Sacroiliac Joint Pain ChiropractorAdelaide

What Sacroiliac Joint Pain Looks Like

Sacroiliac joint pain is typically one-sided, sits at or just below the belt line, and may radiate into the buttock or upper thigh. It rarely radiates below the knee. Aggravators usually involve single-leg loading.

Typical features include:

• Location at or just below the belt line on one side, often into the buttock, sometimes into the groin or posterior thigh.
• Aggravators including stair climbing, rolling over in bed, standing on one leg, and standing up from a low chair.
• Easing often with offloaded positions, gentle walking, and avoiding sustained single-leg loading.
• Differentiation point: pain that travels below the knee in a clear leg-line is more typical of disc-referred sciatica than SI joint pain.

How We Assess It: The Laslett Cluster

A structured bedside assessment may include the Laslett five-test cluster (distraction, thigh thrust, compression, Gaenslen, and sacral thrust). When three or more tests reproduce your familiar pain, the sacroiliac joint is more likely to be a dominant source.

What the evidence base for the assessment tells us:

• Cohen 2005 estimated the sacroiliac joint contributes to 15 to 30 per cent of chronic mechanical low-back pain presentations, depending on population and diagnostic threshold.
• Laslett et al. 2005 validated the five-test cluster against fluoroscopically-guided diagnostic anaesthetic block. Pooled performance with three or more tests positive: sensitivity around 91 per cent and specificity around 78 per cent for patients whose pain does not centralise with repeated movements.
• NICE NG59 recommends a combined package of manual therapy, exercise, and psychological support for persistent non-specific low back pain, delivered as a treatment programme rather than as a standalone intervention.

Sources: Cohen (2005) Anesthesia & Analgesia 101:1440. Laslett et al. (2005) Manual Therapy 10:207. NICE Guideline NG59 (2016, updated 2020).

What the Research Suggests

Conservative manual therapy, graded movement, and load-management guidance are recommended in mainstream low-back-pain guidelines for mechanical sacroiliac joint pain. The studies below summarise what the research suggests, not what any individual person will experience.

How Chiropractic Care May Help

Research suggests conservative manual therapy, combined with graded movement and load-management guidance, may help manage mechanical sacroiliac joint pain. Care is tailored to how your pelvis and lower back respond to assessment. Individual responses vary.

At Stapleton Chiropractic, care for sacroiliac joint pain typically includes:

• Detailed history and red flag screen to confirm the presentation is consistent with mechanical SI joint pain and to rule out anything that warrants urgent medical review.
• Pain-provocation testing using the Laslett cluster, plus a centralisation screen with repeated movements.
• Low-force adjustment using an Activator instrument or drop-piece table where appropriate. Both are well-tolerated and suited to a guarded or irritated pelvis.
• Diversified manual adjustment for patients comfortable with hands-on adjusting, applied to the lumbar spine and pelvis as clinically indicated.
• Soft tissue techniques for the lumbar, pelvic, and hip regions that often guard around an irritated sacroiliac joint.
• Graded movement and load-management guidance for the aggravating positions, including how to get out of bed, climb stairs, and stand up from sitting with less provocation while tissues settle.

Progress is reviewed at each visit. There are no lock-in plans, and the decision to continue is always yours. If your response to care is not what we would expect, we will reassess and, where appropriate, discuss referral pathways back to your GP, to imaging, to a pain clinic, or to a colleague in another discipline.

Chiropractic vs other common approaches

If we feel you would benefit from a different approach, we will always let you know.

Why Stapleton Chiropractic

Adult-first, evidence-informed, and family-run since 1972. No lock-in plans, clear pricing, and the decision is always yours.

What Your First Visit Looks Like

Four straightforward steps. No paperwork marathons, no surprises.

Transparent, Affordable Fees

No lock-in plans, no pressure. Fees sit well below the South Australian average.

Source: Australian Chiropractors Association Consultation Fee Survey 2025 (SA data). All major health funds accepted.

Warning Signs That Warrant Urgent Medical Review

Most sacroiliac joint pain is mechanical and not an emergency. A small number of presentations do need urgent medical review.

Seek urgent medical review if your lower-back or buttock pain is accompanied by any of the following:

• Saddle anaesthesia, meaning numbness in the groin, inner thighs, or the area that would touch a saddle
• New bowel or bladder change, including new incontinence or difficulty passing urine
• Progressive weakness in one or both legs, or a foot that catches or drags
• Fever alongside back or pelvic pain
• Unexplained weight loss over weeks to months
• Recent significant trauma, such as a fall from height or a motor vehicle incident
• History of cancer, particularly if the pain feels different from any prior musculoskeletal pain

If any of these apply, contact your GP, call healthdirect on 1800 022 222, or attend your nearest emergency department. These features may indicate a condition that warrants urgent medical review, rather than a mechanical sacroiliac joint issue. When in doubt, please speak to your GP first.

Frequently Asked Questions