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 SI Joint Pain Get Worse During and After Pregnancy?

Jason Winkelmann

2 hours ago

3 min read

During pregnancy, hormones including relaxin and estrogen loosen the pelvic ligaments, and a forward shift in your center of gravity adds load to the sacroiliac joints. The ligaments that normally keep the joint rigid become more permissive while the demand on them rises, which is why pain builds as pregnancy progresses and can linger afterward.

If you were told this pain is a normal part of pregnancy and to expect it, that reassurance probably did not help much at 3:00 a.m. when you could not roll over. Lukily, common does not mean you have to put up with it.

The Mechanism

The sacroiliac (SI) joints are held together by strong ligaments, and their stiffness is what allows them to transfer your weight to your legs. During pregnancy, the fibrous tissue around the joint loosens through hormonal and biomechanical factors, including relaxin, estrogen, and loosening at the pubic symphysis, which increases joint mobility to allow childbirth. Women also start with more SI joint mobility than men, because of a wider pubic angle and less curved joint surfaces. Pregnancy-related pelvic girdle pain, which includes the SI joints, has been estimated to affect almost half of pregnant women.

The loosening alone does not explain the pain. In the third trimester, weight gain and a more exaggerated curve in the lower back shift your center of gravity forward, which adds additional pull on the SI ligaments. The ligaments are being asked to hold more load while being less able to hold it, and the muscles that provide force closure, the active compression of the joint, have to cover the gap. When they cannot, the ligaments absorb the strain, and their nociceptors, nerve endings that signal strain, report it as pain.

Asymmetry matters too. The same review notes that women with asymmetric laxity between the two joints may be at higher risk of chronic pain after delivery, meaning one side is looser than the other and takes more of the load. After delivery, there is no guarantee that the ligaments return to their former length or symmetry, and daily loading from lifting and carrying a baby can add one-sided stress.

Conventional care typically offers reassurance, a support belt, and rest. A belt can give real short-term relief by supplying external compression, but it does not retrain the muscles that are supposed to do that job, and it does nothing for the asymmetry that tends to keep the pain going.

When It's Something More Serious

During pregnancy, back or pelvic pain with regular contractions, vaginal bleeding, leaking fluid, fever, or burning with urination should be reported to your OB provider or evaluated urgently. After delivery, fever, heavy bleeding, new leg swelling or calf pain, numbness in the groin, or any change in bladder or bowel control also needs prompt care.

How This Gets Addressed

Care during pregnancy has to be gentle and matched to the changes your body is making, which is why the service built for this is the Webster Technique. It is a specific chiropractic analysis and adjustment of the pelvic bones, muscles, and ligaments, aimed at restoring alignment and mobility in the sacrum and pelvis, where the sacroiliac joints sit. It also includes soft tissue work to the round ligaments and psoas, which the technique treats as contributors to pelvic imbalance. The goal is a pelvis that carries your changing load more evenly, so one side is not doing the work of both, and it is offered from early pregnancy through labor.

Naturopathic Medicine addresses the hormonal, inflammatory, and nutritional factors that influence how well connective tissue copes and recovers.

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

Most women improve substantially in the months after delivery as ligaments tighten and muscle control returns, but a minority carry some degree of pelvic sensitivity for much longer, especially if one side stayed looser than the other.

Written By:

Dr. Jason Winkelmann

Naturopathic doctor, Chiropractor, Chronic Pain Specialist, and Educator

Frequently Asked Questions

Is it safe to see a chiropractor while pregnant?

The Webster Technique is a pregnancy-specific chiropractic approach rather than a standard adjustment, and it works alongside your prenatal care, not in place of it. Tell your OB provider or midwife what you are doing, and treat any of the warning signs above as a reason to call them first.

Will my SI joint pain go away after I give birth?

For most women it improves within about four months as the pelvic ligaments tighten again. A minority continue to have pain for a year or more, which is why persistent postpartum pain is worth treating rather than waiting out.

Why does my pain get worse when I stretch my lower back?

If the joint is already too loose, stretching can add to the strain rather than relieve it. Gentle stabilization and support usually serve a loose pelvis better than aggressive stretching.