Neurodivergence & Pain: Could SI Joint Instability Be Behind Your Discomfort?
If you live in a neurodivergent body—whether you’re autistic, have ADHD, experience sensory processing differences, or navigate Ehlers-Danlos or hypermobility—chronic pain might be part of your everyday story. But what if part of that story could be traced to something you’ve never heard of?
Let’s talk about the SI joint—a small but mighty part of the body that plays a big role in how we move, feel, and regulate.
So, What Is the SI Joint?
The sacroiliac (SI) joint sits between the sacrum (base of your spine) and the ilium (part of your pelvis). You have one on each side. Think of it as the hinge that transfers weight between your upper body and legs—it needs to be stable, but also just flexible enough to move with you.
But for many neurodivergent folks—especially those with hypermobile joints, connective tissue differences, or nervous system dysregulation—the SI joint can become unstable. This means it shifts too much or gets stuck, and the surrounding muscles overcompensate.
Why Is This Important for Neurodivergent Bodies?
Neurodivergent individuals often live with:
Hypermobility (including Ehlers-Danlos Syndrome)
Sensory processing differences
Heightened interoception or dysregulated pain signals
Endometriosis or hormonal sensitivity
Tension-based motor issues or low muscle tone
Executive functioning struggles that affect body awareness or movement planning
These factors can lead to micro-instabilities in joints that fly under the radar—until pain, fatigue, or sensory overwhelm starts screaming.
How Do You Know If SI Joint Instability Is an Issue?
Here’s a sensory-friendly guide to tuning into possible SI joint dysfunction:
Pain & Sensation Clues:
Pain in your lower back near the butt dimples, usually one side
Sharp, stabbing pain when rolling over in bed, standing from a chair, or walking
A feeling of "clicking," "popping," or shifting in your hips or pelvis
Butt, groin, or leg pain that doesn’t follow a clear injury pattern
Sensory & Autonomic Clues:
You feel "wobbly" or unstable walking or standing
Your pelvis feels uneven, like one leg is longer
You feel clammy, nauseous, or anxious when flare-ups hit (due to autonomic nervous system activation)
Your bladder or digestion feels off—you pee more often or get stomach upsets during flares
What Conditions Make SI Joint Instability More Likely?
This type of instability is often under-recognized in neurodivergent communities, especially women, AFAB people, and those with overlapping health conditions:
ConditionLink to SI Joint IssuesADHD & AutismDifferences in muscle tone, proprioception, and movement awareness can impact stability. Sensory seeking/avoidant postures may strain the pelvis.Hypermobility / hEDSLigaments and fascia may not hold joints firmly in place, leading to micro-instability. Endometriosis Pelvic inflammation, scarring, and referred pain can destabilize or tense surrounding muscles.CPTSD / Chronic StressConstant muscle guarding in the hips and low back impacts joint mobility and flow.Postural & Gait Patterns Many neurodivergent people naturally shift weight to one side, lock joints, or avoid movement that doesn’t feel “safe” — putting extra strain on the SI area.
What Can Help?
The good news? You’re not stuck. A trauma-informed, neurodiversity-aware approach to SI joint stability includes:
✨ Gentle resistance training focused on the glutes, core, and pelvic floor
🌬 Breathwork and nervous system calming tools
🧘🏽♀️ Somatic practices that reconnect you to your body (like body scanning or rocking)
💪 Gradual, guided strengthening to build trust and function
🩺 Support from a physio who understands hypermobility and neurodivergence
And above all: self-compassion. Pain is not a failure—it’s communication. And in your brilliantly wired body, even the smallest shift toward support and safety can make a huge difference.
Want to Check Yourself?
I've created a simple black-and-white self-check guide to help you explore your SI joint stability. Let me know if you'd like it emailed!
