SIJ dysfunction in pregnancy (or not)

February 17, 2020

By Effie Koustas, MSPT

Sacroiliac joint pain, or SIJ pain, can happen to anyone. However, it is commonly seen in pregnancy.  This pain may seem like sciatica radiating down your thigh on one side. However, the source of the pain begins in a different joint. If the sacroiliac joint moves too little or too much, pain will appear. What makes someone susceptible, pregnant or not, and how you can treat and resolve the pain, is something that can be addressed in physical therapy.


Your SIJ can become inflamed with any traumatic event, such as a motor vehicle accident or a fall, as well as at any point during pregnancy. SIJ pain or low back pain occurs in 50-80% of women during pregnancy. The ligaments are irritated and seeing a physical therapist early can help prevent the symptoms from worsening, as with any diagnosis. Other symptoms include low back pain, altered sensation in leg (pain, numbness, tingling, weakness), pelvic/buttock/hip/groin pain, feeling of leg instability, disturbed sleep, sitting intolerance, and/or pain with sit to stand or vice versa. In pregnancy, the hormone relaxin causes your muscles and ligaments to relax, compromising your SIJ stability.

If your symptoms persist beyond 1-2 weeks and/or worsen, learning what positions to avoid, what exercises to do and what other tools can be used to aide in the healing process can be crucial to begin the recovery process. Initially, ice and rest are recommended. Your sleep can also be affected. Certain positions can be more pain-relieving than others. For example, sleeping on your side, (preferably the left side in pregnancy), with a pillow between knees and ankles is recommended. Also,  you may be more comfortable by bringing your knees closer to your chest.

The most important tool you can learn to use when your SIJ is aggravated is to brace your core, specifically your transverse abdominal muscles. Bracing your core during the day while moving around and performing other exercises that will help to stabilize the SIJ. Strengthening your hips with specific glute exercises is another example. Other manual therapy treatments may also help, such as checking your alignment and soft tissue manipulations. Wearing a Sacroiliac belt can also add stability at your pelvis. Discuss these techniques with your therapist during your PT sessions.


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