When a Sacroiliac Belt Causes Pain
July 15, 2021
Dr. Serola

Unfortunately, any sacroiliac (SI) belt may occasionally cause pain. In most cases, this may be due to several factors that can be alleviated with the right approach; knowing where the pain is and what to do about it.

Issue #1: The pain is localized at the SI joint and may be coming directly from the ligaments. This can occur for several reasons such as:
  • Reason #1: Ligament stress can occur when the SI joint is locked at one point in the joint but the rest of it is free to rotate; this causes the free parts to move excessively to make up for the lack of motion in the locked portion, and stresses the ligaments. Compression may increase the locking and put more stress into the ligaments.

    What to do: Aligning the SI joint through chiropractic manipulation/adjustments or simply freeing it through physical therapy mobilization should allow freer movement and lessen stress on the ligaments. Usually, one alignment will be enough to stop the belt from irritating the SI joint.

  • Reason #2: Inflammation of the joint may cause irritation of the joint surfaces.

    What to do: This may be helped by icing (not heat). However, too much ice for too long will actually reverse the effect, so do it this way: ice for 20 minutes maximum, with a half hour off, then again for 20 minutes. Doing three icings in a row is optimum. Keeping your timing exact and consistent will help your body pump more efficiently.

  • Reason #3: Within the ligamentous portion of the SIJ, there are nerves, blood vessels and lymphatic vessels. Excessive compression of the joint can irritate these nerves and vessels and cause pain, but this is less likely to happen with the Serola Belt because there is no buckle to cinch the belt excessively tight.

    What to do: Avoid belts that use buckles or other methods that allow for over-tightening to occur.

Issue #2: If the pain is along the sides of your pelvis, just under the belt, you may be compressing and irritating the cluneal nerves. One of the problems that occurs with a SIJ injury is excessive angulation at the lumbosacral area, due to excessive anterior pelvic tilt. The cluneal nerves exit the spine at the lumbosacral area and innervate the skin under the belt. If the cluneal nerves are already compressed and irritated at their exit from the spine due to excessive angulation, the compression of the belt along the sides of the pelvis can further irritate them and cause pain.
What to do: Decreasing the angulation between L5 and the sacrum may reduce the stress on the cluneal nerves and relieve pain. Also, since this increased angulation at L5-S1 is usually caused by muscular compensation to the Sacroiliac Nutation Lesion, continuing to wear the Serola Belt should balance the muscles and reduce the anterior pelvic tilt. The belt pulls the pelvis backward and you feel like you are standing taller, more erect. As this happens, it opens the lumbosacral area enough to take some pressure off the nerves. You can feel this happening when you feel like you are standing taller, and the pain reduces or resolves.


Although in rare cases, a sacroiliac belt may sometimes irritate the sacroiliac joint or local nerves, it can be relieved with the appropriate approach, and you can enjoy the pain relieving benefits of the Serola Sacroiliac Belt.

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