If you’ve ever felt a deep, nagging ache right at the base of your spine just above your tailbone, you’re not alone. Patients often come in and say things like, “It’s not quite my lower back… it’s lower than that?”
Welcome to the world of sacrum pain.
It’s one of those areas that doesn’t get much attention until it starts causing problems. And when it does, it can make sitting, standing, exercising and even sleeping feel surprisingly uncomfortable.
Let’s break it down in a way that actually makes sense and give you some practical ways to start feeling better.
What Is the Sacrum (and Why Does It Matter)?
The sacrum is a triangular shaped bone at the very bottom of your spine, sitting between your two hip bones (the pelvis). Think of it as the keystone of your body, it connects your spine to your lower body.
It also forms part of the sacroiliac joints (SI joints), which are where your spine meets your pelvis. These joints are small but incredibly important for:
- Transferring weight from your upper body to your legs
- Absorbing shock when you walk or run
- Providing stability when you move
When this area isn’t moving well or is under stress, pain can creep in.
What Does Sacrum Pain Feel Like?
Sacrum pain can be a bit sneaky because it doesn’t always feel the same for everyone. In my experience, patients often describe it as:
- A deep, dull ache right at the base of the spine
- Pain when sitting for long periods (especially on hard surfaces)
- Discomfort when standing up from sitting
- A feeling of “tightness” or pressure in the pelvis
- Pain that may spread into the glutes or hips
Sometimes it can even mimic lower back pain or feel similar to sciatica, which is why it’s often misunderstood.
Why Does Sacrum Pain Happen?
Sacrum pain usually isn’t random, it’s your body responding to stress, imbalance or lack of movement.
Here are some of the most common causes I see in clinic:
1. Too Much Sitting (Sound Familiar?)
Modern life = lots of sitting.
When you sit for long periods:
- Your pelvis tilts
- Your glutes switch off
- Your lower back and sacrum take more load
Over time, this can irritate the SI joints and surrounding tissues.
2. Poor Movement Patterns
If your hips, core or lower back aren’t working together properly, the sacrum often picks up the slack.
For example:
- Weak glutes → more stress on the sacrum
- Tight hip flexors → altered pelvic position
- Poor core control → instability
Your body is great at compensating… until it isn’t.
3. Sudden Strain or Injury
Sometimes it’s a simple moment:
- Lifting something awkwardly
- Twisting quickly
- A fall or impact
This can irritate the ligaments around the sacrum or cause the SI joints to become restricted.
4. Pregnancy and Hormonal Changes
During pregnancy, the body releases hormones that loosen ligaments (to prepare for childbirth).
This can make the SI joints less stable, leading to sacrum pain, something many expectant mums experience.
5. Asymmetry in the Body
If one side of your pelvis is moving differently to the other, it can create uneven stress.
You might notice:
- One hip feels higher
- You lean to one side
- Shoes wear unevenly
These small imbalances can add up over time.
A Simple Way to Think About It
I often explain it like this:
Your sacrum is like the “bridge” between your upper and lower body.
If traffic (movement) flows smoothly, everything works well.
If there’s a jam (stiffness, weakness, imbalance), pressure builds and that’s when pain starts.
What Can You Do About Sacrum Pain?
The good news? There’s a lot you can do to help this area settle down and move better again.
1. Keep Moving (But Smartly)
Rest isn’t always the answer.
Gentle, controlled movement helps:
- Improve circulation
- Reduce stiffness
- Re-engage supporting muscles
Simple movements like walking can go a long way.
2. Try These Gentle Exercise
Here are a few I often recommend to patients:
Pelvic Tilts (Great Starting Point)
- Lie on your back with knees bent
- Gently tilt your pelvis to flatten your lower back into the floor
- Repeat slowly for 10–15 reps
Knee Rolls
- Lie on your back, knees bent
- Gently rock your knees side to side
- Keep it controlled and pain free
Glute Bridges
- Lift your hips slowly off the floor
- Squeeze your glutes at the top
- Lower down with control
These help restore balance around the sacrum without overloading it.
3. Watch Your Sitting Habits
If you’re sitting a lot during the day:
- Avoid slumping
- Keep both feet flat on the floor
- Try to stand up every 30–45 minutes
Even small posture changes can reduce strain on the sacrum.
4. Don’t Ignore Your Glutes and Core
Strong, active muscles around the pelvis are key.
Focus on:
- Glute strength
- Core stability
- Hip mobility
This takes pressure off the sacrum and helps your body move more efficiently.
5. Hands On Treatment Can Help
In clinic, we often use a combination of:
- Spinal and pelvic adjustments to improve joint movement
- Soft tissue work to reduce muscle tension
- Rehabilitation exercises to build long term stability
In some cases, therapies like acupuncture or shockwave therapy may also be helpful, depending on the underlying issue.
The goal isn’t just short term relief, it’s helping your body function better so the problem doesn’t keep coming back.
When Should You Get It Checked?
While sacrum pain is often mechanical (movement related), it’s always worth getting checked if:
- The pain is persistent or worsening
- It’s affecting your daily activities
- You’re unsure what’s causing it
- Pain is spreading or changing
A proper assessment helps rule out other causes and gives you a clear plan forward.
A Quick Reassurance
Sacrum pain can feel frustrating, especially because it’s not always easy to pinpoint.
But in most cases, it’s not something “serious” or permanent. It’s usually your body asking for better movement, support and balance.
And the sooner you address it, the easier it is to improve.
Final Thoughts
If you’ve been dealing with that annoying ache at the base of your spine, you’re definitely not alone and you don’t have to just “put up with it.”
With the right combination of movement, awareness and support, most sacrum related issues can improve significantly.If you’d like help figuring out exactly what’s going on and what your body needs, you’re always welcome to come in for a discovery visit. We’ll talk through your symptoms, assess how you’re moving and create a plan that’s tailored to you.r recovery..
References
- National Institute for Health and Care Excellence (NICE), 2020, Low Back Pain and Sciatica in Over 16s: Assessment and Management
- American Chiropractic Association, 2022, Sacroiliac Joint Dysfunction Overview
- Vleeming et al., 2012, The Sacroiliac Joint: An Overview of Its Anatomy, Function and Potential Clinical Implications, Journal of Anatomy
- Cohen et al., 2013, Sacroiliac Joint Pain: A Comprehensive Review of Epidemiology, Diagnosis and Treatment, Anesthesiology
