Is this article saying my pain is caused by stress or emotions?

No. This article describes how emotional state amplifies or dampens pain signals that originate from a real physical source. The pain generator, whether it is a joint, a nerve, or inflamed tissue, is still there. Emotional state acts on the volume control for that signal through specific circuits like the periaqueductal gray and RVM. Addressing the emotional and inflammatory layer does not mean the physical layer is being dismissed.

Why does my pain feel worse on some days even when nothing physically changed?

Two mechanisms drive this. Increased connectivity between the default mode network and salience network can pull pain-related threat signals into your ongoing self-focused thinking, and glucocorticoid receptor resistance can leave cortisol circulating without effectively shutting down inflammation. Both of these fluctuate with your stress load, which is why identical days on paper can feel physically different.

Does this mean medication won't work for me if my pain has an emotional component?

Medication still works on the target it was designed for. Anti-inflammatories still reduce inflammation in tissue, and nerve-targeting medications still reduce nerve signal transmission. What they were not designed to do is reach brainstem circuitry, glial activation in the central nervous system, or brain network connectivity. That is why addressing the emotional and inflammatory layer alongside your current medication, rather than instead of it, tends to produce a more complete result.

What can I actually do to influence this brainstem pain circuit?

Structured mindfulness training, consistent breathwork, cognitive behavioral therapy, and consistent sleep have measurable effects on amygdala reactivity, prefrontal regulation, cortisol output, and glucocorticoid receptor sensitivity. These are not generic wellness suggestions. Each one targets a specific mechanism described above, and each requires consistency rather than a single session to produce a measurable shift.

How do positive emotions actually reduce pain, not just distract from it?

Genuine positive emotion activates the ventral tegmental area and increases dopamine signaling, which triggers release of your body's own opioid molecules, beta-endorphins and enkephalins. Those molecules bind to the same mu and delta opioid receptors that prescription opioids target, in the same PAG and RVM circuit described earlier in this article. This is a direct neurochemical effect, not a psychological distraction from the sensation of pain.

Why Does My SI Joint Feel Stuck or Like It's Slipping Out of Place?

Jason Winkelmann

10 hours ago

3 min read

The feeling that your SI joint is stuck or slipping is real, but the joint is not coming out of its socket. It moves only a degree or two and a few millimeters at most. What you feel is usually a stiff or unstable joint with muscles guarding around it, and each pattern needs a different kind of treatment.

If you have described this sensation to someone and been told a joint cannot slip out of place, it can feel like being told your experience is wrong. The sensation is real. The explanation for it is what needs correcting.

The Mechanism

The sacroiliac (SI) joint moves very little. A systematic review of studies that measured it directly found only minute amounts of rotation and translation. Under full body weight in cadaver testing, motion was well under a degree. A joint that moves that little cannot slide out and back in the way a shoulder can, which is the honest reason the phrase out of place does not match the anatomy.

So what are you feeling? Two different things, depending on the person. In the first pattern, the joint feels stuck. The ligaments around it carry nociceptors, nerve endings that signal strain, and when they are irritated the muscles around the joint tighten to splint it. This protective muscle spasm clamps the joint into a narrower range, so it feels locked, and a sudden movement can feel like a catch.

In the second pattern, the joint feels loose. Its stability depends on force closure, the active compression from the gluteus maximus, hamstring, and deep back muscles working with the ligaments. When the ligaments have been stretched, as in pregnancy or in people with generally flexible joints, and the muscles cannot fully make up the difference, the pelvis can feel as though it might give way. A pelvic compression belt often feels better in this pattern because it supplies external compression and shifts muscle activation.

The brief relief that sometimes follows a pop or a sudden position change in the stuck pattern typically fades within hours, because the guarding returns. That fits muscle guarding more than a bone repositioning, and it explains why people chase the pop repeatedly.

Conventional care struggles here for a structural reason. Imaging cannot show a joint's functional pattern. A restricted joint and an unstable joint can look identical on a scan while demanding opposite treatments.

When It's Something More Serious

A true giving-way sensation with leg weakness, numbness in the groin or inner thighs, or any change in bladder or bowel control needs urgent evaluation. Pain that began after a fall, accident, or significant impact should be checked for a fracture.

How This Gets Addressed

The deciding step is identifying whether your joint is restricted or loose, because treating a loose joint with mobilization tends to worsen it.

For a restricted pattern, Chiropractic care uses SI-specific mobilization to restore comfortable motion and reduce guarding, and we do not need a bone to be out of position for that to help.

Massage Therapy and Dry Needling release the spasm that clamps the joint down.

For an unstable pattern, Physical Therapy is the central intervention, building the gluteus maximus, deep hip, and back muscle control that stands in for what the ligaments no longer provide, which is also what prevents recurrence in the stuck pattern.

Naturopathic Medicine addresses the hormonal and connective tissue factors behind ligament laxity when stabilization is slow to progress.

You can learn more about our full approach to sacroiliac joint pain here.

Most people notice the catching and giving-way become less frequent as muscle control improves, although a joint with long-standing ligament laxity may always need ongoing strengthening to stay quiet.

Written By:

Dr. Jason Winkelmann

Naturopathic doctor, Chiropractor, Chronic Pain Specialist, and Educator

Frequently Asked Questions

Why does my SI joint pop and then feel better for a few hours?

The popping sound itself is not well understood, but the temporary relief fits muscle guarding releasing for a short time. Because the underlying guarding or instability is still present, it tends to return, which is why repeated popping rarely produces lasting change.

Is it harmful to keep cracking my SI joint myself?

If your joint is stiff, occasional self-mobilization may feel helpful. If it is loose, repeatedly forcing it through range can add to the irritation. Knowing which pattern you have before choosing is the safer approach.

Can a joint that only moves a few millimeters really cause this much pain?

Yes. The joint's ligaments are rich in pain-sensing nerve endings, and it carries your full upper body load with every step. Small changes in how much it moves, or how well muscles control it, can matter a great deal at that scale.