SI Joint & Pelvic Pain: Do’s & Don’ts

Sacroiliitis or Sacroiliac Joint (SI Joint) Dysfunction can cause significant discomfort and pain in sitting and lying down. Patients often report pelvic pain, sacrum pain, lower back pain, sciatica as well as hip pain when they are experiencing SI pain. What happens in sacroiliac joint pain is that the hip joint seems to have got locked and does not allow smooth transition from one position to another. In this post, we address focused tips to manage movement with minimal discomfort and avoid sacrum pain if you are experiencing pain in the hip and sacral region due to Sacroiliitis.

If the sacroiliac joint becomes inflamed or experiences too much or too little movement, the portion of the sciatic nerve that runs directly in front of the joint can be irritated. Sacroiliac joint dysfunction affects the sciatic nerve and has similar symptoms to sciatica. But a physiotherapist will assess your movements and identify the underlying cause of the pain. They will use specific techniques and exercises for SI joint pain treatment to relieve the pain in sacral region. A detailed post on Sacroiliitis treatment and si joint dysfunction treatment is available here.

Here is a list of things you should do and those you should avoid in case of SI Pain.

Following these guidelines will help you avoid discomfort and pain associated with sacro-iliac joint.

Do’s to Manage Pelvic Pain:

Make sure you do the following if you have SI or pelvic pain:

1. Visit a specialist to treat the pain.
2. Enrol and complete the physiotherapy program for sacroiliitis.
3. Perform exercises only within pain-free range.
4. Place a pillow between your knees and under the abdomen when lying to the side.
5. Learn to brace the abdomen and pelvic floor when lifting weights.
6. Use a SI belt or corset especially when walking. This is especially recommended for pregnant ladies having this condition.

Don’ts to Manage Pelvic Pain:

Make sure you don’t do the following if you have SI or pelvic pain:

1. Don’t perform activities that would make the joint vulnerable such as kicking, twisting, running.
2. Don’t lift heavy loads, specially when you are not used to doing it.
3. Do not travel for long distances without lower back support.
4. Do not sit shifted to one side.
5. Do not stand with weight shifted to one side
6. Do not perform twisting to one side for long
7. Do not engage in sleeping on one side without support
8. Don’t sit on very soft surfaces.
9. Do not climb stairs more than one step at a time
10. Do not sit cross legged

Following are few techniques that can help significantly to ease the movements that are getting restricted and causing pelvic pain.

Getting up from Bed with SI Joint Pain

Rolling Over in Bed:

To roll over from your back to your side, bend one knee, placing your foot on the bed.  Push the heel down, slightly lifting your buttocks and turn towards the side on which the leg is still extended straight. The top arm helps the turning motion.

Sitting with SI Joint Pain

Here are some tips for sitting if you have pelvic pain or sacroiliac joint dysfunction:

1. When sitting (whether you are driving a car, riding a bicycle or sitting on a chair), press your chest upward and let your shoulder blades relax and drop.
2. Sitting in a tailor’s position is good (crossed legged with your feet crossed underneath your legs) on the floor or on a very firm bed; use your hands to pull your knees gently back towards your hips and lift your chest, and keep your shoulders low.
3. If you have been sitting in this position for a while, stretch forward as far as you can and touch the floor in front of you while keeping your spine straight.  At the same time, look up.  Practice this stretch as often as it feels necessary and good.

Static Sitting Positions:

• Sit on a chair with your knees apart and slightly turned out
• Sit in positions that relax your lower back while it remains supported, using a cushion or a rolled towel behind your back; sit upright when the back is not supported
• You can also stretch your hips by sitting high enough so that your knees are lower than your hips or by crossing your feet under your chair.
• Use a ball cushion while you are sitting, or sit on a therapy ball; sitting on a ball cushion allows your tailbone to be free.  When you use a ball cushion or ball, you develop active stomach and back muscles over time as a result of trying to maintain your balance
• A good posture for resting is lying on your back on the floor, putting your feet up on the couch or bed, with a small pillow to support your back and/or head

• If you have tailbone pain, this may be caused by your pelvic floor being too tight.  Favor positions that open your hips, push your legs downward away from your torso (sitting on the edge of the chair or on a ball) or crossing your feet under your chair; let your vaginal muscles relax as much as possible

Standing with SI Joint Pain:

Here are some tips for standing if you have pelvic pain or sacroiliac joint dysfunction:

• Bend your knees slightly
• Distribute your weight evenly on both legs
• Point your toes slightly outward
• This posture may feel unnatural in the beginning, but if you look in the mirror, you’ll see that it looks quite normal.

Related Reading:

Sacroiliitis, Sacroiliac Joint dysfunction

SI Pain & Pregnancy – Tips

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