How to Sleep with SI Joint Pain

How to Sleep with SI Joint Pain

The sacroiliac (SI) joint is core to movements such as walking, sitting up and down, lying down, standing, etc. When you have SI joint pain, it can make it difficult to do these activities.

Notably, SI joint pain tends to get worse at night. Lying down puts pressure on the SI joint, exacerbating the pain. When sleeping, there is limited joint and body movement, which can lead to increased stiffness.

Furthermore, as you fall asleep, your mind chatter reduces, making your brain more receptive to the sensations in the body. Therefore, the SI joint pain may feel heightened.

However, if you know how to set up your bed right, assume a good sleeping position, and manage the pain, you can still get good quality sleep.

Best Sleep Position for SI Joint Pain

The right sleeping position for SI joint pain varies from person to person. That said, certain positions are more favorable than others. Below are some of the best sleep positions for SI joint pain.


Sleeping on your back puts the spine in a neutral position, which can help to alleviate SI joint pain. However, instead of sleeping flat on your back, you want to place a pillow or rolled towel underneath your knees to encourage the back to assume its natural curve and ease back pressure. Also, place a thin pillow or rolled towel under your lower back for extra support.


Some people find it more comfortable to sleep on the side. Sleeping on the side reduces pressure on your back. For added comfort and support, place a regular-sized pillow or a body pillow between your knees. Also, tuck your legs towards your chest into a fetal position.


The traditional stomach sleeping position is generally discouraged for SI joint pain. However, with a few adjustments, it can feel comfortable to sleep in. Experts recommend placing a pillow under your head and your stomach to support your pelvis and take away pressure from your back. 

Also, be careful with your neck rotation, as it can lead to cervical spine misalignment. Therefore, move your head gently and find a comfortable position that makes breathing easy.

Try out different sleeping positions and adjustments to establish the ones that work for you. You may also change positions throughout the night. However, move slowly and avoid jerky movements that may make the pain worse.

Tips for Improving Your Sleep With SI Joint Pain

Find a Good Quality Mattress

Sleeping in the right position is not enough. If your mattress is not good quality, it will make the SI joint pain worse.  Some crucial factors to consider when buying a mattress if you have SI joint pain include the level of firmness, material, and edge support.

A medium-firm mattress is preferable. It offers great lumbar support while maintaining the natural curvature of your back.

A saggy mattress does not provide adequate support. Your pelvis is likely to sink into the mattress, causing spinal misalignment. It is also uncomfortable, resulting in tossing and turning through the night. If your mattress is saggy, consider replacing it immediately. Alternatively, fit it with a well-cushioned and supportive topper.

On the other hand, while a firm mattress is supportive, it keeps your body straight, misaligning the natural curvature of the spine. It can also be quite uncomfortable to sleep on initially. Furthermore, a firm mattress can cause general stiffness in the body, worsening the SI joint pain.

Regarding materials, the common options include innerspring, memory foam, and latex. Innerspring mattresses contain pocket springs in the middle and foam on top, which allows them to contour to your body. The level of firmness depends on the number of coil springs and the density of the memory foam.

Memory foam mattresses are preferable. They conform to the shape of your body and offer adequate support to relieve pressure from your back and pelvis. While latex offers cushioning and is highly durable, some people don’t like that it tends to contour the body.

Also, when choosing a mattress, check that it has adequate edge support.  Adequate edge support makes it easy to get in and out of bed.

Use the Right Pillow

The right pillow for SI joint pain depends on your preferred sleeping position, body weight, and preference. Ultimately, the pillow should help to maintain proper spine alignment and feel comfortable.

The main factors to consider when choosing a pillow include type, size, and thickness. Choose between contour, memory foam, and latex pillows. 

Contour pillows take the natural shape of the head and neck. Memory foams conform to the shape of your head and neck. They offer excellent support and help to relieve pressure. While latex pillows offer adequate support while allowing gentle contouring.

Your sleeping position primarily determines the appropriate pillow thickness. If you are a stomach sleeper, opt for a thin pillow. For side and back sleepers, you require medium-thickness to adequately support your head and neck.

Use Home Remedies to Ease SI Joint Pain Before Going to Bed

Patient exposed to red light therapy on the back

If you are having an SI joint flare-up, the right home remedies can help to relieve pain, enabling you to sleep restfully.

One of the simplest home remedies is taking a warm bath. It helps to relax tense muscles and soothes the SI joint pain. Another option is a gentle massage on your lower back and buttocks. Have someone else do the massage on you.

You could also do heat therapy. Place a heating pad or water bottle on the affected area for 15-20 minutes. The heat helps to relax the muscles and improves blood circulation. Other home remedies to try include stretches and over-the-counter pain relief.

Another excellent home remedy for SI joint pain is red light therapy. Invest in a home red light therapy device that you can use on your lower back and buttocks before going to bed or if you are experiencing a flare-up.

Support Your Back and Pelvis Throughout the Day

Ensuring proper support for your back throughout the day is crucial for managing SI joint pain and preventing it from worsening at night. Therefore, maintain proper posture when sitting, walking, or standing. Avoid slouching to ensure your body weight is evenly distributed on your feet.

Do not lift heavy objects. Wear supportive shoes to promote good posture and prevent strain on the back and pelvis. Wear an SI joint belt or brace throughout the day and remove it only a few minutes before going to bed.

Establish a Good Sleep Routine

A good sleep routine will help you to wind down and fall asleep fast and deeply. First, set up a comfortable and conducive sleep environment. Have fresh, clean bedding and maintain cool temperatures in the room. Also, keep the room dark and quiet.

Start to wind down 30-60 minutes before your bedtime. Turn off electronics, including your phone. Take a shower or bath. Listen to soothing music or read a book. Put on a diffuser with lavender or chamomile essential oils to further help you relax and calm down. Or, infuse lavender or chamomile essential oil in water in a spray bottle and apply it to your bedding.

Limit caffeine and alcohol intake in the hours leading to bedtime to prevent it from interfering with your sleep quality.

Seek Treatment for SI Joint Pain

Ultimately, seek treatment for SI joint pain. Effectively managing the condition not only improves the quality of your sleep but also your overall health.

You can see a general physician or an orthopedist. They will do a physical examination and may order imaging tests such as MRI or X-ray to determine the cause and extent of the SI joint damage. They will then come up with a treatment plan.

Typically, non-surgical treatment options include prescription pain medication, steroid injections, physical therapy, and support devices. If the condition does not respond to non-surgical treatment, the doctor may advise that you consider surgical intervention such as SI joint fusion or denervation procedures.

Whichever your treatment plan is, monitor your progress closely and work closely with your doctor. The doctor will adjust your treatment plan if needed for the best outcomes.


Sleeping can make SI joint pain worse. However, there are ways to manage the pain and set up your bed to have a good night’s sleep. Take precautionary measures throughout the day to avoid exacerbating the pain.

For example, wear your SI joint brace and maintain good posture. If you are experiencing pain in the evening, use home remedies to ease it. Use a good quality medium-firm mattress and pillows. Choose a suitable sleeping position for you.

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