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The sacroiliac (SI) joint is essential for the proper function of the lower back, pelvis, and legs. This vital joint is responsible for supporting and transferring the upper body’s weight to the lower body, as well as acting as a shock absorber to regulate pressures transmitted from the legs to the spine. Acute trauma and recurring microtrauma account for 88% of SI joint discomfort patients.

The most common causes of SI joint pain are activities that involve the lower back, pelvis, and legs moving together, such as sitting, walking, climbing stairs, and standing. Changes in lifestyle and treatment exercises to protect and strengthen the lower back and pelvis can help prevent future flare-ups.

This article explains the most common causes of SI joint discomfort, as well as useful advice on how to adapt regular activities to keep the pain from getting worse.

Activities that aggravate SI joint pain

Overuse or repetitive microtrauma to the SI joint may result from certain physical activities, causing inflammation to flare up. These triggers will be discussed in greater detail below.

    Certain occupations. Jobs requiring a lot of standing, sitting, and walking, such as teachers, retail clerks, and waiters, may cause SI joint pain. Large physical activity, such as repetitive lifting of heavy things, can impose tension on the SI joint, causing pain and discomfort.

    Exercise that has a high amount of impact. High-impact workouts such as running and jumping, as well as plyometric exercises such as lateral leaps and burpees, can strain the back and pelvis, increasing the risk of SI joint pain.

   Cycling. Long durations of sitting in a forward-leaning position on a bike can lead the pelvis to tilt forward, putting additional strain on the SI joint.

    Sports. Sports involving repetitive twisting motions, such as golf and gymnastics, as well as sports involving repeated lateral movements, such as tennis, soccer, ice skating, and basketball, can place significant strain on the lower back and pelvis, resulting in SI joint pain. 

Participation in these activities on a regular basis can cause recurring microtrauma to the joint and surrounding structures, leading the joint to weaken and become painful over time.

SI joint pain is caused by poor posture.

Poor posture can cause SI joint pain by putting strain on the lower back and pelvis, resulting in SI joint misalignment or inflammation. When we sit or stand incorrectly, the natural curvature of the spine is aggravated, causing the pelvis to lean forward or backward, affecting the position of the SI joint, and generating discomfort or pain in the lower back and buttocks. 

SI joint pain is caused by physical inactivity.

Inactivity can cause the muscles that support the spine and pelvis to weaken, resulting in decreased spinal stability and increased stress on the SI joint. Sedentism weakens and stiffens the muscles that support the lower back and pelvis, making it difficult for the body to maintain a supported posture. 

Shoes that are known to induce SI joint pain

Certain types of footwear can induce SI joint pain by altering body alignment and how we walk or stand. When walking, wearing shoes that do not provide appropriate support may cause the feet to roll inward or outward, resulting in pelvic misalignment. 

The following are some common types of footwear that can contribute to SI joint pain:

    Shoes with high heels. High heels can cause the pelvis to move forward, putting extra strain on the lower back and SI joint.

    Flats with inadequate arch support. Wearing flat-soled shoes without arch support can cause the feet to roll inward or outward, putting extra strain on the SI joint.

    Without arch support, wear sandals or flip-flops. Flat sandals with little to no arch support may increase stress on the SI joint.

Wearing particular types of footwear causes recurrent microtrauma to the SI joint, which leads to discomfort and dysfunction over time.

Foods that can make SI joint discomfort worse

Specific foods that trigger arthritic pain include:

    Sugar. Consuming too much sugar can trigger inflammation throughout the body, including the SI joint. Sugar is present in many processed foods, including sweets, sugary beverages, and baked goods. 

    Food that has been refined. Sugar, salt, and trans fats are common ingredients in processed foods, all of which can induce inflammation. Processed foods include fast meals, freezer dinners, and packaged snacks.

    Food that has been deep-fried. Trans fat-rich cooking oils are utilised in high-heat cooking methods such as frying, which enhances the production of inflammatory compounds. 

    Meat that is crimson in colour. Saturated fat, which induces inflammation, is abundant in beef, veal, hog, and lamb. 

Regular use of inflammatory foods, particularly for persons with arthritis, can increase overall inflammation in the body, worsening arthritis-related SI joint pain.  Physical changes that may cause SI joint pain

SI joint pain may be caused by the following physical changes in the body:

    Pregnancy. SI joint pain may be caused by pregnancy-related hormonal and physical changes. As the body prepares for childbirth, the ligaments and joints in the pelvic region relax and become more flexible, increasing the risk of SI joint pain. 

    Obesity. Excess body weight can strain the SI joint, causing inflammation and pain. Obesity can also lead to poor posture and muscle weakness, putting additional load on the SI joint. 

    Age. Although the SI joint is flexible in children, it stiffens as they get older. Inflammation and pain are caused by decreased joint mobility, as are changes in the pelvic musculature and stability. 

Other medical conditions can potentially cause SI joint pathology. Ankylosing spondylitis is the most common kind of rheumatic arthritis, causing inflammation and stiffness in the SI joint and spinal ligaments. This inflammation and stiffness may eventually lead to SI joint and other spinal joint fusion. 

Furthermore, after some spine operations, such as lumbar spinal fusion, larger mechanical loads are passed to the SI joint, which may induce pain within the joint. 

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