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Relieving Pain in the Sacroiliac Joint: Causes and Treatment Options

Beth Bradford

May 11, 2023

Pain in the sacroiliac (SI) joint can be very debilitating and can limit your ability to move freely.

Most people don’t know much about the SI joint and what causes pain in this area. However, understanding more about this joint can help you take preventative measures to minimize your risk of injury and help you relieve any pain that you may already be experiencing.

Years ago, I developed a pain in the back of my left thigh. Although a chiropractor and an exercise therapist first assumed it was a pulled hamstring or an unbalanced pelvis, an orthopedic surgeon believed my pain was rooted in the SI joint. I got a very painful shot in my lower back, which somewhat helped the pain. However, an MRI told my doc that I had a herniated disc. That’s another story, though.

In this article, we will discuss what the SI joint is, what causes SI joint pain or injury, and provide some treatment options such as seated exercises, stretches, and mobility exercises. We will also provide tips on how to best manage your pain in the SI joint so that you can stay active and enjoy life without being held back by pain.

The Sacroiliac Joint: What It Is and How It Can Cause Pain

The sacroiliac joint, or SI joint, is located in the lower back, between the spine and the pelvic bone. This joint is essential for transmission of load from the upper body to the lower limbs and acts as a shock absorber during activities that put pressure on it. Unfortunately, this means that any disruption to its function can cause pain in various parts of your body.

One common cause of SI joint pain is a misalignment in this joint due to structural problems or injury. Other causes include muscle imbalances around the joint such as weak gluteus maximus muscles, tight hamstring muscles and a weakened core, all of which can lead to an unstable pelvis. Additionally, if you have an increased amount of stress on your back—such as having to lift heavy objects or operate machinery often—the SI Joint can be aggravated.

By understanding what causes SI joint pain, you can begin to look for ways to minimize discomfort and improve mobility. There are many exercises that focus on strengthening and stretching out the respective muscles for long-term relief; some examples of these exercises are seated exercises, stretches, and mobility exercises targeting specific parts of your body. Taking time to do these preventive measures may be beneficial in minimizing your pain in the long run.

Common Causes of Sacroiliac Joint Pain and Injury

There are many factors that can cause pain and injury in the sacroiliac joint or SI joint. Poor posture, such as sitting for long periods of time with a forward-leaning posture, can lead to muscle imbalances and an overload of stress on the SI joint. Excessive twisting and lifting can also damage this area, as can running and sports activities that involve repetitive motion. 

Overuse injuries, such as those resulting from activities like gardening, can also place additional strain on the muscles of the lower back, which in turn can lead to pain in the SI joint. Furthermore, conditions like osteoporosis and rheumatoid arthritis can weaken the tissues surrounding the SI joint and make it more vulnerable to injury.

Diagnosing SI Joint Pain: Signs and Symptoms

Understanding the signs and symptoms of SI joint pain is a key part of determining the cause, ensuring you receive the right treatment. Common indications of SI joint pain include localized tenderness, pain in your lower back or buttocks, pain in your upper thigh or hip region, and difficulty standing up straight or sitting for long periods of time. You may also feel occasional shooting sensations down to your legs or feet, i.e. sciatica.

The challenging part is that signs and symptoms of SI joint pain are usually experienced in a variety of different ways, which can make diagnosis difficult. To aid with this process, an orthopedic surgeon, chiropractor, or physical therapist will use various diagnostic tests to determine the underlying cause.

These tests often involve manual manipulation and assessment, such as palpating for tenderness and assessing range of motion through passive motions like leg lifts. You might also get an x-ray or MRI to rule out any other causes.

Exercises to Help Relieve SI Joint Pain

If you're dealing with SI joint pain, seated exercises are a great way to alleviate your discomfort. Seated exercises can help to strengthen the muscles around the joint, improve your flexibility and mobility, and ultimately ease your pain.

A few examples of effective exercises that can help to minimize SI joint pain include:

  1. Clamshells: Lie down on the floor on your side with your knees bent at 90-degree angles and your feet together. Without moving your pelvis, lift the top knee up towards the ceiling as far as it can go while still keeping both of your feet together. Slowly return the top knee back down and repeat until fatigue sets in.

  2. Hip Bridge: Begin on your back with knees bent with both feet on the floor and shoulder-width apart. Engage the core by flattening the curve on your lower back. Digging into your heels, lift your hips slightly off the floor until you can feel your glutes engage. Hold for 10 seconds before lowering down and repeat for 8-10 reps total.

  3. Glute Squeeze: Sit in a chair with feet flat on the ground shoulder-width apart and hands resting gently on each thigh. Using a rolled up towel between your knees, squeeze your knees into the towel until you feel your inner thighs get a little bit of a burn. Release after 5 seconds or more depending on preference and repeat 10 times total for maximum effectiveness.

  4. Seated abductor: Sit tall on the edge of a chair and ground one foot into the floor. Lift the opposite thigh a few inches off the chair and slowly open the leg away from your center. 

By performing these exercises properly, you'll be well on your way to reducing SI joint pain – remember to always consult a professional if symptoms persist or worsen!

Effective Stretches for Reducing Discomfort in the SI Joint

Stretching can be a great tool for reducing pain in the sacroiliac (SI) joint. As with any form of exercise, stretching should only be done when the patient is free from pain, and never to the point of causing additional discomfort. With any stretches, don’t stretch until you feel pain. Instead, it should feel like a nice tug.

The following stretches can help reduce discomfort in the SI joint:

  1. Piriformis Stretch - This stretch improves flexibility in the hip muscles, allowing them to better support the SI joint. To perform this stretch, start sitting on the floor with your feet flat on the ground, then cross one ankle over the opposite knee and lean forward. If you don’t feel a stretch here, hold the back of your uncrossed thigh until you feel a gentle stretch. Hold for 30 seconds before switching legs.

  2. Hamstring Stretch - Start seated with your feet grounded on the floor. Extend one leg straight with a slight bend in the knee. While keeping a slight curve in your lower back, draw your belly towards the thigh of your extended leg. Hold for 15-30 seconds before repeating on the other side.

  3. Hip Flexor Stretch - Tight hip flexors can pull the pelvis out of alignment, which can cause pain in other parts of the body such as in the SI joint. To do this stretch, simply kneel down on one knee and bend your other leg in front of you. Place a rag or small cushion under the knee that’s on the floor, because that’s the leg that will get the stretch. This knee should be on the same vertical line as your hip and shoulders. Press that shin into the floor like you’re trying to kick the floor away. You should feel a gentle tug on the top of that thigh. Hold for about 15 seconds and repeat on the other side. 

Mobility Exercises for Improving SI Joint Movement and Function

Mobility exercises for the sacroiliac joint can help restore normal movement and function. These exercises target the muscles of the lower back, hip and pelvis to reduce tension and pain in the area.

Here are a few movements to consider:

  • Hip Hikes: Standing with your feet hip width apart, shift your weight onto one side while lifting the opposite thigh out to the side. Don't raise it too high - focus on just lifting it slightly. Return to your starting position and repeat on the other side.

  • Lying twists: Lie on your back with both knees bent, being mindful of the curve in your lower back. Raise your knees slightly off the floor, then draw them to one side of your body. Stop when you feel your core putting on the brakes, then draw your legs to the opposite side. Move from side to side slowly and mindfully, noticing the subtle pulling and strengthening during the movement. 

  • Cat/Cow Pose: Begin on all fours with arms directly under shoulders and knees under hips. As you inhale, drop your belly towards the floor as you arch your back towards the ceiling (cow pose). As you exhale, round out your spine as if making a balloon shape (cat pose). Flow between these two poses for 10-15 reps for best effect.

By incorporating these exercises into a regular routine and warming up sufficiently before strenuous activity, you can minimize pain levels in and around this important joint in our body's foundation!


In conclusion, pain in the sacroiliac joint can be a significant source of discomfort that limits mobility and affects everyday activities. It is important to understand what causes this pain in order to identify the best treatment option for you. You should work with a medical professional if the SI joint pain is excessive and limits your everyday activities.

Seated exercises, stretches, and mobility exercises can all help to reduce pain and improve functionality of the SI joint. With proper care and treatment, you can be well on your way to relieving your SI joint pain and restoring your quality of life.

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