When pain in your SI joint flares up, your doctor can bring you relief, but a few moves at home can help, too. It helps to be active, but start slowly, like with a few minutes of daily walking, swimming, or riding a stationary bike. If your pain level doesn’t go up, work up to 20 or 30 minutes of exercise at a time. Iyengar yoga, a gentle practice that focuses on better posture, can also stretch out the tight muscles and joints that could be adding to your back pain.
Some movements can make SI joint pain worse and keep you from healing. Try not to bring your knees to your chest, do sit-ups, twist, or bend from the waist with your knees straight. Running should be off-limits until you’re on the mend. You’ll also want to stay away from activities where you shift your weight from one leg to the other, like golfing, step aerobics, or ice skating. They’ll put more stress on your SI joint.
An ice pack can bring down swelling around your SI joint and numb the pain you feel. Apply one for 20 minutes at a time, then wait at least 30 minutes before you ice it again. That way, you’ll prevent frostbite and let the blood vessels in the area get back to normal. Heat can also be a good choice for tight and painful muscles. Try a heating pad or hot water bottle on your back.
You need to keep from overdoing it, but bed rest isn’t usually the way to go. How active you should be early on depends on the cause of your SI pain. Light walking can often help ease your aches and speed healing. Rest in bed for a few hours on the first day or two that you’re in pain. Keep your body in a neutral position. If you sleep on your back, please a pillow under your knees. If you're a side sleeper, place a pillow between your knees (women may also need a pillow in the small of their waist to prevent bending sideways). Then get moving again as soon as you can.
Good posture can help keep extra stress off your lower back. If you have SI joint dysfunction, limit how often you shift your weight to one side of your body. When you sit, uncross your legs and try not to lean into one hip. Avoid sitting on your wallet or cell phone. When you stand, balance your weight between both legs and feet. And try not to bend at the waist when you pick things up off the floor.
Some people get relief from wearing a special lightweight brace called a sacroiliac belt. Your doctor might ask you to wear one to keep your SI joint from moving too much so it can heal. You’ll need to wear it all day. Wearing it only sometimes probably won’t help.
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can ease SI pain. These meds reduce swelling, too, so your doctor may ask you to keep taking them even after you start to feel better to make sure you heal completely. They can cause problems if you take them for a long time, though, like an upset stomach, ulcers, rashes, or high blood pressure. If you need to take them for more than 30 days, ask your doctor how to avoid side effects.
If nothing seems to tame your SI joint pain, see your doctor for medical treatment. He can prescribe medications, injections, or recommend an appointment with a physical therapist or a chiropractor. Also, you can ask him about alternative treatments that might help. Massage therapy may help relax the tissue around the joint. Some people get relief from acupuncture, in which thin needles are gently placed into the skin at certain points of your body. When needed, surgery can also help ease the pain.