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Does sacroiliac joint pain even exist?

Does sacroiliac joint pain even exist? Barefoot Rehabilitation Clinic
does sacroiliac joint pain exist

10 Jul Does sacroiliac joint pain even exist?

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Does sacroiliac joint (aka SI Joint) pain even exist?

Or is it another body part that nags, bothers, and pains you?

Let’s find out.

What is “sacrioiliac joint pain”?

First, stop googling injuries and self-diagnosing.

The patients who come in our office with a self-diagnosis are almost always wrong.

So, I’ll assume you’ve been diagnosed with “sacroiliac joint pain” by someone who somewhat knows what they’re doing. Here’s how it’s usually diagnosed:

  • Your pain is located between your butt cheek and the spine in your low back. If you’re lean, you may have observable dimples on your low back. That’s your sacroiliac joint. (See the picture below)
  • Your doctor or therapist may have pushed on the dimples, noticing tenderness.
  • You don’t have any numbness or tingling shooting down your legs or into your feet.
  • Your pain increased with hip movements.
  • Joint asymmetry may have been observed on x-ray, CT scan, or MRI.
  • Diagnostic injections into the sacroiliac joint decreased your pain.

If you’re not sure where the location of the SI joints are, find the dimples …

sacroiliac joint dimples


Now, you may be nodding your head, thinking “This sounds just like me.”

If you’re about to start a handful of treatments on your pain from the chiropractor near you, feel free to give it a shot.

But if you’ve had your sacroiliac joint pain for more than a few months and treatment gives you temporary relief (lasting up to 48 hours), but always comes back (we call this the Irrelevant Pain Relief Window ), you may be wondering if there’s something else going on.

fake-pain-treatmentsThere’s a rule that’s meant to protect you from the Irrelevant Pain Relief Window.

The 5 Visit Rule

The 5 Visit Rule

When I get together with my pain-fixing colleagues, we often talk about what effective treatment looks like.

What should you expect when seeing any musculoskeletal provider for your pain, no matter how long you’ve had it?

Your pain should show some sign of permanent and sustainable improvement within 5 visits of seeing any type of healthcare provider (including chiropractors, physical therapists, medical doctors, orthopedic doctors, acupuncturists, or massage therapists).

Those signs include:

  • being located at one spot for 6 months and moving to a new location.
  • reducing in intensity at least 10% or lowering from a 7/10 to a 6/10 that lasts after 48 hours have passed since your last treatment.
  • coming later in an activity (like having to sit for 60 minutes before the pain sets in instead of 30 minutes).

If your pain hasn’t improved within 5 visits, your healthcare provider should now be:

  • ordering imaging for your joint.
  • decreasing the amount of activity you’ve been doing.
  • identifying and offering proposed solutions for other factors (such as weight, medications, other diseases, sleep, stress) that may have been contributing to your pain.

If your healthcare provider hasn’t gotten you results and hasn’t changed the plan in 5 visits, it’s time to find another healthcare provider.

That’s the 5 Visit Rule.

If Natasha, a 40 year old single mom who travels all over New Jersey for work knew about the 5 Visit Rule, she wouldn’t have paid the NUCCA chiropractor she was seeing $5,000 for a treatment plan, seeing them for 40 treatments with 0% improvement.

She would have seen us at our office in Parsippany and seen a 15% improvement in her neck pain in 5 visits like she did just this week.

If it’s not sacroiliac joint pain, what else could it be?

The short answer is most commonly disc damage in your low back.

In the below image, notice all of the different colors.  These are all of the places that disc damage can shoot pain.

The forest green color on his butt cheeks is where the sacroiliac joints are located.


Photo Courtesy of http://www.kinetesisspineandjoint.ca/back-pain/back-pain-referral-patterns/

You can confirm that you have some type of bulging disc pain by observing the following signs in yourself. Do you:

  • wake up each morning with a stiff low back that goes away after 10-15 minutes?
  • have low back pain when you pick up something off the ground or tie your shoes?
  • get up from standing and have low back pain for 5 minutes, before it works itself out?
  • experience excruciating pain in your low back for 2-10 day periods a couple of times per year, always to have your pain go away completely after that period?

The gold standard for knowing, with certainty, that you have disc pain, is when you get treated within 5 visits and your pain is surprisingly, noticeably, and gratefully 10, 20, maybe even 50% better!

Get Your Fake Sacroiliac Joint Pain Fixed!

Now that we’ve agreed that you probably have disc pain, it’s time to address it.

But first, a quick word about actual sacroiliac joint pain.

  • It does exist (usually with degeneration and/or ligamentous instability).
  • It usually involves trauma.
  • It’s very rare.

I’ve been treating pain for 8 years and I can’t recall a single patient who came in saying that they had sacroiliac joint pain who was right.

Every one of them had pain that responded to disc treatment.

You can confirm that you have a disc problem by getting a friend to do the pencil test on you.


Once you’re ready to do something about it, find an Integrative Diagnosis provider near you to diagnose you correctly and to fix you.

If you’re close to Northern New Jersey, give us a call at our Parsippany office (862-205-4847) to schedule your diagnostic session today.

What has your experience been with sacroiliac joint pain? Please share in the comments below.

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Dr. Chris Stepien, DC, Full-Body ID Certified, ART Certified, CSCS, and CrossFit Level 1 Certified, is a Sports Therapy & Chronic Pain Resolution Specialist with Barefoot Rehab in Parsippany, NJ.  When you're in pain that hasn't gone away and you've been to at least 3 other doctors, Dr. Chris wants to help you. And when you're sad, depressed, or not enjoying life, Dr. Chris wants to hug you. He invites you to reach out, no matter what your concern is. Barefoot Rehab is here to serve you.
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