A Detailed Guide On How To Sleep With SI Joint Pain

A Detailed Guide On How To Sleep With SI Joint Pain

By Dr. Shoaib Muhammad , published on September 07, 2023
Dr Shoaib Muhammad,MD

If you're dealing with SI joint pain, getting a good night's sleep can often feel like a feverish dream.

The sacroiliac (SI) joint is a small part of your body. But, because it plays an essential role to your body's structure, working with it can be tough.

Read on for practical tips and facts to help you get that sleep you're looking for and deal with the challenges brought about by SI joint pain.

What Is SI Joint Pain?

To understand SI joint pain, it's important to know the basic anatomy of the SI joint first. It's a small but vital hinge connecting your pelvis and spine. Here are the basics of its structure.

The SI Joint

The SI joint is situated at the bottom of your spine, where the three-cornered bone called the sacrum meets the two big hip bones, identified as the ilia. There's one SI joint on either side of your body[1].


Between the ilium and sacrum, there's cartilage. This works as a cushion and helps your Sacroiliac joint move smoothly.


Ligaments are like stout bands that grip and hold your SI joint together. They offer support and stability to the joint[2].

Now that you have a basic understanding of the SI joint, let's discover why SI joint pain occurs and why it can disturb your sleep.

How to sleep with SI joint pain

Why Does the SI Joint Hurt?

SI joint pain ensues when something goes wrong with this important joint. Here's a simple explanation of what happens inside your body.

  • Inflammation: Inflammation can upset the SI joint, making it sore, tender, and aching. This inflammation and joint space irritation might result from arthritis, injury, or an underlying medical condition[1].
  • Misalignment: Sometimes, the Sacroiliac joint can become misaligned for various reasons, including injury or pregnancy. This misalignment can put stress on the joint, causing pain.
  • Degeneration: Over time, wear and tear can damage the cartilage in the SI joint leading to discomfort and pain.
  • Infection or Disease: In rare cases, certain diseases or infections can affect the SI joint and cause discomfort[3].
  • Stress and Strain: The SI joint can also be influenced by the way you move and use your body. Actions that involve a lot of bending or twisting can stress the joint too, leading to pain.

A Basic Overview of Sleep & SI Joint Pain

The well-being of your SI joint is directly linked to your comfort, particularly when you're resting, and it also affects your quality of life[4].

Sleeping Positions

When you sleep, you might accidentally put pressure on your SI joint if it's misaligned or inflamed. This pressure can cause disturbed sleep and discomfort. We'll discuss how to choose sleep positions with SI joint pain soon.

Long-Term Impact

Sleep is important for your body's recovery and healing. When SI joint pain affects your sleep, it can extend the healing process and thus impact your overall well-being.

Changing Positions

If you have SI joint pain, adjusting positions during sleep can be painful. It can cause waking up frequently, making it difficult to get a good night's rest.

So, if you follow the tips below, it can make a big difference to your life. 

Practical Tips For SI Joint Pain Sleep

In my clinical practice, I've seen numerous cases of SI joint pain. It's often an independent cause of disrupted sleep patterns, leaving the patients irritable and tired.

To cope with this issue, I advise effective and practical tips to my patients to sleep properly and comfortably with SI joint pain.

What follows is my personal experience that has helped my patients, and can help you, to improve your sleep quality and find relief.How to sleep with SI joint pain

Sleep Position Matters

Your sleep position plays a crucial role in managing SI joint pain. Here are some tips on how to position yourself for a more comfortable night's sleep.

Sleeping in Foetal Position

If sleeping on your back is uncomfortable, try curling into the foetal position. Place a pillow between your knees to support your hips and keep your spine in alignment.

Back Sleeping

Sleeping on your back is often the best position for SI joint pain sufferers. Place a pillow under your knees to help maintain a natural curve in your lower back. This can reduce pressure on the SI joint.

Stomach Sleeping (Avoid This One)

Sleeping on your stomach can strain the SI joint and make your SI pain worse. It also tends to force your neck into an awkward position that puts pressure on the lower area.

If you're a stomach sleeper, consider switching to one of the more joint-friendly positions mentioned above.

Pillows & Cushions Can Help SI Joint Pain

Using cushions and pillows strategically can make a big difference in your sleep comfort. It's good to experiment, but here are some pointers.

Lumbar Support Pillow

If you sleep on your back, a lumbar support pillow can help maintain the natural curve of your lower portion and reduce SI joint pressure.

Body Pillow

A body pillow can provide support and comfort in various sleep positions.

You can hug it when sleeping on your side to keep your spine aligned or use it to prop up your legs when sleeping on your back.

Knee Pillow

A knee pillow is specifically designed to help with SI joint pain.

Placing one between your knees when sleeping on your side can help maintain proper alignment and reduce pressure on the SI joint.

Choose the Right Mattress

Your choice of mattress can significantly impact your sleep quality, especially if you have SI joint pain. Here are some mattress considerations[5].

Mattress Firmness

A medium-firm mattress is often a good choice for SI joint pain. It provides support while still allowing some contouring to your body's shape.

Innerspring Mattresses

If you prefer a traditional innerspring mattress, look for one with a pillow top or extra cushioning to provide more comfort for your joints. A little padding between your bones and those springs can go a long way. 

Memory Foam Mattresses

Memory foam mattresses can be beneficial for SI joint pain as they conform to your body, offering support where you need it most.

However, they may retain heat, so make sure to choose one with cooling technology if you tend to sleep hot.

Adjustable Beds

Adjustable beds can be a game-changer for SI joint pain sufferers. They allow you to customize your sleep position, which can help alleviate pressure on the SI joint.

Additional Tips For Better Sleep With SI Joint Pain

Here are some more tips that I advise my patients to enhance their sleep quality when dealing with SI joint pain[6].

Heat Therapy

Applying a heating pad to the affected area for 15-20 minutes before bedtime can help relax the muscles around the SI joint. If you don't have a heat pad then heat rubs such as Tiger Balm or Deep Heat can help.

Stay Active, Consider Swimming

Engaging in regular low-impact exercises and stretches can help reduce pain and improve SI joint stability.

Swimming is typically the go-to low impact exercise for back pain and can help SI joint pain too. Stronger muscles and soft tissues in the surrounding areas will always be a good thing. 

Painkillers & Medication

Consult with your healthcare provider about pain-relieving medications or muscle relaxants if your SI joint pain is severe and interfering with sleep.

I wrote about painkillers for back pain here and the article has some good information on the different types. But, of course, always check with your doctor before taking medications.


Posture matters whether you're standing or sitting. Since sitting with SI joint pain can also be so tricky, see our complete article on that topic at the link above.


Include stretching exercises specific to your SI joint to increase flexibility and reduce pain. Consult with a physical therapist for personalised stretches. We have a lot of stretches for the back here.

Mindfulness and Relaxation

Practice relaxation techniques such as deep breathing, meditation, or yoga before bedtime to improve sleep quality and reduce stress.

Supportive Shoes

Wear supportive footwear during the day to help with SI joint stability, as improper alignment during the day can lead to night-time discomfort.

    Consult a Specialist If You Need More Than Tips

    If your SI joint pain persists despite trying various sleep strategies, I recommend consulting with a specialist.

    That usually means a physical therapist, chiropractor, or orthopaedic specialist for personalised guidance and treatment options.

    Sleep Hygiene for SI Joint Pain

    How to sleep with SI joint painWhile the physical aspects of SI joint pain matter for recovery, it's equally important to consider your sleep environment and habits.

    Proper sleep hygiene can significantly impact your healing process and pain management.

    I'll share a few pointers with you. I also advise my patients on these tips to optimise their sleep hygiene for healing and better rest in general.

    Create a Comfortable Sleep Environment

    Your environment makes a big difference to your sleep quality. A few tweaks to improve it can make a big difference, even if you don't have SI joint pain.

    Here are some key differentiators. 

    Ideal Temperature

    Maintain a comfortable room temperature. A cooler room, usually around 18-20°C (65-68°F), is often best for sleep.

    Experiment with different temperatures to find what suits you. It's common for men to sleep better with colder temperatures and for women to sleep better with hotter temperatures.

    Optimal Lighting

    Keep your bedroom dark when it's time to sleep. Use blackout curtains or an eye mask to block out external light sources. Exposure to light, especially blue light from screens, can disrupt your sleep cycle. We'll get to screens in a moment.

    Comfortable Bedding

    Ensure your pillows and mattress are comfortable and supportive. A quality mattress topper or memory foam pillow can make a significant difference in your sleep comfort.

    Noise Control

    If noise is an issue, consider using earplugs or white noise machines to mask disruptive sounds. Alternatively, use soft earbuds to listen to calming music or nature sounds.

    Stick to a Consistent Sleep Schedule

    Avoid Naps

    While naps can be tempting, they may interfere with your night-time sleep. If you must nap, keep it short (20-30 minutes) and earlier in the day.

    This point can differ depending on age and the level of physical activity you engage in. If you're older and/or do a lot of physical work, it may be okay to power nap.

    Personally, I like to set my alarm for 25 minutes to give me five minutes to get to sleep, then hit that optimal 20 minutes for the nap. 

    Regular Bedtime

    Try going to bed and wake up at the same time every day, even on weekends. This helps regulate your body's internal clock and improves sleep quality.

    Mind Your Eating Habits

    • Limit Caffeine and Alcohol: Both alcohol and caffeine can disturb your sleep cycle. Avoid using them in the hours leading up to bedtime.
    • Avoid Heavy Meals: Don't eat spicy or large meals close to bedtime. Digesting heavy foods can disrupt your sleep. Aim to finish eating at least 2-3 hours before bedtime.
    • Hydration: While it's essential to stay hydrated, try to limit your fluid intake in the evening to avoid waking up for bathroom trips during the night.

    Establish a Relaxing Bedtime Routine

    • Journaling: If you have a lot on your mind, consider jotting down your thoughts in a journal to release any mental tension.
    • Wind Down: Create a soothing bedtime routine to signal to your body that it's time to sleep. This might include gentle stretches, deep breathing exercises, or meditation.

    Digital Detox Before Bed

    In my experience, many people don't realise the effect that too much time on screens before bed time can have a big impact on their sleep.

    This is especially true if you follow stressful news events right before bed. Here are two tips I always recommend my patients who struggle with sleep.

    Relaxation Activities

    Instead of screen time, engage in relaxing activities like reading a book, taking a warm bath, or practising relaxation exercises.

    Screen Time

    The blue light emitted by smartphones, tablets, and computers can interfere with your body's production of melatonin, a hormone that regulates sleep. Avoid screens at least an hour before bedtime.

    Stress Reduction Techniques

    On the topic of stress, it's not just your screens that will do it.

    If you're working hard, having a tough time with your family dynamics or anything else, it will make sleeping with SI joint pain more difficult. 

    Positive Sleep Associations

    Make your bedroom a refuge for relaxation and sleep. Avoid using your bed for work or watching TV. This helps your brain associate your bed with restful sleep.

    Stress Management

    High stress levels can exacerbate SI joint pain and disrupt your sleep. Incorporate stress-reduction techniques like mindfulness meditation, progressive muscle relaxation, or yoga into your daily routine[6].

    Physical Comfort for SI Joint Pain

    • Mattress Maintenance: Frequently rotate or flip your mattress to prevent sagging and maintain its supportiveness.
    • Proper Support: Make sure your sleep position and bedding support your SI joint pain relief efforts, as mentioned earlier. Use knee pillows or lumbar support as needed.

    The Bottomline: An Expert’s Advice

    For my patients, I approach sleep SI joint pain sleep issues with a multifaceted approach that blends physical comfort with sleep hygiene practices.

    My patients often find relief by optimising their sleep environment with the right mattress, pillows, and a consistent sleep schedule.

    Strategic use of knee pillows, lumbar support, and relaxation techniques can significantly improve sleep quality and ease pain.

    I try digging out the cause of their stress and address it, recommend physical activity to stay active with low-impact exercises. Naturally, being a doctor, I always advise on maintaining a healthy bedtime routine.

    My advice for the readers is to understand the crucial nature of SI joint pain management.

    Dealing with sleep problems due to SI joint pain is a personal journey, and an in-person evaluation by a health professional can be invaluable to find your specific needs.

    Prioritising good sleep is not just about rest; it's a critical component of your healing process and overall well-being when living with SI joint pain.


    1. Spine Health. Sacroiliac Joint Dysfunction (SI Joint Pain). https://www.spine-health.com/conditions/sacroiliac-joint-dysfunction/sacroiliac-joint-dysfunction-si-joint-pain

    2. Physiopedia. Sacroiliac Joint. https://www.physio-pedia.com/Sacroiliac_Joint Spine Connection. Sacroiliac Joint Dysfunction. https://spineconnection.org/back-pain-conditions/sacroiliac-joint-dysfunction/

    3. Spine Connection. Sacroiliac Joint Dysfunction. https://spineconnection.org/back-pain-conditions/sacroiliac-joint-dysfunction/

    4. Weill Cornell Center For Comprehensive Spine Care. Why Is My Sacroiliac Joint Pain Worse at Night? https://comprehensivespine.weillcornell.org/why-is-my-sacroiliac-joint-pain-worse-at-night-2

    5. Pain Teq. How to Sleep With SI Joint Pain. https://www.painteq.com/how-to-sleep-with-si-joint-pain

    6. Release Muscle Therapy. How to Sleep With SI Joint Pain. https://releasemuscletherapy.com/how-to-sleep-with-si-joint-pain/