Yoga guide
Your sacroiliac (SI) joints join the base of your spine to your pelvis. They barely move, and they don't slip "out of place", but they can hurt, often low on one side of your back and into your buttock, and very often in pregnancy, when about 1 in 5 women have pelvic girdle pain at the back or front of the pelvis. No trial has tested yoga for SI joint pain itself.
What the evidence does show is that exercise makes pregnancy back and pelvic pain less severe, that strength around the pelvis helps after birth, and that yoga for back pain works about as well as other exercise. So this guide treats yoga as a way to keep moving and build strength evenly: weight on both feet, knees no wider than your hips, small ranges, and fewer of the one-legged, wide-legged, twisted and cross-legged positions that the NHS and physiotherapists say bring the pain on.
It covers what the SI joint is, the "out of place" myth, pregnancy and the months after birth, the poses to use and the ones to change, a 20-minute class, and the warning signs that need a doctor or midwife rather than a mat.
On precise X-ray studies the SI joints moved about 2.5 degrees and less than a millimetre, the same in painful and pain-free joints. Manipulation changed hand tests without changing the joint's position. The pain is real; a joint out of place isn't the cause.
It's thought to cause 15% to 30% of long-lasting low back pain that doesn't travel down the leg. No single test or scan shows it.
About 1 in 5 pregnant women have pelvic girdle pain (PGP). It isn't harmful to your baby, and the Royal College of Obstetricians and Gynaecologists (RCOG) says "PGP is not something you just have to 'put up with'". Ask your midwife or GP about physiotherapy.
The closest evidence: in 60 pregnant women with low back and pelvic pain, 10 weeks of hatha yoga eased pain more than a posture leaflet. For long-lasting low back pain, yoga gives small gains, about the same as other back exercise.
Exercise in pregnancy makes back and pelvic pain less severe, though it doesn't stop it happening. After birth, specific stabilising exercises eased pain and disability in one trial of 81 women, and exercise eased back and pelvic pain by about 2 points out of 10 across trials.
The NHS, RCOG and the Pelvic, Obstetric and Gynaecological Physiotherapy network (POGP) name the same triggers: standing on one leg, moving your legs apart, stairs, turning in bed, and sitting cross-legged, on the floor or twisted. Our reading: in yoga, weight on both feet, knees no wider than your hips, and small ranges while it hurts.
The pelvis is a ring: two hip bones joined to the base of the spine (the sacrum) by the two SI joints at the back, and to each other by the pubic joint at the front. In 25 patients the SI joints rotated about 2.5 degrees on average and glided 0.7 mm, with no difference between painful and pain-free sides, and a review of 7 studies found only tiny movements. That's why hand tests that claim to feel a joint "out" aren't reliable.
Pain low in the back on one side, around the dimple at the back of the pelvis, sometimes into the buttock or thigh. It often starts after a fall, a lift or pregnancy, and older age, previous spine surgery, a difference in leg length and inflammatory arthritis are other risk factors. Estimates of how common it is range widely, from 10% to 62% of people with back pain depending on the setting, with most near 25%. In athletes with low back pain, about a third may have it, but reviewers couldn't give an accurate figure.
A clinician presses and moves your hips and pelvis in set ways (pain provocation tests). In 48 patients, three or more positive tests out of six picked up 94% of people whose pain a numbing injection confirmed. But a 2021 review of 5 studies rated this evidence very low certainty: a positive cluster raises the chance it's the SI joint only to about 35%, while a negative one lowers it to about 8%. The European guideline for pelvic girdle pain doesn't recommend hand tests of joint movement, X-rays or CT scans to diagnose it.
The NHS describes it as pain "caused by a stiffness of your pelvic joints or the joints moving unevenly at either the back or front of your pelvis": over the pubic bone, across one or both sides of the lower back, between the vagina and anus, or into the thighs, sometimes with clicking. About 1 in 5 pregnant women have it, and in about 8% of those with back or pelvic pain it's severely disabling. Risk factors include earlier back or pelvic pain, a previous injury to the pelvis, PGP in a previous pregnancy, a physically demanding job and joints that move more than usual.
Relaxin, the hormone often blamed, didn't match who got pelvic girdle pain in 3 of 4 high-quality studies, and POGP says only a small number of women have pain caused by hormones.
PGP usually improves after the birth, "although around 1 in 10 women will have ongoing pain" (RCOG); serious problems last in about 7%. Higher pain and disability in pregnancy, earlier back pain and fear of moving go with pain that lasts. Some women find it returns with their periods, and POGP says stopping breastfeeding won't speed recovery.
A PubMed search for yoga and the SI joint or pelvic girdle found 6 records and no trial of yoga for SI joint pain itself.
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In 60 pregnant women at 12 to 32 weeks, 10 weeks of hatha yoga eased low back and pelvic pain more than a posture leaflet; tests for the lower back improved more than tests for the back of the pelvis. A 20-woman pilot of weekly prenatal yoga found no difference in back pain, with no yoga-related harms. A 2015 review rated the evidence for yoga in pregnancy back and pelvic pain as very limited.
Across 15 trials, women who exercised in pregnancy had less severe back and pelvic pain, though exercise didn't lower the chance of getting it (very low to moderate quality). In a Cochrane review, an 8 to 12-week exercise programme reduced the number of women with low back and pelvic pain (4 trials, 1,176 women, moderate quality), but group exercise didn't reduce pelvic pain on its own (2 trials). A 2026 review of rehabilitation found less pain and disability, with results that varied between trials.
In 81 women with pelvic girdle pain after pregnancy, 20 weeks of physiotherapy focused on specific stabilising exercises gave lower pain and disability than physiotherapy without them, at the end and 1 year after the birth. At 2 years the differences persisted, but disappeared after adjusting for the 1-year scores. Across trials, exercise after birth eased back and pelvic pain by about 2 points out of 10 (moderate certainty). The trial's author stresses exercise that is individual, supervised and meaningful to you.
In 51 people, exercise, manipulation or both all helped, with no difference by 24 weeks; in 40 people, stabilisation exercise and manipulation did equally well. Neither trial had an untreated group. Across 16 trials, manual therapy improved disability a little (low certainty), and its effect on pain is uncertain.
Across 21 trials (2,223 people with back pain lasting 3 months or more), yoga improved function by about 1.7 points on a 24-point scale and pain by about 4.5 points out of 100 after 3 months compared with not exercising, smaller than the differences people notice, and about as much as other back exercise. The National Institute for Health and Care Excellence (NICE) suggests considering group exercise, including mind-body exercise such as yoga. These trials weren't in SI joint pain.
In 10 patients, manipulation made the hand tests "normal" but didn't change the SI joint's position on precise X-rays. Whatever helps, it isn't putting a joint back.
No study has measured SI joint load in yoga poses. The pose advice on this page is our reading of the NHS, RCOG and POGP lists of movements that bring on pelvic girdle pain.
The NHS suggests you try to:
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The NHS lists sitting or standing for long periods, going up and down stairs too often and lifting heavy objects. RCOG and POGP add standing on one leg, crossing your legs, sitting on the floor, sitting twisted, and bending and twisting to lift or carry a toddler on one hip.
NICE says to consider referral to physiotherapy for exercise advice, a non-rigid pelvic support belt, or both. The NHS lists exercises for the pelvic floor, stomach, back and hip muscles. A 2015 review rated pelvic belts well for pregnancy back and pelvic pain; a belt helps you move, it isn't a treatment on its own (our SI joint pain guide).
The NHS counts yoga towards your 150 minutes a week and your strength exercise. In later pregnancy, "try to avoid any activity that involves lying flat on your back for more than a few minutes". Skip hot yoga, swap face-down poses for all fours, and leave out poses you could fall from (our pregnancy yoga guide). POGP: "Stop any activity that produces pain, especially in the back or pelvis."
POGP: continue the exercises your physiotherapist gave you, "continue to be careful when exercising until you are symptom-free", "avoid high-impact activity, such as aerobics, for a few months" and "avoid any activity that brings back the pain". Painkillers can mask the pain, so be careful with movements that hurt before.
PGP is more likely to come back in a later pregnancy. RCOG says strengthening your tummy and pelvic floor muscles makes that less likely, and women who exercised 3 to 5 times a week before their first pregnancy had a 14% lower risk in one large study.
A pose is fine if your pelvic pain doesn't rise during it and isn't worse later that day or the next morning (our pelvic girdle pain guide). If it is, make the movement smaller or leave it out.
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Load both sides the same while it hurts: weight on both feet, knees no wider than your hips, and all-fours, lying, side-lying and standing poses. Keep your knees together as you change position, and get up from the floor by rolling to your side.
The best-tested exercise for pelvic girdle pain strengthens the muscles around the pelvis. Bridges, bird dogs, side planks on your knees and clamshells do that in a yoga class.
Once even poses are comfortable, add one-legged or wider poses one at a time, with a hand on a wall and short holds, and keep them if the pain rule holds (our editorial suggestion).
Tell your teacher about your pain or pregnancy. Being told to have your pelvis "put back" again and again isn't backed by evidence (our SI joint pain guide).
Slow breathing: 2 minutes to start a class, or at least 5 minutes on its own (the move's page). Corpse pose: at least 5 minutes, up to 10, with your knees bent, or on your side from the end of the first trimester (the move's page).
Cat-cow: 8 waves, slower than feels natural (the move's page). Pelvic tilts: 8 slow tilts (our yoga for back pain class). Knees to chest, both together: hold 20 to 30 seconds, 2 to 4 times (the move's page). Child's pose with knees hip-width: hold 1 to 3 minutes (the move's page).
Glute bridge: 2 sets of 8 to 10, small range; dead bug heel taps: 2 sets of 6 to 8 each side; knee side plank: 3 holds of 10 to 20 seconds each side; clamshell: 2 sets of 10 each side (our SI joint pain guide). Bird dog, one arm or leg at a time: 2 sets of 6 each side, holding 3 to 5 seconds (our editorial starting point). Tummy draw-in on your side: up to 10 holds of up to 10 seconds; pelvic floor exercises: 8 slow and 8 quick squeezes, 3 times a day (the moves' pages). Locust: 3 to 5 lifts held 3 to 5 seconds, not in later pregnancy (our strength yoga workout).
3D demoGlute bridgeBeginner · No equipment
3D demoBird dog, one limb at a timeBeginner · No equipment
3D demoBird dogBeginner · No equipment
3D demoDead bug heel tapsBeginner · No equipment
3D demoKnee side plankBeginner · No equipment
3D demoClamshellBeginner · No equipment
3D demoSide-lying tummy draw-inBeginner · No equipment
3D demoPelvic floor exercise (Kegel)Beginner · No equipment
3D demoLocust pose (Salabhasana)Beginner · No equipmentMountain pose: 5 to 10 slow breaths, 2 or 3 times (the move's page). Chair pose with feet hip-width: 3 holds of 15 seconds (our yoga for back pain class). Sit to stand, evenly: 2 sets of 8 to 10 (our editorial starting point).
Windscreen wipers with knees together, small range: 10 slow passes, 2 rounds (the move's page). Reclined figure four and the lying twist: 45 seconds each side (our runners' and strength yoga classes); skip figure four with pelvic girdle pain, because it crosses the legs, and skip the twist if it brings your pain on.
This is our reading of the NHS, RCOG and POGP trigger lists and the move pages' cautions; no study has tested particular poses for SI joint pain.
Tree pose, warrior III, half moon and dancer's pose: skip them with pelvic girdle pain. Outside pregnancy, hold a wall and keep them short until they're comfortable.
Goddess pose, warrior II, triangle and wide-legged folds, and bound angle, happy baby and frog-type poses: skip them or keep your stance narrow and your knees closer with pelvic girdle pain.
Easy pose, lotus and seated twists: sit on a chair or a firm block with your knees below your hips instead.
Half lord of the fishes, revolved chair and revolved triangle; pigeon and lizard at full depth. The move pages say ease off with sacroiliac pain. Keep twists small and open, or leave them out while it flares.
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Its move page: "A common source of front knee and sacroiliac ache when the stance is too narrow. Widen it before you deepen it."
No evidence helps the SI joint, and with very flexible joints, control comes before range (our yoga for hypermobility guide).
Long spells flat on your back after the first trimester, hot yoga, face-down poses as the bump grows, and headstands, shoulder stands and arm balances such as crow (our pregnancy yoga guide).
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Our 20-minute class keeps everything even and strength-first; do it 2 or 3 times a week alongside your physiotherapy exercises (our editorial starting point). The hip and core control routine is the strength plan our SI joint pain guide uses.
Twenty minutes of yoga for SI joint and pelvic girdle pain: slow breathing, gentle all-fours and lying moves, strength around the pelvis, and even standing poses.
20 minBeginner14 movesA bench or boxA 25-minute routine for a pelvis that feels twisted or uneven: gentle holds, bridges, bird dogs, side planks and single-leg balance, the same on both sides.
25 minBeginner11 movesA band, Other / check instructionsA 20-minute prenatal yoga workout for any trimester: seated breathing, all-fours and kneeling poses, supported standing poses and rest, none flat on your back.
20 minBeginner15 movesA step, A wallA gentle 20-minute yoga sequence for back pain, based on the first weeks of a 12-week trial programme: lying, all-fours and standing poses, then rest.
20 minBeginner12 movesFirm cushionA 20-minute Pilates workout for any trimester: seated, standing, all-fours and side-lying moves, with no lying on your back or front and no jumping.
20 minBeginner15 movesA wall, A bench or boxA gentle 25-minute routine for the first weeks after birth: pelvic floor, breathing, tummy and hip exercises on the floor, sit-to-stands and a walk.
25 minBeginner12 movesA bench or box, Cardio machineA 5-minute daily pelvic floor workout for women and men: slow holds and quick squeezes, three times a day, with how to find the right muscles.
5 minBeginner2 movesNo equipmentPregnancy and after-birth plans, and an easy walking plan to keep you active within comfort.
A pregnancy workout plan for each trimester: walks or swims, two strength sessions a week off your back, daily pelvic floor work and when to stop.
5 training days30 minBeginner5 days a weekA postpartum workout plan from the first days after birth to running and lifting again, week by week, with a caesarean track and readiness checks.
5 training days25 minBeginner6 days a weekA free 8-week walking plan for beginners: build to 150 minutes of brisk walking a week, with intervals, hills and two short strength sessions.
6 training days40 minBeginnerThese follow our back pain, pelvic girdle pain and pregnancy guides word for word. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999.
Call 999 or go to A&E: loss of feeling or numbness around the genitals or bottom, new trouble peeing or controlling your bladder or bowels, changes in genital sensation during sex or problems with erections or orgasm, or pain, tingling, weakness or numbness in both legs. These are signs of cauda equina syndrome, which needs treating in hospital urgently. Don't drive yourself.
In pregnancy: Call 999 or go to A&E if you have back or pelvic pain and you lose feeling in one or both legs, your bottom or your genitals, or you have new trouble controlling your bladder or bowels.
Contact your GP or midwife urgently: back pain in the second or third trimester of pregnancy, or back pain in pregnancy with a fever, vaginal bleeding, pain when you pee, or pain in one or more of your sides (under your ribs). It could be early labour or an infection.
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Stop exercising and call your midwife or maternity unit if you have bleeding from the vagina, tummy pain, regular painful contractions, fluid leaking from the vagina, breathlessness before you start, dizziness, a headache, chest pain, muscle weakness that affects your balance, or pain or swelling in your calf.
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Same day (GP or NHS 111): back pain and you feel hot, cold, shivery or generally unwell, or severe pain that starts suddenly or is getting worse quickly.
Sudden, severe hip or groin pain, or being unable to put weight on a leg, especially late in pregnancy: get help the same day. A rare thinning of the hip bone in pregnancy (transient osteoporosis) or a fracture needs a scan.
After the birth: severe pain at the pubic bone that started during the birth or in the first days after it, especially if you can't walk or take weight, the pelvis feels as if it's giving way, or you have trouble peeing. Tell your midwife or maternity team the same day: rarely, the joint at the front separates.
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Call your midwife or GP if you have pelvic pain and it's hard for you to move around, it hurts to get out of a car or turn over in bed, or it's painful going up or down stairs.
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Pelvic or low back pain still there 6 weeks after the birth: see your GP, health visitor or a pelvic health physiotherapist.
Sudden, severe low back or buttock pain when you stand or walk in the first weeks after the birth: get it checked. A stress fracture at the base of the spine (the sacrum) is rare, but it shows on a scan.
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Back pain that hasn't improved after a few weeks of looking after it at home, stops you doing day-to-day activities, worries you, or you're struggling to cope.
Back pain that started before 45 and has lasted more than 3 months, especially if it wakes you in the second half of the night, comes with buttock pain or gets better with movement, can point to inflammatory back pain: our SI joint pain guide lists the signs NICE uses. In many areas you can refer yourself to NHS physiotherapy.
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Call 999 if:
Stop a pose that sharpens your pain or sends pain, tingling or numbness down a leg. In later pregnancy, roll onto your side if you feel dizzy lying down, and say no to hands-on adjustments of your pelvis.
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The joints move about 2.5 degrees and under a millimetre, the same in painful joints; manipulation didn't change their position on X-ray; and the European guideline doesn't recommend the hand tests said to find a joint "out". Some leaflets still talk of joints moving unevenly or getting "back into position", but strength and comfortable movement are what help.
No study has tested any yoga pose on SI joint position or pain.
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No study shows it, and deep hip openers spread the knees, load one side or twist the pelvis: the movements that bring on pelvic girdle pain.
Relaxin didn't match who got pelvic girdle pain in 3 of 4 good studies. The advice is to keep active within comfort and get treatment early.
No study shows harm to the SI joint. In back pain trials yoga caused more side effects than not exercising, mostly a temporary rise in pain, and about the same as other exercise; across 94 trials, no more than usual care. Choose even poses and build up slowly.
"Most women with PGP can have a vaginal birth" (the NHS), and RCOG says a caesarean "will not normally be needed for PGP".
It can help as a way to keep moving and build strength around your pelvis, but no trial has tested yoga for SI joint pain itself. In pregnancy, one trial of 60 women found 10 weeks of yoga eased low back and pelvic pain more than posture advice, and exercise in general makes pregnancy back and pelvic pain less severe. Choose even poses, keep them within comfort, and see a physiotherapist alongside.
Poses that load both sides evenly and strengthen your hips, trunk and pelvic floor: cat-cow, small bridges, bird dog, side plank on your knees, mountain pose and a shallow chair pose. Keep your weight on both feet and your knees no wider than your hips while it hurts.
While it hurts, skip or narrow one-legged balances, wide stances, deep twists, cross-legged sitting and deep hip openers such as pigeon and bound angle. These overlap with what the NHS and physiotherapists say brings on pelvic girdle pain. Bring them back one at a time, with short holds, once they don't provoke pain.
There's no evidence that it goes out of place: the joints move only about 2.5 degrees and less than a millimetre, and manipulation changed hand tests without changing the joint's position on precise X-rays. Yoga can't reset it, but even, strengthening practice can help you move with less pain.
It can aggravate it, usually through deep twists, one-sided poses at the end of your range or wide stances held for a long time. In back pain trials, yoga caused more side effects than not exercising, mostly a temporary rise in pain, and about the same as other exercise. Stop a pose that sharpens your pain and tell your teacher.
Yes, with changes: keep your knees together as you change position, avoid standing on one leg and crossing your legs, skip wide stances and leave out anything that hurts. In later pregnancy keep time flat on your back to a few minutes, and skip hot yoga.
Pelvic girdle pain is pain at the back or front of the pelvis in pregnancy or after birth, and it can involve the SI joints at the back and the pubic joint at the front. It affects about 1 in 5 pregnant women and isn't harmful to the baby. Our pelvic girdle pain guide has more.
Usually it improves, but around 1 in 10 women have ongoing pain. Exercise after the birth eased back and pelvic pain by about 2 points out of 10 across trials, and specific stabilising exercises helped in one trial. If you still have pain 6 weeks after the birth, see your GP, health visitor or a pelvic health physiotherapist.
Neither has been tested for SI joint pain, and for back pain in general yoga does about as well as other exercise. Choose the one you'll do regularly and can keep even and within comfort; strength around the pelvis is the common thread.
In pregnancy, NICE says a physiotherapist may offer a non-rigid pelvic support belt, and it can ease pain for some women for short periods. Outside pregnancy, NICE advises against belts for low back pain. A belt isn't a treatment on its own, so ask your physiotherapist whether it helps you move.
Two or three times a week is a sensible start, alongside your physiotherapy exercises and daily pelvic floor exercises. A pose is fine if your pain doesn't rise during it and isn't worse later that day or the next morning.
Call 999 for numbness around your genitals or bottom, new trouble peeing or pooing, or pain, tingling, weakness or numbness in both legs. In pregnancy, contact your GP or midwife urgently for back pain in the second or third trimester, or with a fever, bleeding or pain when you pee. Call your midwife or GP if moving around, getting out of a car or turning in bed is painful.
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition such as glaucoma, high blood pressure or osteoporosis, or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.
