Some studies have shown that around one-quarter of people with low back pain have sacroiliitis.

Sacroiliac (SI) joint pain is fairly common; however, it often gets confused with general low back pain. In some cases, there may be inflammation of the SI joint, referred to as sacroiliitis.

The sacroiliac joint is where the spine meets the pelvis. Specifically, it is where the sacrum (the lowest part of your spine) meets the ilium (the top part of the pelvis). There is a left SI joint and a right SI joint – you may only experience pain on one side, or you may experience pain on both sides at the same time. The pain is often sharp with movement and can radiate from the low back into your buttocks, hips, or thighs. At other times, without aggravating movements, you may feel a dull ache in the SI area. You may also experience stiffness in the morning.

SI joint pain could be caused by improper postures or from prolonged periods of sitting. Other causes may include direct trauma to the SI joint (e.g., motor vehicle accidents, falls), arthritis, or pregnancy.

If you have SI pain, it is important to take frequent breaks from any positions and be mindful of your posture in sitting, standing, sleeping, or during aggravating movements:

Sitting

  • Sit with your hips parallel to or slightly higher than your knees.
  • You should be sitting on your “sit bones” rather than on your tailbone.
  • Keep your knees apart, the same width as your hips or slightly wider.
  • Place your feet flat on the floor or on a support/footrest.
  • Support your lower back on the chair, or place a pillow/cushion behind your lower back.
  • Avoid crossing your legs.
  • Avoid leaning, rotating, or twisting at your torso.

Standing

  • Maintain a slight bend in your knees.
  • Tuck in your abdomen and engage your core (known as “core bracing”).
  • Stand with your feet shoulder-width apart.
  • Distribute your weight equally between both feet, avoiding putting more weight on one leg.
  • Turn your toes out slightly.

Sleeping

  • Side-sleeping: Sleep on the opposite side of the pain and place a pillow between your knees.
  • On your back: Place a small pillow under your knees to maintain a slight bend in your knees and hips.
  • On your stomach: Try to avoid sleeping on your stomach; if you must, place a pillow under your abdomen.

Aggravating Movements

  • Turning or rotating at the hips.
  • Climbing stairs.
  • Walking quickly or with large steps.

With these movements, it is important to strengthen the appropriate muscles first so they can better support the SI joint, allowing you to return to these activities without pain. Examples of exercises that may help include:

  1. Glute Bridges
    Lie on your back with your knees bent and feet flat on the floor, hip-width apart. Engage your core and squeeze your glutes as you lift your hips off the floor, creating a straight line from your shoulders to your knees. Lower back down slowly. This exercise strengthens the gluteal muscles, which provide stability to the SI joint.
  2. Clamshells
    Lie on your side with your knees bent and stacked. Keep your feet together and lift the top knee, opening your legs like a clamshell. Slowly return to the starting position. This targets the gluteus medius, an important stabilizer of the pelvis.
  3. Pelvic Tilts
    Lie on your back with your knees bent and feet flat on the floor. Flatten your lower back against the floor by tilting your pelvis upward. Hold for a few seconds, then release. This helps improve mobility and reduces stiffness in the lower back and pelvis.
  4. Cat-Cow Stretch
    On all fours, alternate between arching your back (cat pose) and dipping your belly toward the floor (cow pose). This dynamic stretch improves spinal mobility and helps relieve tension in the SI joint area.
  5. Piriformis Stretch
    Lie on your back and cross one ankle over the opposite knee. Pull the uncrossed leg toward your chest until you feel a stretch in your buttocks. Hold for 20-30 seconds and switch sides. This stretch targets the piriformis muscle, which can alleviate pressure on the SI joint.

SI Joint Pain vs. Other Types of Back Pain

SI joint pain can sometimes be mistaken for other conditions such as sciatica or general low back pain. Unlike sciatica, which typically causes pain that radiates down the leg due to nerve compression, SI joint pain tends to stay localized around the lower back, buttocks, and hips. Proper diagnosis by a healthcare professional is essential to ensure the correct treatment plan.

When to Seek Professional Help

While SI joint pain can often be managed with posture adjustments and exercises, persistent or worsening symptoms may require professional assessment. It is important to consult with a healthcare provider if you experience severe pain, numbness, or weakness, or if your symptoms interfere with daily activities. Early intervention can lead to more effective treatment and faster recovery.

Prevention Tips

To reduce the risk of SI joint pain, consider incorporating the following tips into your daily routine:

  • Use proper lifting techniques, keeping the object close to your body and avoiding twisting motions.
  • Maintain a healthy weight to minimize stress on your joints.
  • Stay active with low-impact exercises such as walking, swimming, or yoga.
  • Strengthen your core and pelvic muscles to provide better support for the SI joint.

The Role of Core Strength in SI Joint Health

A strong core is crucial for stabilizing the pelvis and reducing the strain on the SI joint. Exercises like planks, side planks, and dead bugs can help build core stability. Incorporating these into your routine can prevent future episodes of SI joint pain and improve overall functional movement.

 

Sacroiliac joint pain can significantly impact your daily life, but with the right approach, it is manageable. If you suspect SI joint pain, don’t hesitate to reach out to one of our therapists for support.

 

About the Author:

 

Irene Chau

Registered Physiotherapist

Book with Irene at our Spadina location!