Question: I have found a bunch of people who started having sacroiliac joint problems during pregnancy that does not get better after their delivery…Is this common?

I have found a bunch of people who started having SI joint problems during pregnancy that does not get better after their delivery. Is this common and why wouldn’t the issues get better after pregnancy? More importantly, now that I am pregnant and am starting to have some pain in the SI joint area, what can I do to both manage the pain during pregnancy (without hurting my baby) and also to make sure that I don’t continue to have SI joint pain after pregnancy. Should I be stretching every day? I do yoga, but nothing else. I would prefer not to take medications. If I have bad SI joint pain after delivery, what type of doctor should I see, or should I see a physical therapist? I have had sciatic pain before, and I definitely don’t want to have it again. Thank you for your help!

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Doctor’s Response: Pregnancy is a leading cause of sacroiliac joint dysfunction.

Obstetricians have known about painful sacroiliac joints for decades. Papers have been published over and over in the literature about the young female with low back pain during pregnancy and after pregnancy, secondary to sacroiliac joint problems. Although this is not a frequent problem, it is common enough to be one of the leading causes of sacroiliac joint dysfunction, and one of the leading reasons why young women end up having fusions of the sacroiliac joint at a later date, long after they have delivered their child vaginally.

During the later stages of pregnancy and at the time of delivery, hormonal changes cause the connective tissues that hold the sacroiliac joints together to become more elastic. This allows for the baby’s head to come out of the pelvic ring, and the pelvis spreads slightly at the sacroiliac joints and at the symphysis pubis in front during delivery. Most of the time, all of this goes back to normal within six weeks; but, occasionally, one of the sacroiliac joints literally becomes sprained through this. I have treated patients, as long as twenty years after delivery, with what is believed to be a sacroiliac joint dysfunction resulting from that joint being sprained during a vaginal delivery of one of their children.

If there is pain during pregnancy, and it is suspected to be coming from the sacroiliac joint, then a sacroiliac belt is about all that can be done to try to stabilize the sacroiliac joints until the baby is delivered. If the pain has not gone away within six weeks after delivery, and the pain is disabling, then at that point an injection can be done to diagnose whether the pain is coming from the sacroiliac joint or not. That injection should be done by a professional, under image, to verify that the sacroiliac joint is generating pain.

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In Spine-health’s Doctor Advice section, physicians respond to frequently asked questions about back pain issues. These responses represent the opinion of one physician, and do not necessarily reflect the views of the broader medical community. The advice presented has not been peer reviewed by Spine-health’s medical advisory board.