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How to Sleep with SI Joint Pain

Feb 25, 2022

Sacroiliac joint pain, or SI pain, can be debilitating to live with. Not only does it tend to flare up in situations where you’re trying to be productive, such as while standing up or running, but it doesn’t necessarily go away when you lay back down either. This means that, even when you’re off your feet and resting comfortably in your bed, your back can still cause you to lose sleep as it refuses to stop hurting. Here at AICA Atlanta, we know that sleep is crucial for maintaining the overall health of your body. Therefore, it’s important that you learn how to sleep even with this condition, so you can remain in good health until treatment is available.

SI Pain

Before we can get into how to sleep with SI pain, it’s important to know what SI pain is. As the name suggests, it’s a term used to describe the pain of the sacroiliac joint, which is the point where the sacrum joins the pelvis. The pain caused can also vary in presentation from localized, stabbing pain to a pain that radiates down into the lower body.

It is usually a symptom, not a diagnosis, and can have numerous causes. These can include arthritis, physical injury, pregnancy and postpartum, systemic inflammatory disorders, infection, spinal scoliosis, leg length disparities, and spinal fusion surgery. SI pain can also just occur with no clear cause whatsoever. These vague and loose elements of SI pain make it very difficult to diagnose, which can cause treatment to be delayed.


As a quick note, it should be mentioned that numbness and tingling are often symptoms of sciatica. If you’re feeling pain around your lower back coupled with pins and needles, it may be sciatica rather than just SI pain, which may require a completely different treatment plan.

How to Sleep with It

As stated, SI joint pain is a one-two punch in the sense that it doesn’t immediately calm down upon laying down. In fact, since twisting motions can cause it to flare up, tossing and turning or simply adjusting yourself in bed could potentially cause further pain. The right method for reducing the pain will vary depending on your case, but there are a few methods to try.

Relaxing the Hip Flexors

The hip flexors are a group of muscles positioned in the pelvic area on the front upper section of your thigh. They not only function to make the body more mobile, but they also keep the pelvis in balance. The rectus femoris, iliacus, psoas, iliocapsularis, and sartorius all make up your hip flexors. These muscles are used with every step you take and, as such, are under a lot of strain.

Stretching these muscles can help reduce pressure on the SI joint, mitigating pain. The supine hip flexor stretch may be the best one to use as you’re going to bed, as it can be performed laying down.

Changing Sleeping Positions

How you sleep can dramatically affect how your back feels later on, and different sleeping postures have been linked to different effects. SI pain is no exception, and your sleeping position can determine whether you get pain or relief. It may help to switch up your sleeping position for a few nights to see if your back pain improves as a result. However, if you find that too difficult, there are other steps you can take to improve your current sleep posture.

  • Stomach sleeping. Otherwise known as prone sleeping, this position is notorious for putting stress on the spine. However, this can be mitigated by placing a pillow under your body near the top of your pelvis. This will support the natural curve in that area of your spine, which will take pressure off of the back as a whole.
  • Side sleeping. Sleeping on your side can put pressure on your hip, which may increase SI pain. To reduce this pressure, you can wedge a pillow in the space between your knees and ankles. This will create a gap between your legs, which will, in turn, open up the hip joints and allow the pelvis to enter a neutral position.
  • Back sleeping. Otherwise known as sleeping supine, there aren’t many back issues associated with this position. However, the spine can be more reliably kept in alignment by placing a pillow under the hamstrings. This will tilt your pelvis into a more neutral position, reducing pressure on the SI joints.

Treatment Options

Of course, the ultimate goal in all of this is to not experience the pain at all. SI pain is, once again, a vague condition that can have a myriad of causes behind it. Therefore, your treatment options will be just as varied and could range from some at-home exercises to surgical procedures. However, the one constant is that it always radiates out from the sacrum, which is at the very bottom of the spine just above the coccyx. This begs the question: can chiropractic care help relieve SI joint pain?

Science says yes! Studies have shown that chiropractic adjustments can provide noticeable SI joint pain relief within three weeks to a month after starting treatment, with no surgery or medication required. There are some exceptions to this rule, of course, notably that it’s recommended not to use any manual therapy to treat those with hypermobility of the joints in the area. This is to avoid further injury and to encourage the joint to return to a normal range of motion.

It’s always best to speak to a professional before starting any treatment plans. That’s why it’s best to call your Atlanta chiropractor and discuss your symptoms before diving headlong into any treatment options. With your help, we can get you back on the path to good health.


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