Pregnancy is a beautiful, life-changing experience—but it can also come with some less-than-welcome discomforts. One of the most common complaints I hear from my pregnant clients is pain around the lower back and buttock, especially on one side. This is often sacroiliac (SI) joint pain.
As a physical therapist specializing in women’s health, I want to walk you through what SI joint pain is, why it happens during pregnancy, and most importantly—what you can do to relieve it.
What Is the Sacroiliac Joint?
The SI joints are two joints that connect your sacrum (the triangle-shaped bone at the base of your spine) to the ilium bones of your pelvis. These joints don’t move much, but during pregnancy, they naturally become more mobile due to the hormone relaxin, which helps prepare your pelvis for childbirth.
This increased mobility, combined with changes in your posture, weight distribution, and center of gravity, can put extra stress on the SI joints—leading to inflammation, irritation, and pain.
Symptoms of SI Joint Pain
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Sharp, stabbing, or aching pain in the buttock or lower back (usually one-sided)
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Pain that worsens with prolonged standing, walking, climbing stairs, or rolling in bed
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Discomfort when getting in/out of a car or putting on pants (standing on one leg)
If this sounds familiar, you’re not alone—and there are ways to manage and reduce your pain safely.
What You Can Do: PT-Approved Tips
1. Stabilization Over Stretching (At First)
While it might be tempting to stretch right away, the key in early SI joint discomfort is stabilization—especially for the glutes and core.
Exercise Example: Glute Bridge with Core Activation
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Lie on your back (in early pregnancy only, or propped up later on).
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Bend your knees, feet flat on the floor.
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Engage your core gently by exhaling and drawing your belly button in slightly.
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Squeeze your glutes and lift your hips.
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Hold for 3 seconds, then lower.
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Do 2–3 sets of 10 reps.
This helps stabilize the pelvis and reduce strain on the SI joint.
2. Use Gentle, Targeted Stretches
Once your pelvis feels more supported, gentle stretches can help relieve muscular tension around the SI joint.
Stretch Example: Seated Figure 4 Stretch
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Sit upright on a firm chair.
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Cross one ankle over the opposite knee.
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Keeping your spine straight, gently hinge forward until you feel a stretch in the outer hip.
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Hold for 30 seconds and switch sides.
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Avoid rounding the spine—think “chest forward.”
This relieves tightness in the piriformis muscle, which often contributes to SI joint pain.
3. Watch Your Posture
During pregnancy, your growing belly can shift your center of gravity forward, causing you to arch your lower back more than usual.
Tip: Think “Neutral Pelvis”
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When standing, imagine your pelvis as a bowl of water.
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Don’t let the water spill forward (anterior tilt) or backward (posterior tilt).
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Gently draw your ribs over your pelvis and soften your knees.
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Wear supportive shoes and avoid standing on one leg for too long (e.g., while holding a toddler or brushing your teeth).
4. Use Supportive Gear
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SI Joint Belts: These can offer compression and support to help stabilize the pelvis during movement.
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Pregnancy Pillows: Sleeping with a pillow between your knees and ankles keeps your hips aligned.
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Supportive Footwear: Avoid flat shoes and flip-flops. Cushioned, supportive shoes can help reduce joint stress.
5. Modify Daily Movements
Getting Out of Bed
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Roll to your side, bend your knees, and push up with your arms.
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Avoid jackknifing straight up—this strains your core and pelvis.
Getting Dressed
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Sit to put on pants, socks, and shoes—don’t stand on one leg.
Car Transfers
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Sit first, then bring both legs into the car together.
These changes reduce torsion across the SI joint and can significantly reduce your pain.
6. Pelvic Floor Therapy
Seeing a physical therapist who specializes in pelvic health can be a game-changer. We assess your posture, movement patterns, muscle imbalances, and core control. You’ll receive a custom plan tailored to your pregnancy stage and activity level—ensuring safety and effectiveness.
The Bottom Line
SI joint pain is common—but not something you have to “just live with.” With the right combination of stabilizing exercises, posture awareness, and supportive habits, you can stay active, reduce pain, and feel more confident in your changing body.
If your pain persists, worsens, or is affecting your sleep and daily activities, don’t wait—reach out to a pelvic health physical therapist. You deserve to feel strong, supported, and empowered throughout your pregnancy journey.
Need help?
If you’re struggling with any pregnancy or postpartum concerns and want a personalized evaluation and treatment plan, make an appointment with one of the Pelvic Floor Physical Therapists at The Pelvic Health Center in Madison, NJ. We’re trained to help identify and treat the causes of your dysfunction!