Having difficulty sleeping with your SI joint pain? Tossing about so you just can’t get comfortable? Check out this list of helpful tips.

Pain originating in the sacroiliac (SI) joint can make sleeping a real challenge. But, there are several things you can do to alleviate the pain: selecting the right pillow, mattress, and sleeping position to start. From there, conservative treatments can be tried like: OTC meds, hot & cold pads, an anti-inflammatory diet, and chiropractic care.

According to Anesthesia and Analgesia Sacroiliac joint (SI) pain affects between 15% and 25% of patients who suffer from low axial back pain. There is no standard long-term treatment, however, a study by PM&R Knowledge lists a number of starting treatments including, among other things, chiropractic care and simple sleeping routine adjustments.

Here are the tips to sleep with SI Joint Pain:

When it comes to spinal issues, the primary goal is to maintain spinal alignment. Whether it is SI joint pain or some other issue like, say, a bulging disc, the general idea is to keep your spine in proper alignment as much as possible and maintain its natural curvature throughout the night.

Basically, you want to avoid putting pressure on the hips, back, and neck by keeping the head, shoulders, torso, and hips all in alignment. To that end, you have a number of strategies you can use, many of which are quite similar to this list of tips for sleeping with a herniated disc.

1) Consider the Type of Pillow

This affects the cervical spine (the neck). You want a pillow that will keep your head in a neutral position so that it does not disrupt your overall spinal alignment. The type of pillow you should use will vary depending on how you sleep.

  • Side sleepers should use a thicker pillow to keep your head from tilting downward
  • Back sleepers should use a thinner pillow to keep your neck aligned with the rest of your spine.

2) Choose the Right Type of Mattress

Generally speaking, the right mattress will strike a balance between softness and firmness. That is, it will be soft enough for your body to sink to the point where your bumps and curves receive adequate support. And it will be firm enough to sufficiently support the spine throughout your body so that it maintains its own natural curve that is not distorted by pressure from the mattress. Ideally, you want to find a mattress that is suited to your body and allows you to comfortably rest in more than one position. Click here to learn more about the mattress I recommend.

3) Consider your Sleeping Position

There are three basic sleep positions: on the back, on the stomach, or on the side. Of the three, the one you should avoid the most is sleeping on your stomach. It is not good for your spine. It also requires you to twist your neck in order to breathe. This leaves you with two preferred sleeping positions – either on your back or on your side.

When deciding between the two you should take into account your current spinal health, physical makeup, and personal comfort. And you should also remember that in most situations you should switch sleep positions off and on throughout the night. If you are unsure of your sleep position at night, you can take several measures to get a better handle on it:

  • Take note of your sleeping position when you wake up in the morning.
  • Ask someone else to take note of your sleeping position during the night.
  • Ask someone you know to help you pick out a new sleeping position. You can lie on the bed and try new postures while that person can give you feedback on how it appears to be affecting your spine.

You can check out this post for more details on how to determine the best sleep position in bed.

SI Joint Pain Sleeping Tips for Back Sleepers

Whether you sleep on your back or on your side will determine the particulars of some of the other measures you can take to help you sleep better with SI joint pain.

Extra Pillows and Supports:

As the SI joint is located in the lower back, most of the modifications to your sleep habits should revolve around the lower half of your body.

  • A Towel for the Lower Back: Back sleepers should place a rolled-up towel in the space beneath their lower back. This will alleviate pressure from that area of your back and help the spine retain its natural shape while you sleep. You can adjust the thickness of the towel as needed.
  • Pillows for the Legs: Another effective trick for back sleepers is placing a pillow or two or a sleeping wedge specifically designed for back pain under your lower legs or knees. This will relieve some of the pressure from your lumbar spine allowing the entire spine to better retain its alignment as you sleep.

SI Joint Pain Sleeping Tips for Side Sleepers

Side sleepers use many of the same accouterments as leg sleepers, just in different locations.

  • Place Pillows Between Your Legs: The difficulty with sleeping on your side is that as the legs sprawl out, the lower spine tends to get twisted. That is not good for your spine as a whole, nor is it good for the sacroiliac joint (SI joint) in particular. By placing a pillow between your knees or legs, you can help keep the spine from twisting so it will stay aligned while you sleep.
  • Pillows Under Midsection: This may or may not be necessary. If you feel it is, a small pillow or towel placed under the midsection will support your spine from that side.

Miscellaneous SI Joint Pain Sleeping Tips

In order to sleep while suffering from SI joint pain, you should begin by using all the general techniques and tips listed above. Normally, those tips and techniques will do much to offset the pain. However, in some cases those techniques are insufficient on their own, here are a few other methods to help reduce your sacroiliac pain enough to make sleeping a little easier.

  • Pain Meds: You can use over-the-counter pain medications like ibuprofen or acetaminophen to reduce or eliminate the pain and allow you to sleep throughout the night.
  • Hot and Cold Compresses: alternately applying hot and cold compresses can do much to reduce inflammation and improve blood flow to the areas around the sacroiliac joint. This should relieve pain and stimulate healing.
  • Proper Diet: some foods and/or supplements tend to encourage inflammation of tissues, while others tend to reduce such inflammation. If you change your diet by eating less (or none) of the inflammation-causing foods (and supplements) and more of the inflammation-reducing foods (and supplements), you may find further relief from SI joint pain. Foods and supplements that reduce inflammation include:
    • Ginger
    • Nutmeg
    • Curcumin
    • Magnesium
    • And Green Tea

However, before you start making changes to your diet or taking meds, you should talk to a medical professional.

Why Does SI Joint Pain Feel Worse at Night?

SI pain, like many musculoskeletal issues, can be aggravated by improper spinal alignment. Basically, if your spine is not in a natural normal position, one or more places along it may be suffering from excess pressure building up upon it.

Sleep is intended to rest the body and ease the pain, discomfort, and general weariness that is accrued throughout the day. If something – like improper posture – impacts that rest, pain and other problems may result. This can be combated with some of the techniques listed above. For example, if you sleep on your side, the positioning of your legs may twist your lower spine and aggravate SI pain or other problems. As suggested above, you may be able to offset this by placing a pillow between your legs as you sleep.

It is also worth noting, that when you sleep, you tend to stay in the same position for longer periods of time. This means that even a small imbalance in your posture that you wouldn’t notice during the day, will likely have a greater impact throughout the night.

What Is the Best Way To Sleep with SI Joint Pain When Pregnant?

SI joint pain can offer particular challenges to pregnant women. As with non-pregnant women, sleeping on your stomach is discouraged. However, because the growing baby can put pressure on the various internal organs, tissues, and blood vessels, sleeping on your back is also discouraged. It is generally accepted that a pregnant woman should sleep on her side and fight sacroiliac joint pain with a judicious use of pillows.

A pregnant woman struggling with SI pain can put a pillow between her knees, and, if necessary, a pillow under her abdomen. Likewise, the pillow under the head should be chosen so that it keeps the head in a neutral position throughout the night.

How Do You Sleep with Severe SI Joint Pain?

The guiding rule of medicine in general and chiropractic care in particular is to try the non-conservative treatments first before going into invasive treatments like surgery and whatnot. With that in mind, you should exhaust the tips and treatments listed above, first. However, even if you do all those things you may not be able to eliminate your pain in some cases.

In such cases, you should consult your chiropractor, who, in turn, may refer you to a surgeon or other medical practitioner. The usual high-powered treatments usually include:

  • Joint Injections
  • High-powered painkillers
  • Surgery
  • Or Joint fusion

Hopefully, though, if you catch it early, it won’t get that far. Prevent SI joint pain and avoid these exercises.

How Effective Is Chiropractic Treatment?

Chiropractors are experts on the nervous and musculoskeletal systems. As such, their expertise is uniquely suited to diagnosing and treating musculoskeletal issues like SI joint pain. Through chiropractic manipulation, a process in which a chiropractor can strategically apply pressure with his hands to a joint and the bones and tissues surrounding a joint, the chiropractor can shift pressure away from damaged areas thereby relieving pain and stimulating healing.

In fact, a study by Science Direct found that, both manual and mechanical, chiropractic treatment techniques reduced both pain and disability in patients with sacroiliac joint syndrome. Not only are chiropractors skilled at musculoskeletal manipulations, they can also provide a wealth of knowledge on issues like SI joint pain and the methods and techniques on how to treat it.

Your chiropractor will happily answer any questions you might have about getting manual manipulation.


The sacroiliac joint is an important juncture in the body. Pain there can have a serious impact on a patient’s sleep and sleeping patterns. The tips above are offered to assist someone suffering from SI pain gets the restful, recuperative sleep they need.