How to Heal SI Joint Pain in Perimenopause and Stop the Flare-Up Cycle
That Deep, One-Sided Pain in Your Lower Back
If your back pain feels deep inside your hip or low back, showing up on just one side when you walk, lie down, or carry something, it’s likely not just muscles or spine.
It’s your sacroiliac (SI) joint — a tiny but mighty joint at the base of your spine. And during perimenopause, it’s one of the most commonly overlooked causes of chronic pain.
Treat it like regular back pain, or rush back to workouts too soon, and you risk making it worse.
My 4-Year Struggle with SI Joint Pain
I know this pain because I lived it.
I was misdiagnosed with facet joint inflammation. I chased the wrong solutions: stretching, one-sided stabilizing exercises, even mainstream therapies that only fed the cycle.
For 4 years, I couldn’t walk without pain. My knees, neck, and feet started aching too. I was depressed, stuck in flare-up after flare-up, while on the surface doing “everything right.”
It wasn’t until I turned to Ayurveda and Traditional Chinese Medicine that I began piecing things together. But the final breakthrough came when I realized:
👉 The real cause of my pain wasn’t the facet joint at all — it was SI joint dysfunction and pelvic misalignment.
Once I learned how to restore SI joint stability, I felt better in just 1 month — after years of struggle.
What’s Really Happening in Your Body During Perimenopause
Perimenopause changes more than just hormones. It affects your core stability system:
Hormones fluctuate, changing tissue elasticity.
Joints become more mobile — but less stable.
Muscles may be strong, but they fire out of sync.
The deep core switches “off,” like a breaker protecting the system.
Add years of stress, poor sleep, or carrying bags on one side, and the pelvis loses alignment and support.
The result? Deep, one-sided pain — especially when walking, twisting, standing too long, or turning in bed.
Why SI Joint Flare-Ups Feel So Confusing
During a flare-up, multiple systems are firing at once:
Core is offline → Outer back muscles overwork, causing burning or aching across the waist.
SI joint is irritated → Sharp, electric pain near sacrum, buttock, or groin (often mistaken for sciatica).
Referred nerve pain → Zaps, tingles, or radiating aches into thighs, abdomen, or legs.
It’s not random. It’s your body trying to stabilize an unstable pelvis.
Nervous System: The Missing Link in SI Joint Pain
Most treatments ignore the nervous system — but it’s the command center for muscle firing, pain, and safety.
When the pelvis is unstable, the nervous system goes into protection mode:
Muscles brace constantly.
Movements feel unsafe.
Pain signals amplify.
Until the nervous system feels safe again, no amount of stretching or massage will create lasting relief.
Step One: Calm the Flare-Up with Acupuncture (Not Dry Needling)
When inflammation and pain are high, start with nervous system regulation.
❌ Skip dry needling — it attacks muscle knots and can aggravate a flared SI joint.
✅ Choose Chinese acupuncture — it calms inflammation, regulates energy, and restores balance.
This is your first step before exercise, before strengthening, before anything else.
What NOT to Do During an SI Joint Flare-Up
Avoid these common mistakes that prolong instability:
❌ One-sided strengthening
❌ Heavy weights or spinal compression
❌ Aggressive stretching (especially on painful side)
❌ Twisting and torqueing motions
❌ Forward bends or hinging
❌ Carrying heavy bags on one shoulder
These feed the dysfunction instead of healing it.
Gentle Movements That Restore SI Joint Stability
Once inflammation calms, begin slow, precise movements that retrain your core and pelvis:
Crawling → reconnects core and limbs
Bird Dog / Dead Bug → builds diagonal core stability
Wall Marching → teaches pelvis to stay level
Band Work → progress carefully from thighs to calves
Yoga Ball Work → adds gentle instability to activate deep core
The key isn’t reps or intensity. It’s re-teaching your nervous system: “You’re safe. You can move without pain.”
Healing SI Joint Pain in Perimenopause: A Whole-Body Process
The physical piece matters — but it’s not the whole story.
True healing requires addressing:
The body (core and joint stability)
The mind (safety, stress patterns)
The spirit (energy flow, emotional release)
Your nervous system needs to feel safe not just physically, but emotionally and energetically too.
This is why I go beyond standard rehab in my 1:1 PeriPowerful Program — helping women retrain their core, regulate their nervous system, and release the deeper patterns driving SI joint pain.
Here’s what DOES work—when done with patience and control:
First thing - SLOW DOWN! I mean slow down in everything you do.
Start with BABY STEPS and observe how your body responds with each movement and especially new movement you’ve added.
Crawling — Yes, like a baby. It reconnects your core and limbs.
Bird dog / Dead Bug — Simple, slow, precise. Builds diagonal core support.
Wall marching — Teaches your pelvis to stay level during movement.
Band work — But only once you’re stable. Start above the knees, then below, and finally at the calves—if your body responds well.
*You can use a Yoga Ball to introduce gentle instability, which encourages your deep core muscles to activate—all while maintaining a neutral spine.
You’re not just working out here.
You’re retraining your entire core system to support you again, so forget about counting raps or any of that sort of things. You’re teaching your body to move without pain.
This is slow work—but it’s powerful.
You progress not by pushing harder, but by listening better.
If there’s no flare-up, keep going. If there is, pause and reset.
The goal isn’t a six-pack.
It’s deep, inner stability—so your body can finally feel safe and stop sending pain signals.
Watch for Delayed Nervous System Responses
Sometimes, pain doesn’t show up until hours after exercise. This is your nervous system processing change. Recognizing delayed responses helps you avoid setbacks.
Nervous System Calming Practices
Between movements, use tools like:
Vagus nerve tapping (collarbone + cheekbones)
Slow, deep breathing
Grounding somatic practices
Do these 2–3 times daily to regulate the system and reinforce safety.
Final Thoughts: Stop the SI Joint Flare-Up Cycle
If you’re stuck in the cycle of SI joint flare-ups during perimenopause, remember:
The pain isn’t random — it’s a signal.
Stretching harder won’t fix instability.
Nervous system regulation is the missing piece.
Gentle, consistent retraining restores lasting stability.
👉 Ready to get out of the pain loop? Explore 1:1 PeriPowerful Coaching and start building true pelvic stability and freedom of movement
