Author Topic: Sacroiliac Joint Pain in Pregnancy  (Read 8046 times)

Offline Jemima

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Sacroiliac Joint Pain in Pregnancy
« on: March 10, 2010, 10:33:23 AM »
Wondering how others have dealt with pain in the lower back/hips, caused by the sacroiliac joint...

At 31 weeks, I've had it for about 2 wks now, and it's been getting worse. I had a chiropractor appt yesterday, and was told this is what it is, and that it's extremely common in the last months of pregnancy. The adjustment seemed to help some, but later in the day it was very bad again. The left side of my pelvis just seems to lock up and cause severe pain when movements are made involving the pelvis (which is just about everything I do).

I'm wondering if there's anything I can do for this, other than repeated trips to the chiropractor. He did mention getting some sort of belt to hold things in place; I just haven't been able to get an appt with him again, yet, and thought I'd see if anyone has any other advice.

Thanks!

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #1 on: March 10, 2010, 11:23:37 AM »
I had lots of problems with my sacroiliac joint in my last pregnancy (1994) also & continue to have problems with it although it wasn't until 2007 thanks to WTM that I knew what it was.

In '07 I had posted on the diagnose me thread about the problems I was having & got lots of great advice. The leg tension Littlemama24 explained really helps & I still use it anytime I need it. Here's the posts:


OK guys, I have one for you. For several years now I get pain sometimes in the lower outside edge of my back right above the tush. Both sides act up but mostly it's on the right. It's about a hand width below my waist to the top of the pain & between palm size & hand size. You know how you can rest your hands on your back just above your hip (not at the waist) to balance yourself to arch back & stretch? Well that is the spot & if I place my hand like I was going to stretch it covers the painfull spot. (except I don't ever stretch like that because I can't put any pressure on those spots or it hurts) I've always assumed it was my kidneys but I've been doing some checking & it seems to be too low & it doesn't move, I don't get sick, none of the other things that go with kidney problems. It's just this pain that comes & goes. It varies from a dull ache to sharper pain. It usually starts as an ache & if I do a lot of moving, sitting in a chair, etc. it gets to be more of a sharp pain that sometimes stabs. (like it's doing right now  >:()  It's near the surface but definitely not the skin. It does seem to go along with things like bouncing in a truck, doing heavy house work, sitting too long in a chair etc. so maybe it has something to do with my back. I do have a bad back that goes out of alignment a lot.

As I was saying in one of my other posts, I do have a lot of the tender points of fibromyalgia & the spots that I'm asking about are always tender to the touch but they are not in quite the right place. If you look at this picture: http://www.holistic-online.com/Remedies/cfs/fib_symp_pain.htm
the place where I have the pain is in line with the dots at the hip line on the drawing but further out toward the side. If it's from fibromyalgia why the aching, sometimes sharp &/or stabbing pain that is just below the surface? From what I understand, that doesn't go with Fibromyalgia.

Sitting in a chair & working around the house, etc will make it worse. I usually take antispasmodic & kidney herbs (since I always assumed it was my kidneys) & eventually it goes away but that doesn't mean the herbs have anything to do with it. If for some reason I can't take the herbs, eventually it goes away too. If it gets bad, I will have someone put liniment from my waist to the top of my tush & lay down if I can which helps some but mostly it takes time.

Does anyone have any ideas? Thanks. Blessings ~herbalmom  
« Last Edit: March 10, 2010, 12:11:11 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #2 on: March 10, 2010, 11:24:52 AM »
Does anyone have any ideas? Thanks. Blessings ~herbalmom  
I used to get stabs in the tush in this area and for a long time I believed they were caused by the nerve in the hip being piched.  I recently had an xray done prior to an adjustment and the chiro told me my sacrum was out.  She said this is very difficult to detect without an xray and when she put it back, I thought my butt was going to fall off, but I felt an immediate relief of pressure.  I've only had pain a couple of times since, and I believe it was readjustment or healing pains.  Just a thought.
« Last Edit: March 10, 2010, 12:11:32 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #3 on: March 10, 2010, 11:25:30 AM »

It could also be sciatica.  You have a sciatic nerve that runs in the place you're talking about on both sides, and runs all the way down the leg (at least to the knee, I'm having a hard time remembering my anatomy right now).  I have this every time I get pregnant, and it's also mostly on my right side.  I'm sure a chiropractor could help, but I've never gone.  The activities you describe also aggravate my pain, too.

I'm sure someone else has some great ideas for relief, but I don't.  I just live with it.

Sarah
« Last Edit: March 10, 2010, 12:11:48 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #4 on: March 10, 2010, 11:26:14 AM »
Ok Ditto HB and Ditto Sarah.

You pain sounds exactly like Sciattica and I ditto HB because my Chiro has put my Sacrum back in a told me it was helping to pinch and disturb my Sciattic nerve.  I've had this with both my pregnancies and sitting in certain chairs or for just along time is the thing that agrivates it the most.  This said I have found 2 things (other than chiro adjustment) that really help: first is hard core consistent core exercises, at least three times a week especially when preggo; second is the stretch I discribe here:
 http://www.welltellme.com/discuss/index.php/topic,3591.0.html in post #7

-Heather
« Last Edit: March 10, 2010, 12:12:05 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #5 on: March 10, 2010, 11:26:59 AM »

Thanks everyone. The chiro said my sciatic nerve was irritated when I was pregnant with #2 (15yrs ago) & with #3 (12yrs ago) I had way to much of the hormone that loosens everything up, my pelvis was slipping a lot with him, so this all makes perfect sense. I don't have a chiro right now but I will have to check into it. I don't remember when the pain started, but it's been years & may have been before my pregnancy with #2- I just don't remember. With my bad back back pain is just one of those things I deal with- I don't keep track. Oh wait, it just dawned on me that I had pain that I thought was kidney when I was pregnant with #1- I went to the ER for it but they couldn't find anything wrong. Now that I think about it, I think it was the same pain- I'm not positive, it WAS over 20yrs ago, but mmm... now I wonder.

I will have to look into strengthening my core. I'm overweight & in horrible shape & I'm sure that only makes my back worse. I'm thinking about T-Tapp but haven't gotten around to it yet. (like a lot of things I haven't gotten around to  ::)) Heather, I looked at the post that you linked to but I don't get your description. Help please. You mentioned a video in that post- is the stretch in the video? What is the name of it &/or do you want to sell your copy? Thanks again. It's been getting worse lately & it's nice to know that it's not my kidneys like I though. Blessings ~herbalmom  

« Last Edit: March 10, 2010, 12:12:15 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #6 on: March 10, 2010, 11:27:43 AM »

Oh, HerbalMom you need to read "Health Through Motion" by Pete Egoscue.  He gives tons of helpful exercises (static) and gentle stretches to use to put things back in their proper position.  It can be a little time consuming, so just do what you can consistently.  I found both his books at the public library.

It may be the sciatic nerve, and it also sounds like the sacro-iliac joint.  In any case you might want to look into the Sacro-Wedgy, www.sacrowedgy.com.  It is a little foam thingy that you position over the sacrum area and then lay flat on your back for 20 minutes.  It allows the SI joint to release and realign.  Can be helpful for multiple back and leg problems.  Like anything, some get great results, others only so-so.

From what you have described you need to be VERY careful of movement, especially anything strenuous.  I found out the hard way that joints do not respond well to stress when they need rest.  You really need to be evaluated by a chiropractor, and then choose lots of good movement.

I would consider using a comfrey salve and lots of anti-inflammatories (herbs, oils, DMSO, cool packs, Epsom salt baths, etc).

My chiro is the one who recommended Egoscue and the Sacro-Wedgy.

« Last Edit: March 10, 2010, 12:12:24 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #7 on: March 10, 2010, 11:28:25 AM »

Yes, the stretch is from a video which is called "Leisa Hart's Fit mama Prenatal workout".  I'll take another crack at describing the stretch.  

Lay on your side with your bottom arm wrapped around under your head and your knees gently bent.  Take your top leg and flex your foot so that it is at 90 degrees with your leg (like you were standing flat footed) and bring it up as far as you can toward your waist along the floor with a streight leg (so your leg would be sticking out streight in front of you on the ground).  Then roll your top hip back as far as is comfortable.  repeat on other side.

I hope that is clearer or you can find the video at your library!

-Heather
« Last Edit: March 10, 2010, 12:12:38 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #8 on: March 10, 2010, 11:28:58 AM »

Thank you Heather & DHW. I was able to request the video & 3 books by Pete Egoscue- motion, women & PC. I checked out the Sacro-Wedgy site as well. I want to talk to DH about it & am thinking about both the male & female versions- I'm thinking that DH, oldest DS & DD might all benefit from it- at least it wont hurt them to try it. Heather, this description does make sense now but I'm going to get the video to make sure I get it right- besides it may have some other good stretches for me to use. Thanks again, I should have asked about this a long time ago. Blessings ~herbalmom
« Last Edit: March 10, 2010, 12:12:49 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #9 on: March 10, 2010, 11:32:25 AM »
This sounds like your SI joint or sacroiliac joint.  It is where those dimples are on a really toned person's lower back.  Is that about where you have pain?  Child bearing or poor body mechanics can contribute to this in women as well as LLD (leg length discrepancy) and many other things.  If you can get a helper, lie on your back, flatten your back into the groud (pelvic tilt) using your stomach muscles and not your buttock muscles.  Once you get this lift your leg straight in the air (one at a time)  If your abdominals are weak this will be a workout in itself.  This is an excercise you can do to strengthen the inner abdominals and counteract the lower back pain.  Anyway, back to the pain relief you need the helper for.  While lying on your back like that, let the helper lift your leg into the air and pull gently.  If they are a child they can just lean back using their body weight and gravity.  This can distract the joint slightly and pull the pelvic girdle into a more appropriate position.  

(I have done this successfully with patients in the past and hope it is of some help)  Post again if I need to describe it better!

Thanks. I did a little searching based on what you said & found this:

Sacroiliac joint inflammation

Image 3 is close to where my pain is although mine is further out away from the spine but I am also overweight. When I was pregnant with my youngest (DS is 12 now) the last part of my pregnancy I had A LOT of pelvic slippage- EVERY time I would roll over in bed I could guarantee it would slip at a certain point while I was rolling over. The only reason I was able to roll over is that we had a headboard that had cut outs in it & I would grab it & use it to help me roll over. It would also slip as I was standing up from the couch, etc. Also I pulled a uterine tendon with my 1st that re-pulled with all 3 pregnancies which affects how I move when I am pregnant. I don't know if either of these contributed to my problems now but I figure they probably did. During my 2nd pregnancy, my sciatic nerve was irritated. I have scoliosis (s-curve; 10 & 13 degrees at one time- I have no idea what it is now)  & had to have physical therapy & a brace for it. From what I understand, my legs are the same length but one hip is higher.

OK, I'm trying to follow what your suggesting but I don't quite get it. I know a pelvic tilt- I can do a pelvic tilt lying on my back with my knees bent but never really got the hang of doing it lying on my back with my legs straight or while standing up against a wall even though the therapist tried. I understand the exercise your saying to strengthen the inner abdominal and counteract the lower back pain but I also have always had tight muscles in the back of the legs so I really can't lift my leg high at all when on my back. My PT used to do that same thing with me when I was a pre-teen being treated for the scoliosis only he was lifting the leg to stretch the tight back leg muscles. The leg that isn't being raised- should I have it straight on the floor or bent knee? I hope it's bent knee because for the last several years I have not been able to lay on my back with my legs straight, I HAVE to have 1 knee bent or my back cramps right away. The area it cramps in is between the shoulder blade & waist, if that tells you anything.  

As far as the part with the helper, how high does the helper lift the leg? Then are you saying for the helper to pull on the leg like the helper was trying to pull the leg to lengthen it- traction, basically? Also, same question as I had for the exercise- is the other leg straight or bent knee?

Thanks for the help. Blessings ~herbalmom
« Last Edit: March 10, 2010, 12:13:17 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #10 on: March 10, 2010, 11:33:35 AM »

Okay, great questions, and it shows you have had PT before!   ;)
Yes, the other leg should be bent, for both the exercise and the "manipulation".  Yes, it is like traction on the leg.  You remain as relaxed as possible while they lean back and pull.  The leg should be at about a 45 degree angle if you can, that is about halfway up the shin of the other leg if you have it bent.  Otherwise, just as high as they can lift it with you relaxed and comfortable.  If your hamstrings (back of the thigh muscles) are really that tight, I guarantee that is contributing to the pain.  You need to stretch them daily.  IT can become a chronic and limiting condition indefinately if you do not.  The stretching doesn't feel great but your back will thank you.  One of those muscles inserts to the bottom of your butt bone and it being tight will pull your pelvic girdle out of alignment.  Also, the muscles across the front of your hip will tighten pulling your back into more of an arch and further limiting motion and causing pain.  i hope you have some success.  If you lived closer I'd come yank on your leg myself!  LOL!   ;D
« Last Edit: March 10, 2010, 12:13:33 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #11 on: March 10, 2010, 11:34:07 AM »

Thank you. 45 degrees I can do, it's 90 degrees that I can't. I wish you lived closer also, I would love to meet you & SERIOUSLY pick your brain.  :D :D If you ever visit Denver, let me know.

Your right, I know I should stretch, I just don't do it.  ::) I had the PT when I was 11-12, I'm 41 now. I probably could have saved myself a lot of pain if I had been stretching all along.

Anything you can recommend for a lower back that just locks up? It will just get tighter & tighter until it's basically locked. Sometimes it's just the lower back, many times it starts with my neck tightening & works it's way down until my whole back is basically locked. Also, I have problems with my outer hip cramping at the worst possible moment.  ;) ;) ;) I know DH & I both would like to prevent that one.  :D Thanks for letting me pick your brain. Blessings ~herbalmom
« Last Edit: March 10, 2010, 12:14:11 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #12 on: March 10, 2010, 11:34:38 AM »

That sounds like muscle guarding.  That is when your body recognizes a pain and/or weakness in one spot and then you kind of just tighten up in a "protect" mode all over.  It is beneficial in a short-term setting (like a flight or fight reflex) but is bad when it in itself causes more pain and restriction.  From what you said it also seems apparent that you have a hard time relaxing your muscles in general.  You may even be slightly hypertonic; that is your muscles may hold more "tone" than other people's making it more difficult for you to stretch or relax.  You know how some people can be kind of flacid and extra bendable?  Well, you may be the opposite.  All that to say, you will really have to work at learning to let go and relax.  Breathing is a big part of that.  Especially with back and neck pain.  First off though, for your back and hips and legs I would get those hamstrings stretched out good and keep up those pelvic tilts.  You can never do too much of those.

I once worked with a lady in aquatic therapy who was so hypertonic in her innerthighs that she could not separate her legs enough to sit on the ground.  A huge hurdle for her was learning to just breath and relax and let her muscles go.  Something tells me there may have been emotional or psychological trauma involved too which can sometimes be the case...

« Last Edit: March 10, 2010, 12:14:20 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #13 on: March 10, 2010, 11:35:38 AM »

No emotional or psychological trauma in my case but I have always been overweight, out of shape, hated to exercise & sports because I was out of shape & wasn't any good at it. I was born in the '60's & was given Carnation milk formula (& I have a dairy allergy that to this day causes weight gain when I eat dairy) early solids, etc & was chubby even as a baby. I also had frequent ear infections so had lots of antibiotics which I know contributed to my weight gain.  

I know what you mean about some people being extra flexible- my sister is like that & was a gymnast when she was a kid.

I know the PT used to comment about my tight leg muscles but I really didn't take it seriously. The muscles in the back of my legs have always been tight. I have never been able to touch my toes & I don't like to sit cross legged because my feet & legs fall asleep easily when I do. I can sit cross legged, I just don't like to. If the tight muscles are contributing so much to the trouble with my back, I guess I better start working on stretching them out. The chrio gave me a stretch for my hip that I need to start doing again & hopefully stretching the back of the legs will help with that as well.

I guess it's all catching up with me. The last several years my back has been locking more often, my legs & hip cramps at the worse possible moment more often, my calves & feet cramp when I'm sleeping & just in general for the last several years I have been in a lot of pain. I have also had chronic fatigue for the last several years & I have the tender points of fibromyalgia. I know that chronic fatigue, fibromyalgia & pain all go together & didn't think I could do much about it.

Thank you, I'm happy to know that maybe I can actually do something that might help. Do you maybe know of a web site that you can link or a good book that shows good stretches that don't contort you into a pretzel? (I can't do pretzel  :D ) DH or the kids will help me with anything that needs a helper. Thanks again. Blessings ~herbalmom
« Last Edit: March 10, 2010, 12:14:30 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #14 on: March 10, 2010, 11:36:24 AM »

In my case Littlemama24 was right, it is my sacroiliac joint. The leg pull she recommended REALLY helps. THANK YOU, LM24.  :-* :-* I found a new chiro recently & he did full spine xrays- it was VERY easy to see why that SI joint is stressed- my pelvis is twisted quite a bit- enough that one side LOOKS like it's about 25% smaller than the other although it's not, it's just the way it appears b/c of the twisting. You can tell that the most stress in my entire pelvis is right at that SI joint. HTH Blessings ~herbalmom
« Last Edit: March 10, 2010, 12:14:38 PM by healthybratt »

Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #15 on: March 10, 2010, 11:42:25 AM »
During my last pregnancy, I found that having lots of standard bed pillows helped. I was able to use them to prop & cushion so I could get into a comfortable position to sleep. Usually on my side with a knee bent. You can do the same thing with one of the long body pillows but reg bed pillows gave me more options for how to arrange me & the pillows.

Also my headboard at the time had cut outs in it & I was able to grab those to help me turn over- my pelvis was slipping with most movements & rolling over & getting out of bed were 2 things i really had a problem with. HTH

Offline healthybratt

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #16 on: March 10, 2010, 12:08:07 PM »
wow, you've been busy hm.   ::)

that particular adjustment may not be possible during pregnancy.  it's a fairly ferocious technique that my chiro used and i was not preggo at the time.  it's worth checking into, but i would suspect it's not going to happen until after...however, i may have a solution that will help you manage the pain until then.

during my 2nd and 3rd i had this problem and the pain is fierce especially in the buttocks and the lower back and sometimes the top of the thigh and the knee were numb and prickly.  getting out of bed or trying to sit up after lying on my back was the WORST.

my doc had me and hubby do exercises daily.  so long as i did them faithfully EVERY DAY, the pain was negligible/manageable.  if i missed a day the pain would return full force and without mercy.

lie on your back (owie, i know) with your body straight and relaxed and your toes pointing up (or slightly inward).  have your husband lie his hands atop your leg at approximately the shin and the thigh.  then he needs to roll your leg from the upward position to the outside of your body (toes facing away from each other) as far as you can manage without major stress to the rear and your knee.  the hands may need to be adjusted up or down on the leg if the knee is under too much stress.  the idea is to roll the whole leg much like you would roll out a piece of dough.  you do not want to twist any joints except the hip.  

if i did this for 15 minutes for each leg, every day, i did great.  

you may find it very difficult to get up after the exercise.  this was normal for me.  the best way i found to get off the floor was to have hubby help me roll over to my side, get my bearings and then have him help me roll over to my front where i could get to my hands and knees and get up from that position to put less tension on the painful hip and lower back.

you can try doing this on your bed, but if i remember correctly, hubby and i tried this and it didn't work (can't remember why) correctly.  even though getting off the floor was so difficult, for some reason the floor was our preferred method.  

if the chiro can put the saccrum back in place, that would be great, but you may have to wait until after the baby comes.

hope you feel better soon.
« Last Edit: March 10, 2010, 12:21:52 PM by healthybratt »
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Offline herbalmom

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #17 on: March 10, 2010, 12:28:15 PM »
wow, you've been busy hm.   ::)

not that busy- just copy & paste but I knew I had posted about it before so I went & found the posts.  ;)

Offline boysmama

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #18 on: March 10, 2010, 01:14:10 PM »
I had a lot of trouble with this in the last trimester of my third pregnancy.Here's an exercise that you can do by yourself, anytime even in public, church, etc. It worked better for me than a standard hands and knees pelvic tilt.

 Sit on a hard chair...like a dining chair and slump your shoulders to rock your pelvis back a little. Do several kegels. You can try centering the tightening both in the an*l and v*ginal area.
Now do a couple Kegel like motions while straightening your body to a good posture position. Think about tightening from your perineum  and in while your pelvis is rocking front from straightening your back. If this feels awkward just experiment with rocking your pelvis a couple times to get the feel of it- slump back, straighten back, slump back, straighten back....

This helped me quite a bit. I could often feel the joint popping back. Sometimes the first kegels would get the tailbone and the kegel with rocking pelvis would get the other joint.  Of course it didn't stay put for very long with all the hormones, but popping it releases some of the muscle and nerve pressure.
I also went to the chiro every 7-10 days. The adjustment was painful, and the pain never completely went away, but it was manageable instead of excruciating.

Offline Jemima

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Re: Sacroiliac Joint Pain in Pregnancy
« Reply #19 on: March 13, 2010, 08:54:49 AM »
Thanks for the replies.

I went again to my chiropractor, and he said my pelvis was a little "off", and did a pelvic release. (Anyone know what this is? It was so simple, so painless I was almost wondering if it was some kind of hokey thing!) He then gave me an SI (sacroiliac) belt to try out, and take home for awhile.

The pain was pretty much gone after the second visit, but I could still feel it "catching" in my low back often, and tried to be very careful of my movements. I also wore the belt, which you wear very low around your hips/pelvis for the next 2 days. And I'm so very thankful to report that I am in no pain anymore, and slipping, or catching feeling isn't barely there anymore. I say barely, because certain movements I can feel where it could almost go again, but I'm trying to be careful of posture and my movements.

Some advice he gave to me, also...
    > No sitting on the floor
    > No sitting on couches (lots of back support/upright position)
    > Be careful of bending/twisting movements
    > Gentle walking is good

Hoping and praying it stays feeling good throughout the end of the pregnancy! Going to be moving in the very last weeks, :P so I need to take care of myself so I can be of use then.