Sleeping and Sex Positions for SI Joint Pain

One Sided Low Back Pain Can Disrupt Your Slumber

Sleeping with SI Joint Pain
Sleeping with SI Joint Pain. Noviembre Anita Vela/Moment/Getty Images

Got sacroiliac joint pain? If so, you may feel that successful treatment is elusive. While doctors and physical therapists offer everything from exercise to medication, injection and fusion surgery, many patients claim none are particularly effective for long term resolution of the problem.

Which means you may have to learn how to live with your SI joint problem.

The Sacroiliac Joint is Complex

The first thing to keep in mind is that the SI joint is complex.

So complex, in fact, that even some physical therapists have a hard time understanding how it's put together, and more importantly, how it stays together.

For a pain free SI joint, the two bones that comprise it, the illium and the sacrum, must fit together properly. Otherwise, you're at risk for a sprain. A number of forces are at work to make that fit happen. These include: The way the bones fit together naturally, called form closure, the mechanical tension in the muscles that surround or affect the joint, called force closure and the nervous system's input into these muscles, called motor control.

Not only that, but the surfaces of both the ilium and the sacrum are irregular, to say the least. Along with bumps and grooves spread all over each, the entire SI joint changes type depending on the area. The same is true for the cushioning and/or binding material found between the two articulating surfaces.

For example, the bottom two thirds of the joint is considered to be mobile, but the upper one third is not.

And your SI joint can become either hypermobile, which is related to spinal instability, or hypomobile, which may lead to movement compensations and stiffness. Either way, the delicate balance between the bones of the SI joint become disrupted.

The likely result in each case? Pain and dysfunction.

Bedtime and Sleeping with SI Joint Pain

You are not alone if you think understanding the sacroiliac joint is a daunting task. Many medical professionals feel the same way (although they may not admit it.)

And when the pain keeps you up at night, you may feel like throwing the studious approach right out the window. Or if you're really lucky, all this "SI joint info" is so boring and tedious, it puts you to sleep — despite the pain.

One can only hope...

Seriously, though, a little lifestyle guidance may be in order. Here are a few tips for dealing with bedtime and sleeping when you have SI joint pain.

  • SI joint dysfunction tends to occur on one one side of the body; you may benefit from bending one leg up while sleeping.

    In general, being aware of which side has the problem can be used to your advantage. According to Lauren Hebert, physical therapist and author of Sex and Back Pain, 80% of people who experience sacroiliac joint pain find relief from their symptoms when they can relax the affected hip backward. This can be accomplished by bending the leg of the painful side, she says.
  • Let's talk sex for a minute.

    If you have SI pain, you might consider the modifying the bottom missionary position so that one leg is bent up and resting on the outside of your partner's leg. Another possibility is to sit at the edge of a chair with the leg on the painful side up so that the heel can be placed on the seat of the chair. The other foot is placed on the floor. The top partner kneels on the floor.

    If you're on top, you might modify the missionary position by propping your partner up with pillows. That way you can be on top with your leg of the painful side bent.

    Lying on your side is a positioning option that may help you develop emotional intimacy with your partner. Both partners can lie on their sides, facing one another. If you are on top, place a bent leg under your partner's (closest) leg, and if you're on the bottom, you, too can bend the leg on the painful side.

    And finally, you may want to look into a pelvic floor strengthening program. Relevant for both women and men, pelvic floor work can help you develop balance and stability through your hips, pelvis and low back, while at the same time improving your sex life. You can't beat that!

    Hebert, Lauren, A., P.T. (2001). Sex and Back Pain. Greenville, ME: IMPACC USA.
    White, A., III, M.D. (1990). Your Aching Back: A Doctor's Guide to Relief. New York, NY: Simon & Schuster/Fireside.
    Kisner, C., & Colby, L.A. (2002). Therapeutic Exercise: Foundations and Techniques.Philadelphia: F.A. Davis Company.