“My Back Hurts… But Only on One Side.”
If your low back pain feels off to the side, deep in the buttock or near the hip, but your MRI says “nothing’s wrong,” you may be facing one of the most commonly overlooked spine conditions:
SI joint dysfunction.
At Vertrae®, one of the most trusted spine care clinics in Ohio, we see this weekly. Patients come in frustrated, often after being told they have:
- Sciatica
- Herniated disc pain
- Hip bursitis
- “Just arthritis”
- A muscle strain
And yet, the real source of pain was the sacroiliac (SI) joint all along.
SI joint pain is:
✔ Common
✔ Often misdiagnosed
✔ Confused with other spine conditions
✔ Very treatable when properly diagnosed
Let’s break down the difference and how we help you finally find relief.
What Is the SI Joint, and Why Does It Hurt?
Your sacroiliac (SI) joints connect the base of your spine (sacrum) to your pelvis (ilium). You have two, one on each side. They’re strong, stable joints that support your body weight and transfer load between your spine and legs.
They’re not supposed to move much. But when they become inflamed, irritated, or unstable (due to injury, stress, pregnancy, or degenerative changes), that’s when pain sets in, often deep, sharp, and off-center.
Patients often say:
“It just feels off, like something’s not aligned.”
That’s one of the hallmark clues that we’re not dealing with a disc issue, but rather, the SI joint.
How SI Joint Pain Feels (and Why It’s So Often Missed)
Here’s what patients commonly describe:
- Pain off to one side of the low back
- Deep discomfort in the buttock
- Pain near the hip or groin
- Occasional aching down the outer thigh (but not below the knee)
What makes it flare:
- Standing up from a chair
- Climbing stairs
- Turning in bed
- Sitting too long (especially on soft surfaces)
- Long car rides
And what makes it feel better?
Walking. Lying down. Gentle movement.
“It’s hard to sleep on that side.”
“There’s a catch every time I move.”
If this sounds familiar, there’s a strong chance your SI joint is involved.
Why SI Joint Pain Gets Misdiagnosed as Other Spine Conditions
The SI joint sits close to the lumbar spine and hip, so it often mimics:
- Herniated disc pain
- Hip arthritis or bursitis
- Sciatica
- Piriformis syndrome
- Facet joint pain
But trained spine specialists know what to look for.
Location = key clue:
- Pain just off the spine, near the dimples at the beltline (PSIS)? → SI joint.
- Pain below the knee or into the foot? → More likely nerve-related.
At Vertrae®, our providers test, confirm, and treat based on clear patterns.
SI Joint Pain After Pregnancy: A Common, Often Overlooked Cause
Pregnancy is one of the most common and under-discussed causes of SI joint dysfunction.
Here’s why:
- Hormones cause ligament laxity
- The pelvis widens
- Postural changes strain the joint
- Core muscles weaken
This creates instability, especially on one side, and that pain can linger long after delivery.
If you’ve had one-sided pain that’s worse with standing, walking, or turning in bed, even months postpartum, this may be the root cause. The good news? Targeted rehab works, and you don’t need to live with it forever.
How Vertrae® Diagnoses SI Joint Pain
At Vertrae®, our spine specialists follow a step-by-step approach that leaves no guesswork.
Here’s what we evaluate:
- Your story
We listen closely to where it started, what makes it worse or better, and any history of pregnancy, trauma, or prior spine surgery. - Your movement
We use validated tests like FABER, Gaenslen’s, and sacral thrust. If three or more reproduce your pain → we know we’re on the right track. - Imaging (when needed)
X-rays and MRIs may show changes in the joint, but we never rely on imaging alone. - A diagnostic injection
This is the gold standard. If numbing the SI joint temporarily removes your pain, we’ve confirmed it’s the source and we move forward with confidence.
What Actually Helps SI Joint Pain (Most Patients Don’t Need Surgery)
✔ Physical Therapy
- SI-specific stabilization
- Glute and core strengthening
- Pelvic control retraining
- Hip mobility restoration
✔ Targeted Injections
- Anti-inflammatory medication to reduce joint irritation
- Used to calm flares and confirm diagnosis
✔ Daily Adjustments
- Avoid soft sofas and chairs
- Use pelvic belts (when recommended)
- Focus on balanced movement and lifting form
✔ Medications (if appropriate)
- Short-term anti-inflammatories to reduce flare-ups
The key isn’t more exercise. It’s the right exercise, at the right time.
When It’s Time to Consider SI Joint Fusion
Sometimes, conservative care only goes so far.
If you’ve tried:
- Targeted PT
- One or more injections
- Daily adjustments
… and still feel stuck, we may discuss minimally invasive SI joint fusion.
It’s not a first step, it’s the right step for the right patient.
SI fusion at Vertrae®:
- Uses tiny implants to stabilize the joint
- Stops painful micro-movements
- Preserves motion above and below the joint
- Requires only a small incision
- Allows for a faster recovery compared to lumbar fusion
Patients often describe it as the moment everything finally stopped shifting and started healing.
Why Vertrae® Is Trusted for SI Joint Pain & One-Sided Back Pain in Ohio
We don’t just treat the spine. It’s all we do.
At Vertrae®, every provider, therapist, and care plan is focused entirely on motion-preserving spine treatment, from diagnostics to minimally invasive surgery.
That’s why people search:
- “Best spine specialist near me”
- “SI joint pain relief in Dayton”
- “Top neurosurgeon for low back pain”
- “Outpatient spine surgery in Southwest Ohio”
And that’s why they trust Vertrae® and Dr. Kamal Woods, one of the most respected spine surgeons in the region.
Final Thoughts: You Don’t Have to Live with One-Sided Back Pain
If your pain feels deep, off to one side, and hasn’t improved with standard treatments, it may not be a disc, or a nerve, or “just arthritis.”
It may be your SI joint. The right diagnosis changes everything, and at Vertrae®, that’s where we start.
Patients routinely travel from Southwest Ohio, Northern Kentucky, and Eastern Indiana for Vertrae®’s spine-only care.
Schedule your consultation today and discover what’s really causing your pain.
