain, chosen from your exam findings.
Orthopedic Dry Needling
Dr. Gordon has used dry needling for more than 18 years. Treatment releases the gluteal, piriformis and hip muscles that load the sacroiliac joint unevenly.
See all servicesNeuro-Functional Acupuncture
Electro-acupuncture to calm pain and nerve sensitivity around the joint.
See all servicesStability Plan & Team Coordination
Guidance on movement and activity, coordinated with your physical therapist for strengthening.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Find the main driver
Dr. Gordon confirms which muscles and nerves are behind your symptoms and starts calming the most reactive areas. Many people notice early changes between visits.
Lower the baseline
Day-to-day symptoms ease, flares become shorter and less frequent, and normal routines start to feel more manageable.
Build resilience
Visits are spaced out as improvement holds. You leave with a maintenance and early-flare plan.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
I have seen Dr. Gordon for back pain, knee issue and most recently foot pain and I have to say every single time I visit the very next day I'm back to resuming my very active lifestyle.Judy Castellanos, Google Review
SI Joint Pain Questions
Answers About SI Joint Pain
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
Before You Book
General Questions
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioBook an Evaluation for SI Joint Pain
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Further Reading
Low Back Pain When You Breathe or Twist: The Quadratus Lumborum
From the blog: A deep low back ache that catches when you breathe, twist or roll over in bed often involves the quadratus lumborum. What this muscle does and why it hurts.
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