Sacroiliac Joint Pain and Pregnancy

SIJ pain, or sacroiliac joint pain is one of the most common sources of pain for pregnant women. Pain from the SI joint can often occur at the low back, groin, hips, and can even run down the legs. The severity of pain can vary from person to person, some may experience a dull ache while others can experience severe sharp sudden pain. Often, pain can worsen with getting in and out of a car, lifting heavy items, stair climbing, getting dressed or finding a comfortable position to sleep at night. 

Let’s start with some anatomy….what is the sacroiliac joint?

The sacroiliac joint is the point in which the 2 halves of the pelvis (the ilia) connect to the base of the spine (sacrum). The primary function of our SI joint is to help with the distribution of force from our lower extremities into our pelvis and trunk. The SI joint is surrounded by several strong ligaments as well as the muscles of the low back and abdomen. This strong ligamentous system of the joint makes it better designed for stability and limits the amount of motion available at the joint. Recent studies have shown there are approximately 2-5 degrees of motion or 2mm-4mm of movement at the SI joint. 

…So if the SI joint is generally so stable, how and why does pain occur?

During pregnancy both increased body weight and increased levels of relaxin can help contribute to SI joint pain. Relaxin can cause ligaments and connective tissue in the pelvis to soften and relax, which helps allow the pelvis to widen for labor and delivery. In addition, weight gained during pregnancy can lead to altered gait mechanics. One may commonly think of the “pregnancy waddle” as a common altered gait in pregnancy. This waddle can lead to shortened hip muscles and therefore put increased strain on the SI joint. 

How do we fix it?

If you are suffering from SI joint pain during pregnancy there is good news, PT can help! During the first evaluation your PT may assess your postural and pelvic alignment as well as strength and flexibility testing to see which movements may provoke or reduce pain. Then, from the evaluation your PT can help create an individualized program based on your specific needs. This will likely include strengthening exercises and stretches to improve muscular imbalances and deficiencies. In addition to an exercise routine your PT can help educate you to avoid certain pain provoking movements or positions which could exacerbate your symptoms. There are also pregnancy specific stabilization belts that can be recommended to help manage discomfort felt with everyday movement.

Your pelvic health physical therapist can determine whether these are suitable depending on your evaluation. Body Harmony Physical Therapy offers one on one physical therapy sessions for both pelvic floor and orthopedic conditions. Our treatments are for up to one hour in a private treatment room.

Resources:

1. https://www.expectingandempowered.com/blog/2017/11/12/sacroiliac-joint-pain-and-pregnancy
2. Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L, Willard FH. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat. 2012;221(6):537-567. doi:10.1111/j.1469-7580.2012.01564.x
3. https://www.spine-health.com/conditions/spine-anatomy/sacroiliac-joint-anatomy