Sleeping and Sex Positions for SI Joint Pain

Using certain strategies and sleeping positions for sacroiliitis or other causes of sacroiliac (SI) joint pain can you help get the rest you need. You will likely, for example, find it more comfortable to sleep on your back versus your side. You may also find that some sex positions are more comfortable if you have SI pain.

There are treatments for SI joint pain symptoms like exercise, physical therapy, medication, injection, and fusion surgery, but these strategies alone don't always fix the problem long-term. You may need a combination of treatments, including some lifestyle adjustments, to manage SI joint pain.

This article goes over how to sleep with SI joint pain, including the best sacroiliitis sleeping positions to try. It also covers sex positions to try if you have SI joint pain.

A woman sleeping in her bed
Caiaimage / Paul Bradbury / Getty Images

What Does the SI Joint Do?

The anatomy and function of the SI joint are complex. The joint is made up of two pieces: the ilium and the sacrum. If these bones don’t fit together right, you could get a sprain and have pain.

There are a few key factors that ensure the bones fit together the way they should:

  • The way the bones naturally fit together (form closure)
  • The mechanical tension in the muscles around the joint or the ones that affect the joint (force closure)
  • The nervous system's input into these muscles (motor control)

To make the fit more complex, the surfaces of both the ilium and the sacrum are irregular. 

Along with bumps and grooves spread all over each, the entire SI joint changes type depending on the area. The same is true for the cushioning and/or binding material between the two joinings (articulating) surfaces.

For example, the bottom two-thirds of the joint is mobile, but the upper third is not. 

The SI joint can be either hypermobile (which is related to spinal instability) or hypomobile (which may lead to movement compensations and stiffness).

If the balance between the bones of the SI joint gets disrupted, it can lead to dysfunction and pain. 

How to Ease SI Joint Pain During Sleep and Sex

When SI joint pain keeps you up at night, there are a few lifestyle changes that may help. Here are a few tips for dealing with bedtime, sleep, and sex if you have sacroiliitis.


SI joint dysfunction tends to occur on one side of the body. You may find that it's difficult to sleep because of the pain. There are a few ways you can help prevent or reduce pain while you're in bed at night if you have SI joint pain.

  • Make sure your mattress and pillow provide enough support.
  • Do some gentle stretches as part of your bedtime routine.
  • Avoid sleeping on the side with the hurting hip or on your stomach. Sleeping on your back might be the most comfortable for you because it won't put pressure on your hip. If you do have pain while sleeping only your back, putting a pillow under your pelvis may help.
  • If you sleep on your side, it may help to put a pillow between your knees to help keep your spine in alignment.


You can also have SI joint pain during sex. Making a few adjustments to the positions you use (or trying new positions) can make it easier to have sex with sacroiliitis.

  • Try modifying the bottom missionary position so one leg is bent up and resting on the outside of your partner's leg.
  • Sit on the edge of a chair with the leg on the painful side up and your heel placed on the seat of the chair. Place your other foot on the floor. The top partner kneels on the floor.
  • If you're on top, modify the missionary position by propping your partner up with pillows. You can be on top with your leg on the painful side bent.
  • If you and your partner are both laying on your side, it can help with pain and also be in a more intimate position. If you are on top, place your bent leg under your partner's (closest) leg. If you're on the bottom, again, bend the leg on the painful side.

Pelvic Floor Strengthening for SI Joint Pain

You may want to ask your provider about doing a pelvic floor strengthening program. Pelvic floor work can help you develop balance and stability through your hips, pelvis, and low back. It can also have benefits for your sex life.


SI joint pain can affect your quality of life in and out of the bedroom. It will help to try the best sex and sleeping positions for sacroiliitis and adapt them to your needs.

If you struggle to sleep at night or have comfortable sex, there are some lifestyle changes that can make it easier to manage your symptoms during these activities. Starting a pelvic floor program may also be beneficial for sacroiliitis.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.