back pain

Sacrum pain: 6 causes (And what to do to cure?)

Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine 

Pain in the sacrum can be incapacitating, and limit the activities of everyday life, whether while sitting or even sometimes at rest.

What are the causes of pain in the sacrum? Is that bad ? What are the causes ? And above all, how to relieve this type of pain?

This article tells you everything you need to know about sacral pain, with a focus on strategies to relieve your symptoms.

Sacrum anatomy

The sacrum is an inverted triangle-shaped bone located at the terminal part of the spinal canal. It is formed by the fusion of five vertebrae sacred (called S1, S2, S3, S4 and S5).

It is located below the lumbar vertebrae with which it articulates. The lumbosacral region, between the L5 and S1 vertebrae, is also the lumbar region where there is the most movement (mainly in flexion and extension).

sacral anatomy

The sacrum also forms the posterior part of the pelvis, and articulates with the iliac bone to form the sacroiliac joint.

It is wide and remarkably thick, which helps it support and transmit body weight.

Several muscles attach to the sacrum in its anterior and posterior part. Among the best known are the piriformis muscle, the multifid and spinal erectors.

anatomy of the muscles of the sacrum

6 causes of sacrum pain

Pain in the sacrum can come from several causes. Here are the main ones:

Lower back pain

Any pain in the lower back can tend to refer, that is, it can spread to more or less related regions. This is where the concept of sciatica.

Thus, irritation of the lumbar region can radiate downwards, and cause pain in the hip, iliac crest, the sacrum, or even the thigh. It must be understood that the sacrum does not present any dysfunction as such in this situation, and that the source of the pain comes from the lower back.

Coccyx pain

Pain in the terminal region of the spine does not necessarily come from the sacrum. Il effect, there is a small bone at the end of the sacrum which can also be responsible for pain.

causes of coccyx pain
The coccyx attaches below the sacrum

To know everything about the coccyx pain, click here.


It goes without saying that trauma directly to the sacrum can cause pain there.

This can occur during a fall down the stairs, or even a blow directly on the sacrum to cause a fracture in some cases. In a sports context, repeated movements can cause stress fractures.

Pressure sore in the sacrum

A pressure ulcer is a deep wound in a specific location. It is caused by a compression of tissues that lack oxygen, and no longer benefit from optimal blood circulation.

Pressure ulcers in the sacrum are normally seen in the elderly, people in wheelchairs or people who are bedridden.

As the pressure ulcer sets in gradually, it is important to watch for warning signs before tissue damage. The appearance of redness in the sacrum should indicate that it is time to move the person to another position.

Prolonged static positions

Prolonged sitting posture can put pressure on the sacrum, especially if the seat is not suitable.

It is the same for the posture lying on the back, and even more when the mattress or the surface on which one lies down is very firm.

sacral pain during sleep

Besides the pressure on the skin, the inactivity caused by the exaggerated static posture can cause stiffness in the joints connected to the sacrum (lumbo-sacral and sacro-iliac). This can indirectly cause pain in the sacrum.

Sacroiliac dysfunction

Sacroiliac pain is a condition in its own right. It is caused by a dysfunction of this joint, and causes pain in the lower back and potentially in the buttocks or the lower limb.

It is also more common than pain in the sacrum, and generally more complex to treat.

sacro iliac pain in the sacrum

To learn all about sacroiliac pain and its management, see the following article. 

sacrum pain causes infographic

How to relieve pain in the sacrum?

When you suffer from pain in the sacrum, there are several possible solutions aimed at improving the symptoms.

Here are some tips often recommended to people who suffer from this condition:

Prevention of pressure sores

If the pain is caused by a pressure sore in the sacrum, the best treatment is prevention. Similarly, the observation of a pressure sore at an early stage greatly favors the prognosis for healing.

Treatment for pressure sores varies depending on the stage of the condition. Skin massage, frequent changing of positions, and pillows are possible treatment approaches.

In extreme cases, surgery may be indicated. The objective will be to remove the necrotic tissue, and to compensate for the deformation with a musculocutaneous flap (essentially a patch of muscle and skin aimed at filling the cavity caused by the eschar).

Relief of pain and inflammation

There are several solutions to calm the pain in the sacrum. Anti-inflammatory or painkiller medications are often prescribed by doctors.

Besides medication, there are several products and accessories available on the market to relieve sacral pain. It should be remembered that these tools generally provide temporary relief, and should be used sparingly. Among the products recommended by our professionals, we have:

heat and ice

Local application of heat or ice often relieves symptoms. However, care must be taken that the skin is not damaged in order to benefit from these methods.

To determine whether it is better to put hot or cold, consult the next item.


Avoidance of prolonged static positions

If the pain in the sacrum is caused by a prolonged static position, the frequent change of position will prevent the worsening of the condition.

Even in a seated position, it is possible to do pelvic mobility exercises in order to avoid an accumulation of stress on the lumbosacral region.

seated stretching to avoid sacrum pain

When lying down, the supine position should be avoided while the condition heals. This will reduce the stress on the sacrum.

Sometimes straightening the back indirectly helps reduce stress on the sacrum. With this in mind, some people use ergonomic back cushions (like this one we recommend).

Modify the environment

If the pain in the sacrum is due to an uncomfortable seat, and is increased when sitting, changing the chair can be an interesting solution.

There are also cushions that can be placed on your seat to reduce pressure on the sacrum, and thus relieve symptoms.

alternative ergonomic cushion to the active base seat

If it is the lying position that causes the pain, you can consider changing the mattress and opting for something less firm.

In short, although frequent change of position remains the ideal option, we modify our environment so that the sacrum does not undergo too much pressure, which can relieve pain in the long term.

Manual therapy

A qualified therapist (such as a physio, physio, osteo or chiropractor) can relieve pain by applying manual techniques to their patient.

Relaxing the muscles attaching to the sacrum may indirectly relieve symptoms. Mobilizations of the lumbar region and the sacroiliac joint can also be beneficial in certain cases.

manipulation to relieve pain in the sacrum

Be careful, do not think that the sacrum is displaced. The movements of the sacrum (called nutation and counter-nutation) are so minimal, making the displaced sacrum theory unlikely.

Thus, the therapist cannot “put the sacrum back in place”. On the other hand, manipulations can reduce muscle tension, and act by desensitizing the nervous system (which causes pain relief).


If the pain in the sacrum comes from a dysfunction of the sacroiliac joint, a sacroiliac infiltration may relieve symptoms. This approach is especially indicated when the pain persists despite well-conducted conservative treatment, and when this joint is indeed the main cause of the symptoms present.

sacroiliac infiltration

Essentially, a sacroiliac infiltration consists of inject a local anesthetic and/or an anti-inflammatory agent in the sacroiliac joint.

To know everything about this type of infiltration, see the following article.


Surgery is rare, and is generally used as a last resort. Often this is because all of the above modalities have failed to provide significant relief, and the patient remains limited on a day-to-day basis.

The most common operation is sacroiliac arthrodesis. It is a surgical fusion of the sacroiliac joint using implants and/or bone grafting to reduce pain and instability.

What about natural remedies?

Although they are not supported by solid scientific evidence, several natural products and home remedies are used to treat sacrum pain, especially for their anti-inflammatory power.

Here is a non-exhaustive list of plants and essential oils that are effective in controlling pain and inflammation. The products are available on the site Country. Use promo code LOMBAFIT15 if you wish to obtain one of the following products, or any remedy aimed at relieving your symptoms and improving your quality of life:

  • Turmeric. Thanks to its antioxidant and anti-inflammatory powers very powerful, turmeric is one of the most used plants in a culinary and therapeutic context. The composition of turmeric is essentially made of essential oils, vitamins (B1, B2, B6, C, E, K) and trace elements. But it is to its composition rich in curcumin and curcuminoids that we owe them and calm skin of this spice.
  • Ginger. In addition to the special flavor it brings to the kitchen and its aphrodisiac properties, ginger is a root well known for its anti-inflammatory powers. the gingerol gives it its anti-inflammatory action. It is an active component acting on the inflammatory pain related to chronic joint inflammatory diseases, including rheumatoid arthritis, lupus, rheumatic diseases, etc. It has been proven that this active element is also effective in acting on the inflammation linked to arthritis and sciatica. Ginger also has other benefits thanks to its high potassium content and its richness in trace elements (calcium, magnesium, phosphorus, sodium) and vitamins (provitamin and vitamin B9).
  • Omega-3s. Omega-3s are polyunsaturated fatty acids that play a very important role in the functioning of our body. They are provided by food in three natural forms: docosahexaenoic acid (DHA), alpha linolenic acid (ALA) and eicosapentaenoic acid (EPA). Beyond their action on the brain and the cardiovascular system, omega-3s prove very effective against inflammation. Indeed, they have the ability to act on the inflammatory mechanisms in osteoarthritis by slowing down cartilage destruction, thus they reduce the intensity of osteoarthritis pain. Sciatica, being most often linked to an inflammation secondary to a herniated disc, it can also respond to omega-3 provided it is consumed regularly. 
  • Lemon eucalyptusEucalyptus is a plant most often used in the form of herbal tea or essential oil. She would have anti-inflammatory effects which give it the ability to act on the bone and joint pain in general and the pain of sciatica in particular.
  • wintergreen. Wintergreen is a shrub from which a very interesting essential oil is extracted. It is one of the most used essential oils in aromatherapy. This oil extracted from the shrub bearing the same name, is used in massage to relieve sciatica and act like a analgesic. Indeed, it provides a heating effect thanks to its ability toactivate blood circulation locally.


The sacrum is a bone located at the bottom of the spine. It articulates with the lumbar vertebrae, the coccyx and the iliac bone.

sacral pain

It can be the seat of pain for many reasons. Essentially, any continued pressure at this level can cause pain in the sacrum.

Strategies to reduce symptoms include prevention of pressure ulcers, avoidance of prolonged static postures, and several other treatment modalities.

If you have sacral pain, a healthcare professional can help you identify the exact cause of your symptoms, as well as treatment strategies to get better.

Good recovery !

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