Sacroiliac Joint Pain: Why The Low Back Aches On One Side, And Why Stability Beats Stretching
Sacroiliac joint pain: the short answer
Sacroiliac joint pain is an ache low in the back, usually on one side, near the dimple at the top of the buttock. It comes from the two sacroiliac (SI) joints, where the base of the spine meets the pelvis. When the pelvis is uneven, these joints can ache, especially when you stand on one leg, climb stairs or roll over in bed.
What helps most is an even, stable pelvis and strong legs, more than deeper stretching. That is exactly what Iyengar standing poses train. Here is the article in short form:
- SI joint pain sits low on one side, where spine meets pelvis.
- Most of us are lopsided, and the SI joints feel it.
- A sore SI joint needs stability and strength, not more stretch.
- Even feet, level hips: the core of the work.
- Twelve yoga classes kept backs working better for a year.
- Never push through SI pain.
A quick word on Iyengar yoga. Iyengar yoga is the style developed by Mr BKS Iyengar. In the 20th century he did more than anyone to set down traditional Indian yoga, and he is known for his precise attention to alignment, of muscles, bones and joints. It is the style we teach at Flametree, in Darwin and live online.
Both feet working, both hips level. An even pelvis in the standing poses is the core of SI joint work.
What is the sacroiliac joint?
At the base of the spine is a flat, triangle-shaped bone, the sacrum. On either side it meets the big bones of the pelvis at the two sacroiliac joints. They move only a little, but they carry the whole weight of the upper body down into the legs, every step you take.
When the pelvis is level and both legs share the load, the joints are happy. When one side takes more, for years, one joint starts to complain. Geeta Iyengar, Mr Iyengar’s daughter and senior teacher, put the goal in one line: “Freedom on the sacroiliac muscles gives full extension.”
Why does my lower back hurt on one side?
Because most of us are lopsided. We stand more on one foot, sit more on one buttock, cross the same leg and point our two feet in different directions. We do not notice any of it until it hurts.
Dr Krishna Raman, a medical doctor from Chennai who studied yoga with Mr Iyengar, describes the motorbike rider who kick-starts the bike with the same leg for years. In time, the buttock on that side begins to ache. Sport does the same. When the Australian Test opener Justin Langer visited Mr Iyengar’s institute in Pune in 2004, Mr Iyengar told him over tea he could see trouble in his lower back “by the way you are sitting there”. He found tight muscles in the lower back and buttock on one side, and put it down to the long hours Langer spent batting left-handed.
Hips squared, hands on a chair. Keeping the two sides of the pelvis level is what a sore SI joint needs.
Should I stretch a sore SI joint?
Mostly not more. Rachel Krentzman, a yoga therapist and author of Yoga for a Happy Back, says a sore sacroiliac needs stability and strength more than deeper stretching, and that pain there should never be pushed through.
That fits what we see. Deep, one-sided stretches and strong twists can rock an unstable joint further. Standing poses with both feet pressing evenly, the thighs working and the hips level build the support around the joint instead.
Get the free ebook Happy Backs. New to Flametree, or away for 3 months or more? You get 2 free classes + 2 ebooks, only available via this offer. Already coming to class? You can still get the book.
Does yoga help sacroiliac joint pain?
Yoga is one of the best tested practices for low back pain, and SI pain sits inside that. In an English trial of 313 adults with long-lasting low back pain, 12 yoga classes left the yoga group’s backs working better at 3, 6 and 12 months. A large Cochrane review found yoga eased pain and improved function compared with no exercise.
And it is safe: in that review, about 5 more people in every 100 had a short flare of back pain with yoga, and none was serious. In our classes, poses are changed for a sore joint from the first day.
Twelve classes, and backs worked better for a whole year. That is the English trial of 313 adults.
What does an Iyengar class do for SI joint pain?
- Even feet. Mountain Pose with a block between the thighs shows you where your weight really falls.
- Level hips in the standing poses. Both feet working, both hips level, in Triangle, Warrior 2 and Intense Side Stretch.
- Strength around the pelvis. The thighs and buttocks work to hold the joint steady.
- Gentle twists. Turning comes from the upper back, with a chair holding the pelvis still.
- Sitting bones, not the tail. A folded blanket under the sitting bones keeps the pelvis upright in seated poses.
Our books and posts explain rather than teach poses step by step, because a teacher adjusts each pose to the person in front of them.
A chair twist turns from the upper back while the pelvis stays still. Twists are kept gentle for a sore SI joint.
Yoga for backs is safe: in the Cochrane review, about 5 in 100 had a short flare, and none was serious.
How long does SI joint pain take to settle?
Many people feel steadier within a few weeks of regular classes. In the English trial, twelve classes over three months gave gains that were still there a year later. The habits matter as much as the poses: standing evenly, sitting on both sitting bones, and swapping the leg you cross.
Where can I get help with SI joint pain in Darwin?
For SI joint pain in Darwin, come to class at Flametree’s Woolner or Coolalinga studio, or join live online from anywhere in Australia. Our beginner classes work on even standing and strong legs, and the Wednesday evening Yoga For Backs class, in the studio, focuses on backs. Tell your teacher before class so they can adapt the poses for you. Feel free to check with your professional advisers if you wish, but also give yoga a try.
See also How To Reduce Lower Back Pain, Tight Hips and Yoga For A Sore Back.
Happy Backs, our free ebook on yoga for backs, with a section on the sacroiliac.
Your free copy of Happy Backs is waiting. New to Flametree, or away for 3 months or more? You get 2 free classes + 2 ebooks, only available via this offer. Already coming to class? You can still get the book.
Frequently asked questions
Where is sacroiliac joint pain felt?
Usually low in the back on one side, near the dimple at the top of the buttock. It can spread into the buttock or the back of the thigh, and often aches on standing on one leg, climbing stairs or rolling over in bed.
What causes SI joint pain?
Most often a pelvis that takes uneven load for years: standing on one leg, sitting on one buttock, one-sided sport or work. Pregnancy and falls can also set it off. Even standing and strong legs take the strain off the joint.
Is stretching good for SI joint pain?
Mostly not more stretching. The yoga therapist Rachel Krentzman says a sore sacroiliac needs stability and strength more than deeper stretching, and pain there should never be pushed through. Even, strong standing poses build that support.
Can yoga make SI joint pain worse?
Deep one-sided stretches and strong twists can, which is why they are changed for a sore joint. Overall yoga for backs is safe: in the Cochrane review, about 5 in 100 people had a short flare, and none was serious.
Which yoga poses help the sacroiliac joint?
Standing poses with both feet working evenly and the hips level, such as Mountain Pose with a block between the thighs, Warrior 2 and Triangle. Twists are kept gentle, turning from the upper back with the pelvis held still.
Why does my SI joint hurt when I sit?
Sitting on the tail, with the pelvis tucked under, or on one buttock loads the joint unevenly. Sitting on both sitting bones, with a folded blanket under them if needed, keeps the pelvis upright and the load even.
How long does SI joint pain last?
It varies, but many people feel steadier within a few weeks of regular classes. In an English trial, 12 yoga classes left people’s backs working better a full year later. Daily habits, like standing evenly, matter as much as the poses.
Where can I get help with SI joint pain in Darwin?
Flametree Yoga Studio teaches Iyengar yoga at Woolner and Coolalinga in Darwin and live online. Beginner classes work on even standing and strong legs, and the Wednesday evening Yoga For Backs class focuses on backs.
Where to next
- New to yoga, or coming back? Start with our half price 10 class pass with 2 classes free, in Darwin or live online.
- For a workplace, team or group: book private yoga classes for groups, online, at a Flametree studio or at your venue.
- Want to see class times first? Look at the beginner timetable.
Flametree Yoga Studio, Darwin and live online. This article is general information, not medical advice. Feel free to check with your professional advisers if you wish, but also give yoga a try.
Sources: Tilbrook HE and colleagues, Yoga for chronic low back pain: a randomized trial (313 adults), Annals of Internal Medicine, 2011; Wieland LS and colleagues, Yoga treatment for chronic non-specific low back pain, Cochrane Database of Systematic Reviews, 2017; Rachel Krentzman, Yoga for a Happy Back, 2016; Dr Krishna Raman, A Matter of Health; Greg Wythes, Aussies Go To Bat For Yoga, Australian Yoga Life, 2005; Geeta Iyengar’s teaching. Further reading: Tilbrook and colleagues, Annals of Internal Medicine, 2011. Full references are in the Happy Backs ebook.
