A deep ache in your lower back or buttock can make ordinary movements like standing for a while, climbing stairs, or getting up from a chair, surprisingly uncomfortable. Sometimes, the source is one of the sacroiliac joints, where the base of your spine connects to your pelvis. You may see this described as joint sacroiliac pain, though “sacroiliac joint pain” is the more natural term. The discomfort can feel persistent, but it is often manageable with a combination of gentle movement, changes to daily activities, and care guided by a healthcare professional.
Here, we’ll look at what can cause the pain, which symptoms to watch for, exercises that may be safe to try, and treatment and comfort strategies that can make everyday movement easier.
What Is Sacroiliac Joint Pain? Causes and Sacroiliitis
Your two sacroiliac (SI) joints connect the base of your spine to your pelvis. They help transfer weight between your upper body and legs and normally allow only a small amount of movement. When the area becomes painful, the ache may feel as though it comes from your lower back, buttock, or hip. That overlap is one reason SI joint pain can be hard to identify without a medical assessment.
Sacroiliac joint dysfunction is a broad term for pain associated with a joint that is moving too much, moving too little, or otherwise failing to function comfortably. What is sacroiliitis? It means inflammation of one or both SI joints. Sacroiliitis can be one cause of SI joint pain or dysfunction, but an uncomfortable SI joint is not necessarily inflamed. A clinician may need to look beyond the joint itself to work out what is causing the pain.
You may also see the term SI joint inflammation. It describes inflammation on one side or both; when both joints are affected, it is called bilateral sacroiliitis. In some cases, sacroiliitis is associated with inflammatory arthritis, including ankylosing spondylitis. Pain on both sides alone does not establish that diagnosis.
Several factors can contribute to SI joint pain. Wear-and-tear arthritis may affect the joints over time. An altered walking pattern can change how weight passes through the pelvis, while a previous fall or other injury may damage the area. During pregnancy, the joints loosen and stretch, and changes in weight and walking can add stress. These factors offer clues, though the cause is not always clear from symptoms alone.
SI joint pain is a meaningful source of persistent back pain: a medical review estimates that it affects 15%-30% of people with chronic lower back pain that does not radiate along a nerve. That figure describes a particular group of patients; it does not mean that every lower back ache comes from the SI joints.
Recognizing Sacroiliac Joint Pain Symptoms
Sacroiliac joint pain often feels like a deep ache near one side of the lower back or buttock. It can also be felt around the hip or spread into the thigh or down one leg. Because the SI joints sit close to the spine and hips, the pain may be hard to pinpoint.
Signs your SI joint may be bothering you
Common sacroiliac joint pain symptoms can affect more than your lower back. Notice where the discomfort starts and which movements bring it on.
- 01 A deep ache in the lower back, buttock, or hip
- 02 Pain that travels into the thigh or down one leg
- 03 Discomfort with movement, such as standing for a long time, climbing stairs, or getting up from a chair
- 04 Pain or stiffness after sitting or standing in one position for a while
The pain is often more noticeable on one side. If inflammation affects both SI joints - called bilateral sacroiliitis - symptoms may occur on both sides at once. Some people find that changing position or walking gently eases stiffness for a short time, only for the discomfort to return after another long period of sitting or standing. The pattern can vary with the cause of the pain.
It may help to notice where the pain starts and which movements bring it on. For example, does it catch when you rise from your usual chair, or build gradually while you stand at the kitchen counter? Those details can give a healthcare professional useful clues. They cannot confirm an SI joint problem on their own, though: hip conditions, spinal problems, and other causes of lower back pain can feel similar.
If pain persists, worsens, or interferes with daily activities, an evaluation can help identify its source and guide the right care.
Sacroiliac Joint Pain Exercises: What Helps and What to Avoid
Gentle exercise can help the muscles around your abdomen, hips, and buttocks support your pelvis. That support may reduce strain on the SI joints during everyday movement. Physical therapists often use strengthening exercises as part of SI joint care; a small study also found improved glute muscle function after a targeted exercise program. The right movements depend on what is causing your pain, so ask a healthcare professional before starting a new routine if you have persistent symptoms.
These sacroiliac joint pain exercises are gentle starting points to discuss with a physical therapist:
- Pelvic tilts: Lie on your back with your knees bent and feet flat. Gently tighten your abdominal muscles to tilt your pelvis and bring your lower back slightly toward the surface beneath you. Breathe normally, then release slowly. Keep the movement small and comfortable.
- Glute squeezes: While lying down or sitting upright, gently tighten both buttock muscles without holding your breath or shifting your hips. Relax fully between squeezes. This lets you begin working the glutes without lifting your pelvis.
- Supported bridges: If pelvic tilts feel comfortable, lie on your back with both knees bent and feet flat, hip-width apart. Tighten your abdomen and buttocks, then lift your hips a short distance. Lower slowly, keeping your weight even through both feet. Skip this exercise if it brings on pain.
- Gentle abdominal bracing: Lying on your back with your knees bent, lightly tighten your lower abdominal muscles as though preparing for a cough. Keep breathing and avoid pressing your back forcefully into the floor. Release after a few seconds.
Sacroiliac Joint Pain Exercises to Avoid
During a flare, movements that place uneven or sudden stress on the pelvis may aggravate symptoms. Be cautious with repeated twisting or turning at the hips, heavy lifting, running or jumping, and exercises that keep your weight on one leg for an extended period. These are not permanent bans; a physical therapist can help you decide when and how to return to them. SI joint pain can also worsen with stair climbing or standing on one leg.
Treatment, Pain Relief & Sleep Positioning
What is the treatment for sacroiliac joint pain? It depends on what is causing it. A healthcare professional may recommend physical therapy to improve strength and movement around the pelvis. Anti-inflammatory medication can help some people, though it is important to check whether it is appropriate for you, particularly if you have kidney problems, heart disease, high blood pressure, or a history of stomach ulcers. In some cases, a physical therapist may suggest a supportive sacroiliac belt to limit painful movement.
For pain relief for the sacroiliac joint during a flare-up, cold therapy may help calm a sore area. Research on musculoskeletal injuries shows that cooling can temporarily reduce blood flow, swelling, and inflammatory activity, although evidence that it improves longer-term outcomes is limited. MedlinePlus recommends applying ice to the lower back or upper buttock for about 20 minutes at a time and keeping it off bare skin. Cold therapy can ease discomfort; it cannot resolve the underlying cause of SI joint pain.
When your lower back needs a cool-down
A short cold-therapy session may help ease discomfort during an SI joint flare-up. Choose a flexible pack you can position where it hurts, or a wrap that keeps the pack in place while you rest.
Cold therapy supports comfort; it does not treat the underlying cause of SI joint pain. Follow the product instructions and avoid prolonged contact with cold.
If the sore spot is around the upper buttock or hip, the Pelegon Ice Packs for Injuries offer a flexible, reusable option. The packs remain pliable when frozen, so they can follow the curve of the lower back or hip more comfortably than a rigid block. The larger size may be useful when the painful area is broad.
If you would rather keep the cold pack in place while resting, the Pelegon Lower Back Ice Pack Wrap has an adjustable brace that holds its flexible gel insert against the lower back. Its position can be adjusted lower toward the sacroiliac area. Use it for a brief cooling session while awake, following the product instructions, rather than wearing it to bed. The wrap is a comfort aid, not a sacroiliac support belt or a treatment for joint inflammation.
Sleeping Position for Sacroiliac Joint Pain Relief
At night, try sleeping on your side with a pillow between your knees. This can help keep your hips and pelvis in a more comfortable position. If you sleep on your back, placing a pillow under your knees may ease pressure on the lower back. Choose the position that feels best rather than forcing yourself to stay in one posture. These adjustments may improve comfort overnight, but persistent pain that disrupts sleep deserves a medical assessment.
When Sacroiliac Joint Pain Needs Medical Attention
An aching lower back or buttock can often be assessed at a routine appointment, especially if it is mild and improving. Seek prompt medical evaluation, though, if back pain comes with any of these signs:
- Fever: This can point to an infection or another illness that needs attention.
- New numbness or weakness in a leg: These symptoms may involve a nerve and should not be assumed to come from the SI joint.
- New loss of bladder or bowel control: Go to an emergency department immediately. This can be a sign of a rare but serious spinal nerve problem.
You should also arrange an evaluation if pain is getting worse, is not improving, or is making it difficult to walk, sleep, or manage daily tasks. SI joint symptoms can resemble pain from the spine or hip, so identifying the source matters before settling on a care plan.
A clinician will usually ask where the pain is, what brings it on, and whether you have had an injury or other symptoms. They may watch you walk and gently move or apply pressure around your hips and pelvis to see which positions reproduce the pain. An X-ray or MRI may be considered if symptoms persist, the diagnosis is unclear, or there are signs that need further investigation; imaging is not limited to cases where home care has failed.
The exercises, positioning tips, and cold therapy products in this article can support comfort, but they cannot replace a medical diagnosis.
Moving More Comfortably with SI Joint Pain
Sacroiliac joint pain can make familiar movements feel difficult, but there are ways to manage it. Once a healthcare professional has identified the likely cause, care often begins with gentle strengthening, changes to activities that aggravate the joint, and treatment suited to your symptoms. Cold therapy may offer comfort during a flare, while a supportive sleep position can make nights easier.
Let your body set the pace.
Notice how you feel during and after activity. If a movement keeps aggravating your pain, a physical therapist can help adjust your routine.
With the right care, exercise, and daily support, you can work toward greater comfort and independence.
Get prompt medical care if back pain comes with fever or new leg numbness or weakness.
Seek emergency care for new loss of bladder or bowel control.
Frequently Asked Questions
Is sacroiliac joint pain the same thing as regular lower back pain?
No. Sacroiliac joint pain comes from the joints between the spine and pelvis, while lower back pain can have many different causes.
Can sacroiliac joint pain go away on its own?
Yes, some episodes improve with time and changes to painful activities. Pain that persists or keeps returning needs an evaluation.
Is walking good or bad for sacroiliac joint pain?
Gentle walking is often helpful if it does not worsen your symptoms. Start with a comfortable distance and stop if the pain increases.
Can sacroiliitis be caused by arthritis?
Yes. Osteoarthritis and inflammatory forms of arthritis can affect the sacroiliac joints.
Is a sacroiliac belt actually effective for pain relief?
It can help some people by limiting painful joint movement, especially when recommended and fitted by a physical therapist.
When does sacroiliac joint pain mean I should see a doctor instead of treating it at home?
Seek medical care if pain worsens, persists, or comes with fever or new leg numbness or weakness. New loss of bladder or bowel control requires emergency care.
