From the Guidelines
Managing sacroiliac (SI) joint pain during pregnancy requires a multifaceted approach that prioritizes the safety and well-being of both the mother and the fetus. To effectively manage SI joint pain, start with gentle exercises like pelvic tilts, cat-cow stretches, and swimming to strengthen supporting muscles while maintaining proper alignment, as recommended by prenatal specialists 1. Physical therapy with a prenatal specialist can provide personalized exercises and manual techniques to address your specific needs. Use supportive devices such as pregnancy belts or SI joint belts to stabilize the pelvis and reduce strain. Maintain proper posture by sitting with back support, avoiding prolonged standing, and using pillows between knees when sleeping on your side. Some key points to consider when managing SI joint pain during pregnancy include:
- Gentle exercises to strengthen supporting muscles
- Physical therapy with a prenatal specialist
- Use of supportive devices like pregnancy belts or SI joint belts
- Maintaining proper posture
- Applying heat or cold packs to the painful area for 15-20 minutes several times daily For pain relief, acetaminophen (Tylenol) is generally considered safe during pregnancy at regular doses (up to 3000mg daily divided into doses), but always consult your healthcare provider first, as noted in studies on postdelivery pain management 2. Complementary therapies like prenatal massage, acupuncture, or chiropractic care from practitioners experienced with pregnant women may also help. SI joint pain occurs because pregnancy hormones like relaxin loosen ligaments to prepare for childbirth, while your growing baby shifts your center of gravity, placing additional stress on these joints. It is essential to discuss your symptoms with your healthcare provider to rule out other conditions, such as stress fractures or insufficiency fractures, which can occur in the sacrum or femur during pregnancy, and develop a comprehensive treatment plan tailored to your specific situation, taking into account the latest research on stress fractures and insufficiency fractures 1.
From the Research
Management of SI Joint Pain in Pregnancy
- The management of sacroiliac (SI) joint pain in pregnant patients can be achieved through various methods, including osteopathic manipulative treatment (OMT) 3.
- Kinesiotaping (KT) has been shown to be effective in reducing SI joint pain in pregnant women, with significant improvements in pain levels, functioning, and quality of life 4.
- Expert advice on therapeutic exercise has also been found to be effective in reducing the symptoms of sacroiliac dysfunction in pregnancy, with better results obtained when intervention is implemented earlier 5.
Treatment Options
- Nonsurgical modalities such as activity modification, use of a sacroiliac (SI) belt, NSAIDs, and physical therapy can be used as initial treatment options for SI joint pain 6.
- Prolotherapy and radiofrequency ablation may offer potential benefits as therapeutic modalities, although limited data support their use as primary treatment modalities 6.
- Surgical treatment, such as percutaneous SI arthrodesis, may be indicated for patients with a positive response to an SI injection and failure of nonsurgical treatment 6.
Key Considerations
- Early intervention, such as expert advice on therapeutic exercise, can lead to better outcomes in reducing sacroiliac dysfunction symptoms during pregnancy 5.
- A comprehensive review of the epidemiology, anatomy, alarm findings, standard treatment, osteopathic assessment, and osteopathic manipulative treatment (OMT) of the SI joint can provide a general and in-depth understanding of SI joint pain in pregnant patients and its management 3.