Promising relief from these troubling symptoms, online retailers and medical supply stores sell SI belts for around $50. The elastic belts are worn tight and low around the hips in order to support and stabilize the SI joints. But do they work? According to Jesse Lewis, a doctor of physical therapy and the owner of District Performance & Physio in Washington, DC, SI belts can make a difference for PsA patients with specific back and hip problems. “Typically I will recommend an SI belt if we need to improve hip, core, or pelvic strength but the patient is in too much pain to do any strengthening exercises,” Lewis says. “The SI belt allows us to get through more exercise with less pain, which will help long term with improving the person’s stability.” It’s a common misconception that SI belts hold the hips or SI joints in place, says Lewis: Even patients with PsA are not so fragile that they need to have their bodies held together with an elastic belt. Instead, the belt provides compression and feedback to the muscles around the hips and pelvis to help them work together more effectively and recover more quickly from spasms. If you decide to purchase an SI belt, be sure to try it on first to make sure it fits properly. It should go around the hips below your pelvic bones but above the bony part on the side of your hip (usually a couple of inches below your belly button). Lewis does not recommend wearing the SI belt to sleep unless you really need it. Aly Cohen, MD, a rheumatologist and integrative medicine practitioner in private practice in Monroe Township, New Jersey, says that while SI belts may be worth trying, it is best to seek a more permanent solution. “I recommend that my patients with psoriatic arthritis try manual manipulation, pelvic manipulation, or physical therapy to straighten out biomechanical abnormalities,” Dr. Cohen says. “Yoga and Pilates are both good for straightening out SI joints and resolving pelvic pain.” She also suggests that patients with pelvic or hip pain focus on strengthening their core, ideally through physical therapy. “If that does not give relief,” says Cohen, “cortisone shots are helpful for acute pelvic or hip pain.” If you have a flare-up of SI joint problems, “massage can help reduce pain,” Lewis says, “but it typically should be paired with physical therapy or other rehab to find a longer-term solution.”
