Is Your Buttock Pain Really Coming from the Sacroiliac Joint?

Struggling with deep discomfort around your lower back, hip, or buttock-especially when sitting, standing, or walking? You might be dealing with sacroiliac (SI) joint dysfunction.

This is a condition often mistaken for sciatica, piriformis syndrome, or general low back pain. Yet, each condition stems from different sources and needs specific treatment. Accurate diagnosis makes a huge difference. At Perfect Balance Clinic in Hatfield, we help people uncover the true cause of their pain and guide them toward a focused plan that works.

Book your SI joint assessment today and take the first step toward lasting relief.

Understanding the Pain: SI Joint or Something Else?

The sacroiliac joints connect the sacrum (the base of the spine) to the ilium (pelvic bones) on both sides. They link the upper body and legs, absorbing the stress of walking, running, or standing still.

Although these joints allow only a few degrees of movement, too much or too little motion can irritate the joint, leading to deep, uncomfortable pain in the buttock, hip, or groin. People of any age can face SI joint problems, mainly if they’re active, have had trauma, or have posture that’s out of balance.

Common Signs of SI Joint Pain

• Pain located in the lower buttock, either on one side or both

• Pain that may radiate into the groin, thigh, or hip-but rarely below the knee

• Increased discomfort during activities like getting up from a chair, climbing stairs, or turning in bed

• A sensation of being “twisted,” “stuck,” or unstable on one side of the pelvis

• Worsening with asymmetrical loading (e.g. standing on one leg)

Because these symptoms can resemble several other musculoskeletal problems, proper differentiation is essential for effective care.

Why Is This Pain So Hard to Diagnose?

SI joint dysfunction is often misdiagnosed. Clients at Perfect Balance Clinic in Hatfield often arrive after trying other back pain treatments that didn’t help, only to find the SI joint was the real issue.

The Challenge of Overlapping Symptoms

Symptoms of SI joint dysfunction can mimic:

• Lumbar disc herniation or nerve root compression

• Hip osteoarthritis

• Piriformis syndrome

• Myofascial trigger point pain from the gluteus medius or minimus

• Referred pain from other pelvic structures

To complicate things further, there’s no single gold-standard test to definitively diagnose SI joint pain. This makes expert clinical judgement critical.

Diagnosis: How We Find the Root Cause

At Perfect Balance Clinic, we use a multi-layered diagnostic approach combining physical tests, movement screening, and (when necessary) imaging or diagnostic injections.

Step 1: History and Symptoms

A detailed patient history often reveals key patterns-like pain triggered by certain positions, postnatal changes, old injuries, or activity-related aggravation.

Step 2: Clinical Testing

We perform a range of provocation tests designed to stress the SI joint specifically, including:

• Fortin Finger Test - Patient points to pain directly over the joint

• Gaenslen’s Test - Stretching the hip joints in opposite directions

• Thigh Thrust Test - Compressing the SI joint with a controlled load

• Compression and Distraction Tests - Applying pressure across the pelvis

• Yeoman’s Test - Hip extension performed with the client prone

If three or more of these tests reproduce your pain, there’s strong evidence the SI joint is involved.

Step 3: Rule Out Other Causes

We also check for:

• Sciatica: Using nerve tension tests and strength assessments

• Hip joint pathology: By observing range of motion and joint-specific signs

• Muscle involvement: Identifying tenderness and trigger points in gluteal muscles

Step 4: Gait and Postural Analysis

Through digital gait analysis, we assess how you walk, stand, and load each side of your body. Imbalances in foot position, stride length, or pelvic rotation may explain why one joint is under more strain than the other.

Step 5: Diagnostic Injections (if needed)

In select cases, we refer for a diagnostic SI joint injection. If the pain disappears temporarily following an anaesthetic injection under X-ray or ultrasound guidance, this confirms the SI joint is the primary pain source.

Not All Buttock Pain Is the Same

Differentiating between similar conditions is key to successful treatment. Here’s how SI joint dysfunction differs from other common sources of buttock pain:

SI Joint Dysfunction

• Pain is deep, dull, and aching

• Often one-sided, sometimes bilateral

• Pain stays above the knee

• Triggered by weight-bearing, prolonged sitting, or rolling in bed

Sciatica

• Sharp, electric pain running down the leg, often past the knee

• May be accompanied by tingling or numbness

• Linked to disc bulges, spinal stenosis, or nerve entrapment

Piriformis Syndrome

• Pain along the sciatic nerve path but due to muscular compression

• Tenderness in the deep buttock region

• Often worsens with sitting or rotating the hip

Gluteal Trigger Points

• Localised knots in gluteus medius or minimus

• Cause referral patterns similar to joint pain

• Often overlooked but easily treatable with hands-on techniques

What Causes SI Joint Dysfunction?

There are multiple potential contributors:

• Post-pregnancy ligament laxity

• Leg length differences

• Pelvic rotation or scoliosis

• Falls, car accidents, or repetitive lifting

• Inflammatory joint diseases, such as ankylosing spondylitis

• Hypermobile joints, especially in younger or more flexible individuals

• Joint degeneration, often from age-related wear

How We Treat Sacroiliac Joint Dysfunction

At our Hatfield clinic, we combine hands-on treatment, guided exercise, and movement correction for long-term results.

Manual Therapy

Our osteopaths and physiotherapists use:

• Joint mobilisation techniques to free restrictions

• Muscle energy techniques to correct asymmetry

• Myofascial release for gluteal or piriformis tightness

• Gentle manipulation (when clinically safe and appropriate)

Movement-Based Rehabilitation

We build stability through progressive loading and functional re-training. Your personalised programme may include:

• Pelvic tilts, bridges, and clamshells for pelvic control

• Side planks and core integration drills

• Hip mobility routines for joint balance

• Balance and proprioception exercises

In many cases, a Pilates-based foundation is introduced to restore controlled movement patterns.

Gait Correction and Biomechanics

With gait analysis, we target:

• Uneven stride mechanics

• Excessive internal rotation or pelvic drop

• Overuse of compensatory muscles like the quadratus lumborum

This allows us to correct the forces that feed into the SI joint-preventing recurrence.

Advanced Therapies

For chronic or resistant cases, we may also incorporate:

• Shockwave Therapy - To reduce inflammation around joint capsules or tendons

• Laser Therapy - For tissue healing and pain modulation

• Taping or bracing - In cases of hypermobility, to provide stability during movement

Everyday Adjustments That Help

Sometimes, the small daily habits matter most. We guide you to:

• Use a lumbar roll or wedge cushion when sitting

• Adjust your car seat and desk posture

• Avoid crossing your legs or leaning to one side

• Use stairs with proper form-lead with your stronger leg

• Return to running or high-load activity gradually, with supervision

You’ll also receive customised advice on lifting techniques, household tasks, and sleep positions that support your recovery.

What Others Say About Us

Hearing directly from people we’ve helped is often the most reassuring step for new clients. Patients at Perfect Balance Clinic in Hatfield often share how they’ve moved from daily pain and worry to feeling free, steady, and back to doing what they love.

Our clinic has supported hundreds of people with sacroiliac joint dysfunction and related conditions, and we’re proud to share their feedback.

When It’s Time to Take Action

Lingering buttock, hip, or low back pain can gradually take over your daily life. Whether it’s affecting your work, fitness, or family time-pain that’s rooted in the sacroiliac joint often continues until it’s properly identified and treated.

You don’t have to guess anymore. If your symptoms haven’t responded to stretching, rest, or standard back care, it’s time to look deeper.

At Perfect Balance Clinic in Hatfield, we combine precise assessment, skilled manual therapy, and proven rehabilitation to give you clarity, relief, and confidence in your body again.

Book your SI joint assessment today-and take the first step toward feeling steady, strong, and pain-free.

Book Your Appointment

Let’s help you recover properly and return to the activity you enjoy. Fill in the form below and one of our team members will reach out shortly to arrange your assessment.

Finding Us in Hatfield

Perfect Balance Clinic - Hatfield Located within David Lloyd Hatfield, our clinic is easy to reach from surrounding areas and ideal for clients in Hertfordshire.

Free parking is available onsite for all clients.

We offer flexible appointment times, including early mornings and evenings, to fit around your schedule.

Book a Consultation Today

Perfect Balance Clinic, Hatfield