Getting out of the car is painful?
SIJ pain in pregnancy can make everyday movements surprisingly difficult.
Getting out of bed, turning over at night, putting your pants on, getting in and out of the car or even taking a step can suddenly become uncomfortable.
The sacroiliac joints — often shortened to SIJ — are located at the back of your pelvis, where your sacrum meets your pelvic bones. During pregnancy, your body goes through significant changes that can alter how your pelvis, spine and surrounding muscles move and work together.
For some women, this can contribute to sacroiliac joint pain during pregnancy.
If you're experiencing pain around your SIJ, pelvis, buttock or lower back, you don't necessarily have to simply put up with it because you're pregnant. A pregnancy osteopathic assessment can help identify what may be contributing to your discomfort and how your treatment can be tailored to you.
What is the sacroiliac joint?
You have two sacroiliac joints — one on either side of your pelvis.
They connect your sacrum, which sits at the base of your spine, with your pelvic bones.
The SI joints help transfer load between your upper body and legs. They are involved in everyday movements such as walking, climbing stairs, standing up, getting in and out of the car and turning in bed.
During pregnancy, your growing baby and changing body can alter your posture, balance and the way you distribute your weight through your pelvis.
Your ligaments and joints are also affected by hormonal changes.
All of these changes can influence how your pelvis and surrounding muscles are functioning.
What does SIJ pain in pregnancy feel like?
Sacroiliac joint pain in pregnancy can feel different from woman to woman.
You may experience pain:
Around one or both sides of your lower back
Over the back of your pelvis
Around the dimples at the back of your pelvis
Into your buttock
Around your hip
Into the groin or thigh
When moving from sitting to standing
When walking or taking longer strides
You may notice that the pain is particularly noticeable during movements where your legs are doing different things — for example, getting dressed, climbing stairs or getting into a car.
Some women describe the pain as aching, sharp, catching or uncomfortable pressure.
Why can pregnancy cause SIJ pain?
Pregnancy involves a huge amount of physical change.
As your baby grows, your centre of gravity changes and you may naturally adjust the way you stand, walk and move.
Your pelvis and spine also need to accommodate your growing abdomen.
At the same time, pregnancy hormones influence your ligaments and joints, while the muscles around your pelvis, hips, abdomen and lower back adapt to the changing demands placed on them.
This doesn't mean that your SI joints are necessarily "out of place" or that your pelvis needs to be put back into position.
Instead, SIJ pain during pregnancy is often influenced by a combination of factors, including load, movement, muscle tension, joint mechanics and the changes happening throughout your body.
That's why I prefer to look at the whole picture rather than simply treating the painful spot.
Everyday activities that can become difficult
SIJ pain can be particularly frustrating because relatively simple movements can become uncomfortable.
Turning over in bed
You may wake every time you try to roll from one side to the other.
The movement of your legs and pelvis together can cause a sharp or catching sensation around your SIJ or buttock.
You may start dreading turning over during the night — particularly when you're already struggling to get comfortable because of your growing bump.
Getting out of bed
You might find that sitting up and swinging your legs out of bed causes pain through your pelvis or lower back.
Moving slowly and keeping your knees together can sometimes make the movement more comfortable.
Putting on pants and underwear
Standing on one leg to put your pants on can be surprisingly painful with SIJ pain.
You may find yourself sitting down to get dressed instead because lifting one leg at a time aggravates your pelvis.
Putting on your shoes
Bending, twisting and balancing on one leg can all be uncomfortable.
Something as simple as putting on your shoes can suddenly require much more thought than it used to.
Getting in and out of the car
Getting one leg out of the car while the other remains inside can place a lot of demand through your pelvis.
You may find it more comfortable to turn your whole body and bring your legs out together rather than twisting and stepping out one leg at a time.
Walking
Long walks may become uncomfortable, particularly if you increase your stride length or walk on uneven surfaces.
You might notice pain after walking rather than immediately.
This can make exercise and getting around during the day more challenging.
Climbing stairs
Going up and down stairs can aggravate SIJ pain, particularly when you are carrying something or trying to move quickly.
You may find yourself taking stairs one step at a time when your pain is worse.
Getting up from a chair
Moving from sitting to standing can cause a painful catch around the back of your pelvis.
You may need to push yourself up with your arms or take a moment before walking.
Getting in and out of the bath
Lifting one leg over the side of the bath or standing on one leg can aggravate pelvic and SIJ symptoms.
Looking after older children
If you already have children, pregnancy doesn't mean the rest of life stops.
Picking up toys, getting down onto the floor, helping children get dressed, lifting them into the car or carrying them can all become more difficult when your pelvis is sore.
Exercising
You may have been happily exercising throughout your pregnancy but suddenly find certain movements uncomfortable.
Walking, lunging, single-leg exercises, squats, getting on and off the floor or changing direction can all feel different.
SIJ pain doesn't necessarily mean you need to stop exercising completely.
Often, the goal is to understand which movements are aggravating your symptoms and modify them appropriately so you can continue moving within your comfort level.
How can osteopathy help SIJ pain during pregnancy?
When you come to see me, I don't just look at your SI joint.
I'll take the time to understand:
Where you are experiencing pain
When it started
Which movements aggravate it
What activities you are struggling with
What stage of pregnancy you're at
Your exercise and activity levels
Your previous injuries and health history
I'll then assess how your whole body is moving and working together.
This may include looking at your:
Pelvis and SI joints
Lower back
Hips
Gluteal muscles
Thighs
Abdominal and pelvic region
Spine
Posture and movement patterns
Treatment may include soft tissue techniques, joint mobilisation, articulation, muscle stretching and other appropriate hands-on techniques.
The aim isn't simply to treat the painful area. It's to understand what may be contributing to your symptoms and help your body move as comfortably as possible during pregnancy.
Can SIJ pain be treated during pregnancy?
Yes. Osteopathic treatment can be adapted throughout pregnancy.
Your treatment will be tailored to your stage of pregnancy, symptoms and comfort.
There isn't one treatment approach that suits every pregnant woman.
Sometimes the aim is to reduce discomfort. Sometimes it's about improving movement. Sometimes it's helping you find ways to continue exercising or manage the physical demands of work and family life more comfortably.
And sometimes it's simply about being able to turn over in bed without wincing!
What can you do at home?
There are some simple strategies that may help reduce irritation around your pelvis.
Keep your knees together during certain movements
When getting in and out of bed or the car, try to move your legs together rather than taking one leg away from the other.
Avoid standing on one leg where possible
Sit down to put on pants, underwear and shoes rather than balancing on one leg.
Take smaller steps
If longer strides aggravate your symptoms, try shortening your stride and slowing your pace.
Keep moving
Complete rest isn't usually the answer.
Gentle, comfortable movement can be helpful, but listen to your symptoms and modify activities that clearly aggravate your pain.
Avoid repeatedly pushing through painful movements
If a particular exercise or activity consistently makes your SIJ pain worse, it may be worth modifying it rather than repeatedly pushing through.
A pregnancy osteopath or pelvic health physiotherapist can help you work out appropriate modifications.
When should you seek medical advice?
Although SIJ and pelvic pain are common during pregnancy, not every pregnancy-related pain is musculoskeletal.
Speak with your midwife, GP or other appropriate healthcare professional if you have severe or rapidly worsening pain, significant abdominal pain, vaginal bleeding, regular contractions, fever, loss of sensation or strength, changes to bladder or bowel control, or any other symptoms that concern you.
If you're unsure whether your pain is coming from your SIJ, pelvis or somewhere else, it's worth getting assessed rather than trying to diagnose yourself.
You don't have to just put up with SIJ pain
Pregnancy changes your body — but being pregnant doesn't mean you should have to accept being in pain every day.
If SIJ pain is making it difficult to sleep, walk, exercise, get dressed, drive, work or look after your family, it's worth getting some support.
As an osteopath with over 10 years of clinical experience and more than 8 years specialising in pregnancy and postpartum care, I understand that pregnancy care needs to fit around real life.
I'll listen to what's bothering you, assess your whole body and tailor your treatment to you and your stage of pregnancy.
If you're struggling with SIJ pain, sacroiliac joint pain or other pregnancy aches and pains, you're welcome to book an appointment with me in Milford, Auckland.
You don't need to wait until your pain is stopping you from doing the things you enjoy.
Book an appointment and let's work on helping you move more comfortably through your pregnancy.
