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How to Sleep With SI Joint Pain: Best Sleeping Positions for Sacroiliac Relief (2025)
- Dawn Chambers, PT, DPT
- Apr 14, 2023
- 8 min read
Updated: May 3
How to Sleep With SI Joint Pain: Best Sleeping Positions for Sacroiliac Relief (2025)
If you suffer from sacroiliac joint pain (SI joint pain), you know just how debilitating it can be. Sitting, standing, and sleeping for long periods can be incredibly painful, making simple daily activities far more difficult than usual. Luckily, there are some things you can do to relieve pain and improve SI joint dysfunction.
What Is SI Joint Pain?
There are two sacroiliac joints that connect the lower spine to the pelvis. These joints help to transfer weight from the upper body to the lower body. [*] A variety of conditions can cause SI pain, including:
Injuries
Arthritis
Pregnancy
Infection
Systemic inflammatory conditions
Issues with these joints can cause pain in the lower back, the buttocks, and even the lower legs. In fact, roughly 25% of all low back pain could be attributed to the sacroiliac joint. [*]
With SI joint pain, sleeping and sitting can be especially difficult. It can cause dull, aching pain near the top of the buttocks and lower back. You may also notice that pain is worse at night, and even experience sharp stabbing pain when moving quickly, like sitting up in bed or rolling over.
Pain can move down the body and into the legs. It can feel like tingling, burning, stiffness, and tightness. Proper sleep positioning and support are essential parts of SI joint pain management—especially if your symptoms flare up at night.
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The Best Sleeping Positions for SI Joint Relief
With the right sleeping position, sacroiliac joint pain relief is possible. Here's a quick rundown of how to modify your preferred sleep position to protect the painful side of your body and lessen pain.
Sleeping with proper hip and pelvic alignment isn’t just about comfort — it’s one of the most important steps you can take to reduce SI joint strain and prevent further back pain.
Best Pillows and Sleep Accessories for SI Joint Pain Relief
Using the right support pillow can reduce pelvic strain, relieve lower back tension, and improve your overall sleep quality — especially if you sleep on your back or side. Here are two top tools designed to support proper SI joint alignment.
🌙 Support Your SI Joint While You Sleep
Sleeping with proper hip and pelvic alignment can make all the difference when managing SI joint pain. The ComfiLife Orthopedic Knee and Leg Pillow is designed to keep your knees and hips properly aligned during the night, helping to relieve pressure and promote better sleep posture. Made from 100% memory foam, it offers lasting support without flattening out.
🌙 Protect Your SI Joint & Lower Back While You Sleep
The ComfiLife Multi-Position Lumbar Support Pillow is a versatile memory foam wedge designed specifically to support your lumbar curve and keep your pelvis neutral while you sleep. It can be placed behind your lower back, under your knees, or even under your abdomen if you sleep on your stomach — helping you wake up with less stiffness and discomfort.
SI Joint Pain Relief for Side Sleepers
Place a pillow between your knees and ankles to align your pelvis, which helps lessen SI joint pain. It's also important to understand that when you sleep on your side, your weight naturally puts more pressure on your bottom hip. Aim to sleep with the more painful side of your body on top.
SI Joint Relief for Stomach Sleepers
Stomach sleeping often causes the pelvis and lower back to over-arch, which can increase stress on the SI joint. If you prefer sleeping on your stomach, place a pillow under your lower abdomen to help maintain a more neutral spine and reduce pressure on the lumbar area and SI joints.
SI Joint Relief for Back Sleepers
Back sleepers may experience an anterior tilt to their lower backs and pelvises, especially if they have tight hip flexors. This puts pressure on the spine and SI joint, leading to sacroiliac pain. Place a pillow under your knees, or under your sit bones if needed, to maintain a more neutral spine and reduce pressure on the SI joints.
Pregnancy Sleep Tip: Support the Belly to Ease SI Joint Pain
Pregnant women dealing with SI joint pain often struggle to get comfortable at night, especially when sleeping on their side. One effective way to relieve tension in the lower back and pelvis is to place a thin pillow or folded blanket beneath the belly. This simple support reduces pulling on the sacroiliac joint and helps maintain better spinal alignment, allowing for deeper, more restful sleep during pregnancy.
Adjusting your sleeping position is one of the easiest ways to reduce SI joint pain at night, helping you wake up with less stiffness and better mobility.
5 Tips for Sleeping, Sitting, and Living with SI Joint Pain
Aside from changing your sleeping position, there are several things you can do outside of the bedroom to get better sleep with SI joint pain - as well as a better quality of life overall. Here are my best sleeping tips:
1) Gently Activate Your Core Muscles for SI Joint Stability
Stabilizing the muscles around your pelvis is one of the most effective ways to reduce SI joint pain and protect your lower back at night. Lightly engaging your core muscles can help support the joint, promote better alignment, and ease pressure while you rest.
Start with these two simple exercises:
Abdominal Bracing: Lie on your back with your knees bent and feet flat on the floor. Gently tighten your lower abdominal muscles, as if you're drawing your belly button toward your spine, without holding your breath. Hold for 5–10 seconds, relax, and repeat 10 times.
Diaphragmatic Breathing: Stay in the same lying position. Place one hand on your chest and one hand on your belly. Take slow, deep breaths, focusing on expanding your belly rather than your chest. Practice for 1–2 minutes to engage your core muscles and promote relaxation.
Why Stretching Alone Isn’t Enough for SI Joint Pain
While gentle stretching can help ease tension in muscles that support the SI joint, it doesn't address the underlying stability your body needs for long-term relief. That’s why it's important to focus on core activation first — and then use stretching as a supportive tool.
Stretching your hip flexors and piriformis muscles may reduce tightness and complement your stability efforts:
Hip Flexor Stretch: Step one foot forward into a lunge, keeping your hips square and chest open. You should feel a stretch in the front of the hip on the back leg. Hold for 30 seconds, repeat 2–3 times on each side.
Piriformis Stretch: Sit in a chair and cross one ankle over the opposite knee to form a figure 4. Lean forward gently until you feel a stretch in your buttocks. Hold for 30 seconds, and complete 2–3 sets on each side.
2) Check Your Daytime Ergonomics
Your posture throughout daily activities has a big impact on SI joint pain. When you sit, your hips and lower back should be in a neutral, relaxed position.
Your chair should have ergonomic support with a back that you actually use. Try to catch and stop yourself from leaning forward and hunching over your desk.
Hip angle also matters. Keeping your hips slightly higher than your knees can help your hip flexors relax, which limits pulling on the SI joint.
You may also want lumbar support in your chair, which you can also get from a lumbar pillow or a rolled-up towel.
3) Monitor Sitting and Standing Times
Remaining in a sitting position for too long can also put pressure on your SI joint. Aim to get up once every hour to stretch and relieve any tense or tight muscles.
For some people, choosing a standing desk makes the most sense. This can allow you to continue working while moving from sitting to standing throughout the day. There are additional benefits of standing desks aside from joint pain relief as well.
*The Comhar All-in-One standing desk from FlexiSpot is a great option if you are searching for a modern desk with easy installation!
4) Add a Stool
If you must stand all day at work, consider propping your leg on a stool a few times during the day, each time for about 30 minutes. Simply position the stool under the foot on the painful side, resting your foot gently on the stool while keeping the other leg standing. This slight elevation helps reduce pressure through the SI joint and lower back, offering relief without overloading your spine.
This small adjustment can also help relax tension in your hip flexors and promote a healthier pelvic alignment — allowing you to ease discomfort and improve balance at the same time.
5) Consider a Sacroiliac Belt
Benefits: A sacroiliac belt offers targeted support to the pelvic region, stabilizing the sacroiliac joint and reducing strain. It can alleviate lower back pain, enhance comfort during daily activities, and promote proper posture.
How/When to Wear: Secure the belt snugly around your hips for a comfortable yet supportive fit. Wear it during activities, including prolonged sitting, or whenever you experience lower back and pelvic discomfort.
Can You Wear a Sacroiliac Belt at Night?
While sacroiliac belts are typically recommended for daytime use during activity, some people find relief wearing them at night when pain interferes with sleep. If you choose to wear a belt overnight, it’s best to keep the fit looser to avoid skin irritation or circulation issues. Always monitor for discomfort and adjust as needed. For most people, SI belts work best during movement-based activities, but gentle nighttime support may be helpful during flare-ups.
Top Sacroiliac (SI) Belts for Lower Back Pain
Here are 2 top-rated SI belts designed to offer lasting support, comfort, and stability for your lower back and pelvis.
Key Features: Unmatched support, comfortable fit, breathable, and can be worn safely 24/7
Pelvic Support Belt
Key Features: Lifts and supports the belly, is adjustable, promotes proper posture, and supports the lower back and abdominal area.
If the pain persists, be sure to seek professional medical advice. Your doctor may recommend pain relievers, joint injections, or further physical therapy.
Bonus: Consider Your Nighttime Routine
You may not realize it, but your nightly routine can also be inhibiting your ability to fall and stay asleep. While it may not directly relieve SI joint pain, building a healthy nighttime routine can set the stage for deeper, more restorative sleep. A healthy sleep routine is the key to unlocking your best self for the next day!
Final Thoughts
Ultimately, managing SI pain usually comes down to keeping your lumbar spine in a natural position, giving yourself frequent stretching breaks during the day, and avoiding staying in the same position for extended periods. Adding adequate support while sleeping can also help you enjoy a full night's sleep.
Medical Disclaimer: The information on this site, including text, graphics, images, and other material, is provided solely for informational purposes and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other healthcare professional with any questions or concerns you may have regarding your specific condition.
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