What causes SIJ pain?

SIJ pain may follow a fall, a lifting twist, pregnancy-related pelvic girdle strain, arthritis, or a spike in walking, running, or work loads. Sometimes the pain comes from the lower back or hip and feels like SIJ pain, so assessment helps guide the right plan.

How is SIJ pain diagnosed?

A physiotherapist combines your history, movement assessment, and a cluster of SIJ provocation tests to see if the joint is likely involved and to rule out other causes. Imaging does not reliably confirm SIJ pain on its own, but your GP may request scans when symptoms suggest another condition.

Can exercise help with SIJ pain?

Yes. Many people improve with a graded program that builds hip and trunk control, glute strength, and load tolerance. Your physiotherapist will choose exercises that match your irritability level and progress them as symptoms settle.

An SIJ belt may help some people in the short term by reducing strain during walking, standing, or transitions. It works best when used alongside a strengthening and control program, rather than as the only strategy.

SIJ Pain Treatment: Sacroiliac Joint & Buttock Pain Options

Article by John Miller & Erin Runge

Sacroiliac joint pain treatment physiotherapy assessment for buttock pain — A Physiotherapist Discusses Sacroiliac Joint Pain Treatment And Personalised Recovery Planning.

Sacroiliac joint pain treatment, SIJ pain, buttock pain relief

If SIJ pain or buttock pain keeps returning, the right plan depends on what is driving it. A physiotherapist will assess your sacroiliac joint (SIJ), hips, lower back, and movement control, then match treatment to your symptoms and goals.

Most people improve with a mix of load management, targeted exercise, and hands-on care. In some cases, inflammatory causes (such as ankylosing spondylitis) or referred pain from the lower back can mimic SIJ pain, so a structured assessment matters.

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What’s the best treatment for SIJ and buttock pain?

The best SIJ pain treatment usually follows a staged approach: calm symptoms first, then rebuild pelvic control, then return to full activity. Along the way, your physio may also check hip pain triggers, muscle overload (see muscle pain), and movement habits that keep loading the pelvis.

Phase 1: Settle pain and protect irritated tissues

First, aim to calm pain and sensitivity. Many people find short bouts of heat or ice useful, especially after activity or prolonged sitting. Over-the-counter anti-inflammatory medicines may help some people, but they do not address the driver of the problem, so treat them as one small part of the plan.

If pain flares with standing, turning in bed, stairs, or long sitting, your physio may adjust activity and teach load-sparing strategies for daily life. Where support helps, taping or a sacroiliac belt can reduce strain while you rebuild control. In pregnancy-related pelvic girdle pain, a belt and pacing strategies may also help reduce flare-ups while you build strength.

Phase 2: Restore pelvic control and build strength

Sacroiliac joint pain treatment glute bridge exercise rehabilitation — A Physiotherapist Guides A Glute Bridge As Part Of Core Stability Training For Sacroiliac Joint Pain Treatment.

Next, focus on muscle control around the pelvis. A physio may start with a core stability program and progress to strength work that targets deep gluteals and hip stabilisers. If you want a broader menu of options, see core stability exercises for examples and common progressions.

After that, you will usually layer in stronger hip work (glutes, hamstrings, and adductors) plus gradual exposure to the positions that trigger symptoms. Consistency matters more than intensity early on, so keep changes small and repeatable.

Phase 3: Return to walking, work, sport, and training

Once symptoms settle, you will rebuild tolerance for bigger tasks like lifting, longer walks, hills, running, and gym work. Your physio may use gait analysis and broader biomechanical analysis to spot loading patterns that keep re-irritating the pelvis and lower back.

At this stage, a clear “do more” plan helps. For example, increase walking time, hills, or strength loads by a small amount each week, then hold steady if symptoms spike.

Phase 4: Reduce recurrence risk

Recurring SIJ pain often links to deconditioning, sudden workload spikes, or repeated poor movement patterns. A simple plan that you repeat each week tends to work best. You can also review injury prevention programs if you want a structured approach for sport or busy work periods.

Finally, keep the “minimum effective dose” going. Two to three short strength sessions per week often beats occasional long sessions that lead to flare-ups.

What to do next

If SIJ or buttock pain keeps coming back, start with a clear assessment and a simple plan you can follow. Track what triggers your pain, stay active within comfortable limits, and progress strength and control in small steps. If pain spreads, you notice numbness, marked weakness, fever, unexplained weight loss, or night pain that does not settle, see your GP promptly.