Posture for sacroiliac joint pain: 13 medically-approved methods

If you frequently experience sacroiliac (SI) joint pain, even sitting for work, driving, or watching TV for about 20–30 minutes can intensify pain in your lower back, buttocks, or hips. According to the World Health Organization (WHO), lower back pain is one of the leading causes of disability globally, and many cases are related to SI joint dysfunction. In fact, just a single incorrect sitting posture can increase pressure on the joint, leading to prolonged pain and difficulty recovering.

In this article, Tiptory will guide you on how to sit with SI joint pain, share postures that help reduce SI joint pain while working or resting, and introduce simple stretching exercises to alleviate pressure on the joint. If you are looking for safe, easy-to-apply at-home solutions to reduce SI joint pain and improve your daily quality of life, this information will be very helpful to you.

Method 1: Keep your chest open, shoulders relaxed

Maintain correct upper body posture to reduce pressure on the SI joint

• When sitting, slightly open your chest and keep your shoulders naturally relaxed, avoiding slouching or shrugging your shoulders forward. This is one of the simplest ways to reduce SI joint pain when sitting for long periods.

• Imagine a string pulling the crown of your head towards the ceiling. This helps to naturally lengthen your spine, prevent hunching, and distribute body weight more evenly.

• After slightly arching your chest to feel the natural curve of your spine, gently relax your body by about 10%. This posture helps you maintain a comfortable sitting position without putting excessive pressure on your lower back and SI joint.

• Avoid trying to sit too straight or tensing your shoulder and back muscles for extended periods. A natural, relaxed posture is easier to maintain and effectively helps to reduce SI joint pain.

Why does upper body posture affect the SI joint?

• The SI joint connects the spine to the pelvis and transmits force from the upper body to the legs when sitting, standing, or moving.

• When you sit in an incorrect posture, the force on your spine and pelvis increases, making SI joint pain more likely to appear or become more severe.

• Maintaining a correct sitting posture not only helps to reduce SI joint pain but also alleviates lower back muscle tension, improves spinal stability, and prevents pain recurrence when working or studying for long periods.

Method 2: Keep your knees slightly apart

Keep knees and feet in the correct position to reduce pressure on the SI joint

• When sitting, keep your knees slightly apart, just enough to relax your hip flexors. This helps reduce tension on the pelvis and more effectively reduces SI joint pain.

• If hip flexor muscles are tight for too long, they can alter the position of the pelvis and lumbar spine, thereby making SI joint pain more severe.

Do not sit against the front edge of the chair with the backs of your knees

• Leave a small gap between the back of your knees and the front edge of the chair, about 2–5 cm is suitable for most people.

• This gap helps prevent the pelvis from tilting too far backward or forward, while improving sitting posture and reducing pressure on the SI joint.

Place your ankles slightly in front of your knees

• Instead of having your ankles directly under your knees, move your feet forward slightly so your ankles are a bit in front of your knees.

• This posture helps distribute body weight more evenly between the hips, pelvis, and spine, helping to reduce SI joint pain when sitting for long periods.

Place your feet firmly on the floor

• Always place both feet flat on the floor to create a stable base for your body.

• If your chair is too high for your feet to touch the ground, use a footrest to keep your knees and hips in a comfortable position.

• Avoid sitting on your toes, crossing your legs, or dangling your legs, as these postures can unbalance the pelvis and increase SI joint pain.

Method 3: Distribute body weight evenly

Sit evenly on both hips

• When sitting, distribute your body weight evenly on both buttocks so that both hip bones are on the same plane. This is an important principle to help reduce SI joint pain and prevent uneven pressure on the pelvic region.

• Avoid leaning to one side or placing weight only on one buttock for extended periods, as this can make SI joint pain more severe.

Do not cross your legs when sitting

• Limit the habit of crossing your legs, as this posture causes one side of the pelvis to be higher than the other, leading to imbalance in the spine and SI joint.

• If you need to change your posture, place both feet parallel on the floor instead of stacking them.

Keep both knees bent at approximately 90 degrees

• Adjust your chair height so that your knees are bent at about 90°, with your thighs almost parallel to the floor.

• This angle helps the pelvis maintain a neutral position, reduces pressure on the SI joint, and supports better blood circulation when sitting for long periods.

Why is even weight distribution necessary?

• The SI joint is responsible for transmitting force between the spine and legs, and helps the body maintain balance when sitting, standing, and moving.

• When body weight is evenly distributed, both SI joints share the load, reducing overload on one side and more effectively helping to reduce SI joint pain.

• Combining balanced sitting posture with changing positions every 30–60 minutes will help reduce muscle tension in the lower back and hips, and prevent pain recurrence.

Method 4: Use a pillow to support your lower back

Increase spinal support when the chair lacks proper backrest

• If your chair doesn't have lumbar support, place a small pillow or roll up a thin towel behind your lower back. This is a simple way to maintain the natural physiological curve of the spine and help reduce SI joint pain when sitting for long periods.

• Place the pillow in the curve of your back, just above your sacrum, so your lower back is gently supported while maintaining a natural sitting posture.

Choose the right pillow size

• The pillow or rolled towel should be of appropriate size, just enough to fill the gap between your back and the chair back.

• Avoid using pillows that are too thick or too firm, as they can overarch the lower back, increasing pressure on the spine and SI joint, making the pain more uncomfortable.

Maintain the natural curve of the spine

• The purpose of a support pillow is to support the spine in a neutral position, not to force the back to sit too straight.

• When the spine maintains its natural physiological curve, the force on the lower back and SI joint will be more evenly distributed, thereby helping to reduce SI joint pain and limit muscle fatigue when sitting for extended periods.

Combine with correct sitting posture

• Lumbar support will be most effective when you simultaneously keep your shoulders relaxed, both feet firmly on the floor, knees bent at about 90°, and weight distributed evenly on both hips.

• Don't forget to stand up, walk around, or do some stretching exercises every 30–60 minutes to relieve continuous pressure on the SI joint and improve muscle and joint flexibility.

Method 5: Stand up and move frequently

Do not sit continuously for too long

• If you have to work or study for long periods, stand up after every 30 minutes of sitting and do light exercise for about 5 minutes. This is a simple but very effective habit to reduce SI joint pain and prevent joint stiffness.

• Changing your posture frequently helps reduce compression pressure on the SI joint, while improving blood circulation and reducing tension in the lower back and hip muscles.

Benefits of short breaks between sitting sessions

• Studies show that breaking up long periods of sitting can help reduce lower back pain—one of the most common symptoms of SI joint pain.

• Standing up, stretching, or walking around for a few minutes also helps reduce fatigue, improve alertness, and increase focus when working.

Walking to help relieve pain

• If possible, spend about 15 minutes walking at a moderate pace daily or during breaks.

• Walking helps the hip, gluteal, and lower back muscles work rhythmically, increases pelvic stability, and naturally helps to reduce SI joint pain.

• Avoid sitting back down immediately after standing up. Use your break time to get water, perform a few stretches, or walk around the room to help your joints relax and reduce the risk of pain recurrence.

Create a habit of daily movement

• Set reminders on your phone or computer to prompt you to stand up every 30–60 minutes.

• Maintaining this daily habit not only helps to reduce SI joint pain but also protects your spine, reduces lower back pain, and improves overall health when sitting for long periods of work.

Method 6: Stretch your back with a seated back extension

Perform stretching exercises to relieve lower back and SI joint pain

• If your SI joint pain radiates to your lower back or buttocks, you can perform a seated back extension to help relax your muscles and reduce stiffness.

• Sit close to the front edge of the chair, keep both feet firmly on the floor, and maintain a stable posture before starting.

Steps to perform

1. Sit upright about 1/3 of the way from the front of the seat.

2. Reach both hands behind you and grasp the edge or back of the chair.

3. Slowly pull your shoulder blades back, while opening your chest and gently arching your upper back.

4. Keep your neck in a neutral position, eyes looking straight ahead, and breathe slowly and evenly.

5. Hold the posture for 1–3 breaths, then return gently to the starting position.

Repeat according to your body's ability

• You can repeat the exercise several times a day, especially after sitting continuously for 30–60 minutes.

• Only perform within a comfortable range. Do not try to overarch your back or hold your breath while stretching.

Notes to ensure safety

• Stop immediately if pain increases, sharp pain occurs, or numbness radiates down your leg.

• The movement should create a gentle stretch in the chest and back, without causing pain in the SI joint or spine.

• If SI joint pain persists, recurs frequently, or is accompanied by leg weakness, numbness, or loss of bladder control, you should consult a doctor or physical therapist for evaluation and appropriate exercise guidance.

Why is this exercise effective?

• Opening the chest and pulling the shoulder blades back helps improve sitting posture, reducing pressure on the lumbar spine and SI joint.

• Regular practice combined with correct sitting posture and regular breaks can help reduce SI joint pain, increase spinal flexibility, and help you sit more comfortably for longer periods.

Method 7: Perform seated cat-cow exercise

Spinal stretching to relieve SI joint pain

• The seated cat-cow exercise helps increase spinal flexibility, relax the muscles around the back and pelvis, thereby helping to reduce SI joint pain and decrease stiffness in the lower back.

• This is a gentle exercise, suitable for people who frequently sit for work or often experience SI joint pain.

Steps to perform

1. Sit at the front edge of the chair, with both feet firmly on the floor and knees bent at approximately 90°.

2. Place both hands on your thighs and keep your shoulders relaxed.

3. Inhale, slowly lift your chest and chin, pull your shoulder blades back and down, avoiding shrugging your shoulders towards your ears. This is the "cow" pose.

4. Exhale, gently contract your abdominal muscles, round your back into an arch, and tuck your chin towards your chest. This is the "cat" pose.

5. Perform slowly with your breath, repeating 1–3 times or more if your body feels comfortable.

Benefits of the cat-cow exercise

• Helps relax the muscle groups that support the spine and SI joint.

• Improves spinal mobility, reduces back stiffness after prolonged sitting.

• Helps to reduce SI joint pain, alleviates tension in the lower back and hip muscles, and improves sitting posture.

Notes when performing

• Move slowly, coordinating smoothly with your breath, do not perform movements too quickly or too forcefully.

• Only stretch to a comfortable level, do not force your body beyond its limits.

• If SI joint pain increases, sharp pain radiates down your leg, or you experience numbness, stop the exercise and consult a doctor or physical therapist.

• For better results, combine this exercise with correct sitting posture, standing up to move every 30–60 minutes, and maintaining exercises that strengthen your core, hip, and gluteal muscles.

Method 8: Rotate your upper body to increase spinal flexibility

Spinal stretching helps relieve SI joint pain

• The seated upper body rotation exercise helps increase spinal mobility, especially in the upper and middle back. When the spine is more flexible, pressure transmitted to the SI joint is also more evenly distributed, contributing to SI joint pain relief.

• This exercise is suitable for people who frequently sit for work, helping to improve posture and reduce back stiffness.

Steps to perform

1. Sit upright on a chair, with both feet firmly on the floor and both hips balanced.

2. Cross your arms over your chest, placing each hand on the opposite shoulder.

3. Slowly rotate your upper body to the left until you feel a gentle but comfortable stretch.

4. Hold the posture for about 5 seconds and breathe evenly.

5. Return to the starting position, then rotate to the right and hold for another 5 seconds.

6. Repeat the movement about 5 times for each side.

Keep your hips still when twisting

• Throughout the exercise, keep your hips and pelvis facing straight forward, only rotating your upper body.

• Do not let your knees or hips rotate with your body, as this will reduce the effectiveness of spinal stretching and may increase pressure on the sacroiliac joint.

Benefits of the exercise

• Increases flexibility of the spine and back muscles.

• Helps improve sitting posture, reducing hunching and body rotation.

• Helps reduce sacroiliac joint pain, ease lower back muscle tension, and improve pelvic stability in daily activities.

Notes when exercising

• Perform the movement slowly, without twisting too forcefully or abruptly.

• Only twist to a comfortable range, do not try to reach maximum range of motion.

• If sharp pain, radiating pain down the leg, or increased sacroiliac joint pain occurs during exercise, stop immediately and consult a doctor or rehabilitation specialist. Combining this exercise with frequent changes in sitting posture will provide better pain relief.

Method 9: Seated hamstring stretch

Loosen hamstrings to reduce pressure on the sacroiliac joint

• The hamstrings are located at the back of the thigh and play an important role in stabilizing the pelvis and sacroiliac joint. When these muscles are tight, pressure on the pelvic region and lumbar spine can increase, making sacroiliac joint pain more severe.

• Regular hamstring stretching helps increase flexibility, improve mobility, and aids in reducing sacroiliac joint pain.

Steps to perform

1. Sit upright on a chair, with both feet flat on the floor.

2. Keep one leg naturally bent, and extend the other leg straight forward, heel touching the floor and toes pointing up.

3. Keep your back straight, slowly lean forward from your hips, while reaching both hands towards the foot of the extended leg.

4. There's no need to try to touch your toes. Just lean until you feel a gentle stretch in the back of your thigh.

5. Hold the position for about 10–30 seconds, then return to the starting position and switch to the other leg.

Perform correctly for effectiveness

• Always keep your back in a natural position, avoiding excessive rounding of the back when bending forward.

• Move slowly and combine with steady breathing to allow muscles to relax better.

• You can perform 2–3 repetitions for each side, especially after prolonged sitting.

Notes when stretching

• Only bend forward until you feel a gentle stretch in the back of your thigh; do not try to reach your toes if your body is not yet flexible enough.

• Stop the exercise if sharp pain occurs in your back, hip, or sacroiliac joint.

• Combining this exercise with movements that strengthen the abdominal, gluteal, and hip muscles, along with changing your posture every 30–60 minutes, will help to more effectively reduce sacroiliac joint pain and improve long-term mobility.

Method 10: Tailor's Sit to relax the sacroiliac joint

Stretch hips and pelvis while sitting on the floor

• The Tailor's Sit is a gentle stretching exercise that helps increase the flexibility of the hips, inner thighs, and pelvis, thereby helping to reduce sacroiliac joint pain.

• This exercise is particularly suitable for pregnant women with sacroiliac joint pain, but also benefits anyone experiencing pain or stiffness in the pelvic area.

Steps to perform

1. Sit on the floor or a yoga mat, keeping your spine straight and shoulders relaxed.

2. Bend both knees, bringing the soles of your feet together.

3. Allow both knees to open naturally to the sides, creating a butterfly-like posture.

4. Place both hands on your feet or ankles to maintain a stable position.

5. Breathe slowly and steadily, maintaining the posture for about 20–30 seconds or longer if comfortable.

Increase stretch if needed

• If you want to stretch deeper, slowly lean forward from your hips, keeping your back straight instead of rounded.

• Hold the position for about 5 seconds, then slowly return to the starting position.

• Only go as far as you feel a gentle stretch in your hips, inner thighs, or pelvis; do not force your body down too far.

Benefits of the posture

• Helps relax the muscles of the hips, inner thighs, and pelvic floor.

• Improves hip joint flexibility and reduces stiffness around the sacroiliac joint.

• Aids in reducing sacroiliac joint pain, alleviating discomfort in the buttocks, hips, and lower back, while improving daily mobility.

Notes when performing

• Always keep your spine in a neutral position and avoid excessive rounding of the back.

• Do not use your hands to forcefully push your knees towards the floor, as this can cause muscle strain or increase joint pressure.

• If pregnant or experiencing severe sacroiliac joint pain, practice with gentle range of motion and consult a doctor or physical therapist before performing regularly.

• Stop the exercise if sharp pain or increased pain occurs during stretching.

Method 11: Choose an office chair that supports the spine

Prioritize chairs with lumbar support

• If you often have to sit for work, choose a chair designed to conform to the natural curve of your spine, especially the lumbar region. This is an important factor in helping to reduce sacroiliac joint pain and prevent back fatigue when sitting for many hours.

• The backrest should have a gentle curve to support the lower back, helping to maintain a neutral sitting posture and reduce pressure on the sacroiliac joint.

Adjust chair height appropriately

• Adjust the chair so that your knees are roughly level with your hips or slightly lower than your hips.

• When sitting at the correct height, both feet can be placed completely on the floor, which helps distribute weight evenly and reduces pressure on the pelvic area.

• If your feet don't touch the floor, use a footrest to maintain a stable sitting posture.

Adjust armrests correctly

• If the chair has armrests, adjust them so that your wrists are level with or slightly below your elbows when working.

• Armrests at the appropriate height help relax your shoulders, reduce tension in your neck, shoulders, and upper back, and prevent you from leaning or shrugging your shoulders for extended periods.

Notes when choosing a chair

• Choose a seat that is wide enough for you to sit comfortably but not too deep, ensuring there's about 2–5 cm between the edge of the seat and the back of your knees.

• Prioritize chairs with adjustable height, backrest tilt, and armrests to suit individual body types.

• Even with a good quality chair, you should still get up and move around every 30–60 minutes. Combining the right chair with correct sitting posture will help to reduce sacroiliac joint pain, protect your spine, and improve long-term work efficiency.

Method 12: Replace your chair with an exercise ball

Use an exercise ball to reduce pressure on the sacroiliac joint

• If you have to sit for long periods, you can replace your regular chair with an exercise ball (or yoga ball) for short periods. The elastic surface of the ball helps reduce direct pressure on the tailbone and sacroiliac joint, thereby helping to reduce sacroiliac joint pain.

• However, an exercise ball should not completely replace an office chair because sitting on the ball for too long can cause muscle fatigue and reduce the effectiveness of maintaining good posture.

Strengthen core muscles

• When sitting on an exercise ball, your abdominal muscles, back muscles, and the muscles around your pelvis automatically engage to keep your body balanced.

• Regularly activating these muscle groups helps strengthen your core, improve spinal stability, and reduce the burden on the sacroiliac joint during daily activities.

Use correctly for effectiveness

• Choose a ball that is the right size for your height so that when you sit, your knees are bent at approximately 90° and both feet are flat on the floor.

• Keep your spine in a neutral position, shoulders relaxed, and weight evenly distributed on both hips.

• Initially, only sit for about 15–30 minutes at a time, then switch to a chair with a backrest to avoid muscle fatigue.

Notes when using an exercise ball

• Do not use an exercise ball if you are experiencing acute sacroiliac joint pain, have balance issues, or are at risk of falling.

• If you feel increased pain or difficulty maintaining proper posture, return to using a chair with good back support and consult a doctor or physical therapist.

• To effectively reduce sacroiliac joint pain, combine the exercise ball with core, back, and gluteal muscle strengthening exercises, and change your posture every 30–60 minutes instead of sitting continuously for many hours.

Method 13: Use a standing desk

Alternate between sitting and standing to reduce sacroiliac joint pain

• Instead of sitting continuously for many hours, alternate between sitting and standing while working. Changing postures frequently helps reduce prolonged pressure on the sacroiliac joint, improves blood circulation, and aids in reducing sacroiliac joint pain.

• Some studies show that standing desks can significantly reduce chronic lower back pain in some individuals, especially when combined with correct working posture and regular movement.

Adjusting a standing desk to the correct posture

• The height of the desk surface should be adjusted so that your elbows are bent at about 90° when typing or using the mouse.

• Keep your wrists straight and resting lightly on the desk surface, avoiding excessive bending up or down of the wrists.

• Keep your shoulders relaxed, not shrugging or leaning forward while working.

Keep your head and neck in a neutral position

• Your head and neck should be aligned with your shoulders to reduce pressure on your spine.

• The computer screen should be positioned so that the top edge of the screen is level with or slightly below your eye level. This helps prevent prolonged head tilting or neck craning.

• The distance from your eyes to the screen should be sufficient for you to see clearly without having to lean or strain your neck.

Gradually get used to a standing desk

• If you are new to using a standing desk, only stand for about 30 minutes at a time, a few times a day.

• After that, switch to a sitting posture to allow your body to rest, then continue alternating between sitting and standing.

• Do not stand motionless for too long, as this can also cause muscle fatigue, leg pain, and increased pressure on your joints.

Combine with movement for greater effectiveness

• Whether working in a sitting or standing posture, you should still walk around or perform stretching exercises every 30–60 minutes.

• Combining a standing desk with correct posture, good supportive chair, and core, back, and hip strengthening exercises will help to more effectively reduce sacroiliac joint pain, protect your spine, and improve musculoskeletal health in the long run.

Properly apply heat, cold, and pain relievers

Apply heat or cold to relieve sacroiliac joint pain

• Applying heat or cold is a simple method to reduce sacroiliac joint pain at home without medication.

• Each application should last about 15–20 minutes. It can be repeated several times a day depending on the intensity of the pain and your body's response.

• Cold therapy is usually suitable for the first 24–48 hours after pain onset or after overexertion, as it helps reduce inflammation and swelling.

• Heat therapy is suitable when the muscles in the lower back, hips, or buttocks are stiff, helping to increase blood circulation and relax muscles.

• Do not place the hot or cold pack directly on the skin. Wrap it in a thin towel to prevent thermal burns or cold injuries.

Consider using over-the-counter anti-inflammatory drugs

• Some over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation in cases of mild to moderate sacroiliac joint pain.

• Only use the dosage indicated on the instructions or as prescribed by a doctor; do not self-medicate for prolonged periods to avoid the risk of side effects.

Cases requiring caution when using medication

• You should not self-medicate with anti-inflammatory drugs if you:

  • Are taking anticoagulants.

  • Have uncontrolled high blood pressure.

  • Have kidney disease or impaired kidney function.

  • Have a history of peptic ulcers or gastrointestinal bleeding.

• If you belong to one of the above groups, discuss with your doctor or pharmacist to choose a safer method for reducing sacroiliac joint pain.

Topical pain relief creams can be used

• If you prefer not to use oral medication, you can consider topical products to help temporarily reduce sacroiliac joint pain.

• Some commonly used active ingredients include:

  • Capsaicin helps reduce pain sensation after regular use.

  • Lidocaine has a local anesthetic effect, helping to reduce pain for a short period.

  • Diclofenac gel helps reduce inflammation and pain in the affected joint or muscle area.

• Only apply to intact skin, avoid contact with eyes, mouth, or open wounds, and wash hands thoroughly after use.

When to see a doctor?

• If sacroiliac joint pain lasts for several weeks, steadily worsens, radiates down the leg with numbness or muscle weakness, or does not improve despite rest and home treatment, you should seek medical attention for an accurate diagnosis.

• Identifying the correct cause will help your doctor develop a suitable treatment plan, which may include physical therapy, rehabilitation exercises, or specialized treatments if necessary.

References

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Content editor: Rene Lee Nguyen.

Information consulted and verified by expert: Michael Anderson.