Pelvis & SI Joint
Lower Back & Pelvic Pain — North Vancouver
The deep ache low and off to one side that flares when you stand on one leg, roll over in bed, or get up after a long sit. When the SI joint and pelvis are involved, the plan looks different from ordinary low-back care.
What it is
Understanding your lower back / pelvic pain.
Lower back and pelvic pain often travel together. It can read as a dull ache low down and off to one side, or as a deeper, sharper discomfort around the back of the pelvis, and it commonly spills into the buttock, hip, or thigh. The people we see with this pattern tend to fall into a few groups: those with sitting-heavy jobs, athletes loading the pelvis hard, and those who are pregnant or recently postpartum.
The driver is usually a mix of joint, muscle, and posture factors centred on the pelvis rather than the lumbar discs. The sacroiliac joints — where the spine's base meets the pelvis — can become irritated and start referring pain. Muscle imbalances through the hips, deep core, and pelvic floor create uneven pulls, and a long history of sitting or one-sided loading lets some muscles tighten while others switch off.
Pregnancy and the postpartum stretch amplify all of this. Hormonal changes loosen the pelvic ligaments, the growing load shifts the centre of gravity, and the deep core and pelvic floor have to relearn how to stabilize afterward. This is mechanical, common, and treatable — and it's a different conversation from a straightforward lumbar strain.
What to expect
SI-joint and pelvic patterns usually respond over four to eight weeks, with the sharp catches easing first and the staying power arriving as the deep stabilizers come back online. Pregnancy-related pelvic pain can be managed well through pregnancy and tends to settle further afterward with the right postpartum progression. We pace everything to your stage — there's no rushing a deep-core return.
Get a plan
Not sure if we're the right fit?
Send us a quick note about what's going on. A physiotherapist — not a receptionist — will read it and reply with what they'd recommend. No commitment to book.
Common questions
About lower back / pelvic pain.
How is this different from regular low back pain?+
Ordinary low back pain usually centres on the lumbar spine and the discs, and often worsens with bending and sitting. Pelvic and SI-joint pain sits lower and off to one side, flares with single-leg loading — stairs, standing on one leg, rolling in bed — and responds to stability work for the pelvis rather than the lumbar-focused plan on our low back page.
I'm pregnant and my pelvis aches constantly. Is physio safe?+
Yes, and it's one of the most useful things you can do. We use pregnancy-appropriate hands-on techniques, gentle stability work, and positioning and support strategies for sleep and daily activity. Everything is paced to your trimester, and we coordinate with your maternity care provider when that's helpful.
I sit at a desk in Lower Lonsdale all day and the pain is worse by evening. What helps?+
Long static sitting lets the deep stabilizers switch off and loads one side of the pelvis. The fix is a setup review, regular position changes, and a short daily activation routine for the core and glutes. Most desk-driven pelvic pain improves a lot once the sitting load is broken up and the stabilizers are working again.
Do I need an X-ray of my pelvis first?+
Usually not. SI-joint and pelvic pain is diagnosed largely through movement and loading tests in person, not imaging, and X-rays rarely change the plan. We assess first and only suggest your GP arrange imaging if there are red flags or you aren't responding as expected.
This page is for general information only and does not constitute medical advice, diagnosis, or treatment. Individual presentations vary — assessment findings and treatment plans differ from person to person. If you are experiencing severe symptoms, neurological changes (numbness, weakness, bowel or bladder changes), or a significant trauma, contact your physician or emergency services. Physiotherapy at Medstar Sport Physio & Health is provided by physiotherapists registered with the College of Physical Therapists of British Columbia (CPTBC).