Written by Emma Cronan, Writer
Sacroiliac joint pain, also known as SI joint pain, is a painful condition that affects one or both sacroiliac joints near your lower back. If you experience SI joint pain, you may have trouble sleeping at night because you’re struggling to get comfortable enough for a good night’s rest.
In this article, we’ll delve into what exactly sacroiliac joint pain is in more detail, why it seems to worsen at night, and what sleeping position is best for pain relief. Additionally, we will provide some other tips to help you relieve your SI pain at night. Finally, we’ll answer some commonly asked questions about sacroiliac joint pain.
What Is Sacroiliac Joint Pain?
Your sacroiliac joints1 are on each side of your body, where your spine and your pelvis connect. These joints are important because they provide support for the upper body’s weight when standing and transfer weight2 from your upper to lower body without discomfort.1 However, many people can develop sacroiliac joint pain, which is a common type of lower back pain, affecting up to one-fourth of people who generally experience low back pain.2
This joint pain typically feels like stiffness and general pain3 or discomfort in the lower back and buttocks region. Some people feel this pain on both sides of their body, while others only experience the pain in one of the two joints.3
Medical professionals attribute sacroiliac joint pain to various causes4, including traumatic injury, arthritis, pregnancy, and inflammatory conditions.
Are You Sleeping with Arthritis?
Why Is My Sacroiliac Pain Worse at Night?
Since much of sacroiliac pain is stiffness, sleeping or sitting for long periods of time can worsen the severity of the symptoms.3 Additionally, moving around in bed at night may lead to more pain, according to Dr. Jennifer Soo Hoo5, physical medicine and rehabilitation specialist at Weill Cornell Medicine.
Another reason why this joint pain may be worse at night is the circadian rhythm. A 2022 study6 found that the neurobiological mechanisms that regulate your body’s pain perception are partially controlled by your circadian rhythm. In other words, your body may experience pain differently depending on whether it is daytime or nighttime.6
Lastly, sleep problems associated with worsened SI joint pain could potentially cause a negative cycle. If you’re in pain while you try to sleep, you’re likely getting fewer hours of deep, restful sleep. Additionally, research conducted in 20207 reveals that “poor sleep quality and insufficient sleep duration are risk factors for the development of chronic pain,” which means your chronic pain could be leading to poor sleep which could then worsen your chronic pain.
What Is the Best Sleeping Position for Sacroiliac Joint Pain Relief?
Sleeping on your back8 is the best sleeping position if you have sacroiliac joint pain because this sleeping position best supports your lower back, which is the area in pain.
Back sleeping keeps your spine in a neutral position9, which helps reduce additional pressure on the already painful joint areas. To add even more support for your joints, you may want to place a pillow10 under your neck and another one under your knees, which can further align your spine.
Other Tips for Nighttime Sacroiliac Pain Relief
A Mattress With Good Bounce
Bouncy or responsive mattresses are great for people who experience chronic pain such as sacroiliac joint pain. Specifically, medium-firm or firm mattresses provide less sinkage, which supports your body’s pained areas.
If you’re sinking into a soft mattress, it will likely be more difficult to move around on your bed or adjust from one position to another, which could further the severity of your joint pain. In fact, a 2021 study11 found that a medium-firm mattress was most successful in promoting comfort and avoiding back pain. Therefore, to find some nighttime sacroiliac pain relief, we suggest that you find a responsive, medium-firm mattress that will support you as you sleep on your back.
Related: Best Mattress for Arthritis and Best Mattress for Back Pain
Good Sleep Hygiene
Sleep hygiene is a term that refers to good sleep habits to help you improve your sleep quality. The following are some examples of good sleep hygiene tips to follow:
- Keep your bedroom dark, quiet, and relaxing at bedtime
- Go to sleep and wake up around the same time every day
- Avoid alcohol, caffeine, and electronic use before bedtime
- Get exercise during the day
Research published by the Journal of Behavioral Medicine12 has revealed that sleep hygiene and sleep quality are positively correlated, meaning that those who practice good sleep hygiene typically see increased sleep quality. Although sleep hygiene may not directly improve your sacroiliac pain, these practices can relax you and prepare your body for sleep.
Stretch Before Bedtime
Romano Orthopaedic Center13 suggests various stretches and exercises to reduce SI joint pain:
- Hamstring stretches
- Hip adductor stretches
- Glute exercises
- Knee-to-chest stretches
- Back bridge stretches
- Quad stretches
- Yoga
Stretching before bed14 is relaxing, promotes mindfulness, relieves stress, and can also alleviate muscle tension. Before trying any of these stretches, though, you may want to consult a medical professional.
Heat and Ice Therapy
Mount Sinai Hospital15 suggests both heat and ice to reduce sacroiliac joint pain. They say to ice your lower back and upper buttocks two or three times a day for 20 minutes to relieve pain, and using a low-heat heating pad on the affected areas can help loosen tight muscles.15
More Information: Cold Plunge Benefits and How to Use a Sauna
Anti-Inflammatory Diet
Following an anti-inflammatory diet may reduce your sacroiliac joint pain overall, not just at night. An anti-inflammatory diet16 cuts out fried foods, refined carbohydrates, soda, red and processed meat, and margarine.
Research conducted in 202017 found that inflammation is a main physiological pathway of chronic pain. Thus, reducing inflammation by following an anti-inflammatory diet should help alleviate pain overall, whether it be during the day or at night.17
Relaxation Training
Relaxation training18 is a form of cognitive behavioral therapy (CBT) in which a psychologist helps their patient de-stress and relax. Chronic pain can be stressful, so learning some relaxation techniques could decrease your stress levels for better sleep.
Some specific types of relaxation training are progressive muscle relaxation, diaphragmatic (deep) breathing, and guided imagery relaxation.18 At least 21 different studies19 have found that regular use of relaxation techniques is effective in pain reduction for people with chronic pain.
Learn more: Stress and Sleep
SI Joint Belt
An SI joint belt20 is a supportive belt that people might wear to reduce SI joint pain and inflammation. If you wear an SI joint belt during the day, you’ll ideally feel less inflammation, which will hopefully lead to more comfortable sleep. You may want to wear the SI belt while you sleep as well, but you should consult a doctor before doing so.
Frequently Asked Questions
What aggravates sacroiliac joint pain?
According to the Mayo Clinic, stair climbing, sitting or standing for too long, standing on one leg, standing up from a seated position, and running are all activities that may aggravate sacroiliac joint pain.3
What are the symptoms of an inflamed SI joint?
The main symptoms of an inflamed SI joint are stiffness and general pain or discomfort in the lower back and buttocks area.3
Is walking good for SI joint inflammation?
Walking for 20 to 30 minutes21 daily at a gentle pace in comfortable and supportive shoes could help to reduce sacroiliac joint pain and inflammation. However, too much walking can stress the SI joint22, which can worsen your pain and inflammation. If you begin experiencing pain during a walk, we urge you to stop. Make sure to listen to your body and do physical activity in moderation.
Final Word of Advice
You should hopefully now feel more informed about how to reduce the pain and inflammation associated with sacroiliac joint pain before you go to sleep. With some of the suggested techniques, such as staying in the ideal sleeping position for spine support, using ice and heat, stretching before bed, and practicing good sleep hygiene, you should be able to reduce the severity of your joint pain. Remember that although we can provide you with advice, we are not medical experts ourselves, so you should consult a healthcare provider about your SI pain.
Emma Cronan
Writer
About Author
Emma is an Editorial Intern for Sleep Advisor. She collaborates with the editor and staff writers to come up with article ideas, create article outlines, and write for the website.
Combination Sleeper
- 1. “Sacroiliac Joints”. Mayo Clinic. Webpage accessed December 4, 2024. –
- 2. Raj, Marc A., Ampat, George., Varacallo, Matthew. “Sacroiliac Joint Pain”. StatPearls. Last modified August 14, 2024. –
- 3. “Sacroiliitis”. Mayo Clinic. Last modified January 12, 2024. –
- 4. “Sacroiliac joint pain”. Mayo Clinic Orthopedics and Sports Medicine. Webpage accessed December 4, 2024. –
- 5. Soo Hoo MD, Jennifer. “Why Is My Sacroiliac Joint Pain Worse at Night?”. Weill Cornell Medicine Center for Comprehensive Spine Care. Webpage accessed December 4, 2024. –
- 6. Daguet, Inès., et al. “Circadian rhythmicity of pain sensitivity in humans”. Brain. 2022. –
- 7. Haack, Monika., et al. “Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications”. Neuropsychopharmacology. 2019. –
- 8. Covey DC, Lisa. “Sitting and Sleeping Comfortably with SI Joint Pain”. Spine Health. 2024. –
- 9. Carey, Doug., Briffa, Kathy., McKenna, Leanda. “Identifying relationships between sleep posture and non-specific spinal symptoms in adults: A scoping review”. BMJ Journals. 2019. –
- 10. “The Best — and Worst — Sleep Positions for Back Pain”. Keck Medicine of USC. Last modified August 12, 2022. –
- 11. Caggiari, Gianfilippo., et al. “What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature”. Journal of Orthopaedics and Traumatology. 2021. –
- 12. Mastin, David F., Bryson, Jeff., Corwyn, Robert. “Assessment of Sleep Hygiene Using the Sleep Hygiene Index”. Journal of Behavioral Medicine. 2006. –
- 13. “Sacroiliac Joint Pain Exercises and Stretches for Relief”. Romano Orthopaedic Center. Webpage accessed December 5, 2024. –
- 14. Caplan, Lisa. “Why stretching before bed can help you sleep better”. Maryland State Bar Association. 2022. –
- 15. “Sacroiliac joint pain – aftercare”. Mount Sanai. Last modified December 12, 2022. –
- 16. “Foods that fight inflammation”. Harvard Health Publishing. 2021. –
- 17. Dragan, Simona., et al. “Dietary Patterns and Interventions to Alleviate Chronic Pain”. Nutrients. 2020. –
- 18. “Learning to Relax”. Roger Cancer Center University of Michigan Health. Webpage accessed December 5, 2024. –
- 19. Magelssen Vambheim, Sara., et al. “Relaxation techniques as an intervention for chronic pain: A systematic review of randomized controlled trials”. Heliyon. 2021. –
- 20. “Sacroiliac (SI) Belt”. Dunbar Medical. Webpage accessed December 5, 2024. –
- 21. “Exercises To Improve Sacroiliac Joint Pain”. Florida Surgery Consultants. Webpage accessed December 5, 2024. –
- 22. “Sacroiliac Joint Pain”. University of Michigan Health. Webpage accessed December 5, 2024. –