Sacroiliitis

Explanation of Diagnosis

Sacroiliitis means inflammation and irritation of the sacroiliac (SI) joints, which connect your spine to your pelvis. It often happens after a strain, overuse, pregnancy-related or hormonal changes, or sometimes as part of an inflammatory condition. Common symptoms include pain near one or both sides of the low back or buttock, stiffness (especially in the morning), and discomfort that can worsen with standing, walking, climbing stairs, or rolling in bed. Some people also notice pain with prolonged sitting or when shifting weight from one leg to the other.

Specific Work Modifications

• Change positions frequently, such as standing up every 20 to 30 minutes and taking brief walking breaks.
• Use a supportive chair with your feet flat on the floor and consider a small lumbar roll to reduce low back/SI strain.
• Avoid prolonged single-leg loading; keep your stance balanced and switch which foot you put your weight on.
• If you lift, keep loads close to your body and use a hip hinge with minimal twisting instead of bending and twisting together.
• Use a cart or rolling bag for supplies to reduce repeated heavy lifting or asymmetrical carrying.
• If your job involves driving, try to adjust the seat so you are not slumped, and take short stretch breaks every hour.

Specific Activity Modifications

• Choose low-impact activities like walking on flatter surfaces while symptoms are active; avoid running or jumping temporarily.
• Limit deep hip bending, hard twisting, or quick pivoting motions that stress the SI joint.
• Reduce time on uneven terrain, steep hills, and high-camber treadmills, as these can increase SI joint loading.
• Avoid heavy yard work, squats to deep depth, or lifting from the ground when it reproduces your buttock/SI pain.
• If rolling over in bed or getting in/out of a car triggers pain, slow down and use a “log roll” technique rather than twisting.
• When returning to sport, build gradually and stop if pain increases beyond mild soreness during the activity.

Recommended Supplements

None

Recommended Nutrition and Hydration

Diet Recommendations

• Focus on an anti-inflammatory pattern with plenty of vegetables, fruit, beans/lentils, whole grains, nuts, and olive-oil based fats.
• Include adequate protein at meals (for example fish, poultry, tofu, eggs, yogurt, or legumes) to support tissue repair.
• Add omega-3 rich foods such as salmon, sardines, chia, or ground flax, which may help calm inflammation.
• Limit highly processed foods, sugary drinks, and frequent alcohol, which can worsen inflammatory balance in some people.

Hydration Tips

• Aim for regular fluid intake throughout the day, using pale yellow urine as a practical guide.
• Stay well-hydrated before and after activity, especially if you sweat or spend time in heat.

Home Exercise Prescription

Perform these exercises 4 to 6 days per week, with gentle effort and symptom-guided movement.

1. Pelvic tilts: Lie on your back with knees bent; gently rock your pelvis so your low back flattens slightly toward the floor, then return to neutral. Do 10 repetitions, 2 sets.
2. Cat-cow (gentle spinal mobility): Get on hands and knees; slowly arch and then round your back within a comfortable range, keeping movements smooth. Do 6 to 8 slow reps.
3. Glute bridge (small range): Lie on your back with knees bent; tighten your glutes and lift your hips only to the point that feels supportive, not sharp or increasing pain. Do 8 to 10 reps, 2 sets.
4. Clamshells: Lie on your side with knees bent; keep feet together and slowly open your top knee without twisting your trunk. Do 10 to 12 reps per side, 2 sets.
5. Hip flexor stretch (gentle lunge): From a half-kneeling or lunge position, gently shift your weight forward until you feel a mild stretch in the front of the hip, keeping your pelvis level. Hold 20 to 30 seconds per side, 2 rounds.

Stop if you feel sharp pain, significant worsening during the exercise, or new numbness or weakness.

Helpful Books

• "Explain Pain" written by David Butler and Lorimer Moseley
• "The Back Mechanic" written by Stuart McGill
• "Move Your DNA" written by Katy Bowman