How to Sleep With SI Joint Pain: 5 Expert Tips on Relieving SI Pain From a Physical Therapist

Updated: May 19

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. Here are my top tips as a licensed physical therapist.

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.

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.

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 sleepers usually end up over-arching their pelvis and lower back, which can contribute to SI joint pain. Add a pillow below your lower stomach to keep your spine aligned and in a more neutral position, decreasing lumbar stress and SI pain.

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. Add a pillow underneath the buttocks or sit bones to keep your spine in natural alignment.

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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) Stretch Your Hip Flexors and Piriformis

Stretching the muscles that support the SI joint, like hip flexors, can reduce pain, improve mobility, and ultimately help prevent SI joint pain.

Stretch your hip flexors with a standing stretch. Stan

ding feet shoulder-width apart, take a step forward into a lunge position. Keep the hips square, chest open, and front knee in line with your toes. You should feel a stretch in the hip flexor of the straight leg. Hold for 30 seconds on each side and do 2 to 3 sets.

Stretch your piriformis by sitting on a chair and crossing your legs so that the ankle of the leg you want to stretch is on your thigh. Your legs should resemble a figure 4. Lean forward until you feel stretching in your buttock. Hold for 30 seconds, and complete 2 to 3 sets.

2) Consider Your Nighttime Routine

You may not realize it, but your nightly routine can also be inhibiting your ability to fall and stay asleep. Although you may not be easing SI joint pain, making sure you're practicing good sleep hygiene can set you up for a great night of sleep. A healthy sleep routine is the key to unlocking your best self for the next day!

3) 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 from a rolled-up towel.

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4) 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!

5) Add a Stool

If you must stand all day at work, consider propping the leg on a stool a few times during the day, each time for about 30 minutes. Simply position the stool under the painful side and rest your knee on the stool, as if you were kneeling on the ground. Meanwhile, keep the other leg standing.

This practice can even stretch your hip flexors. That means you can do two things to help with SI joint pain at once!

If the pain persists, be sure to seek professional medical advice. Your doctor may recommend pain relievers, joint injections, or further physical therapy.

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.