Sacroiliitis: Causes, Picture, Symptoms, and Treatment

Sacroiliitis is pain-inducing several problems in your life. It is the inflammation of the sacroiliac joints in your body. Pain can restrict your movement and control your actions. But, the joint pain can make your condition worse. So, sacroiliitis makes it difficult to stand or climb a stair. You feel excruciating pain, especially in your lower back. So, you feel discomfort in your buttocks as well as your legs. The condition can confuse you as lower back pain is synonymous with several other conditions. Therefore, you need to gather as much information as possible. It will help you pinpoint the actual cause leading to the pain. Read ahead to gain valuable information on the problematic condition.

What Is Sacroiliitis?

Sacroiliitis is the combination of two words, sacroiliac and Itis (the Latin word synonymous with inflammation). Therefore, the term refers to the inflammation of the sacroiliac joint in your body. Sacroiliac joints (a combination of sacrum and ilium) are situated at the region where the lower spine connects with the pelvis. One or both the joints can have issues like inflammation leading to the lower lumbar spine pain or discomfort in the buttocks. So, the pain gets worse once you transition from the sitting position to standing after a long time. You may feel agony after standing or walking for a long time. But, the problem is mostly confused with inflammatory arthritis (spinal region) due to the similarity in the symptoms.

The issue can cause axial pain to you. Now you may wonder what axial pain is. It is the type of pain that does not spread to another area. So, the pain you experience may not move to the spine or go down the legs. But, it is possible that you may experience pain radiating below the leg (but not below the knees).

Sacroiliitis Vs Sacroiliac Dysfunction

Both conditions affect the sacroiliac joint. So, you may experience similar pain. But the condition differs from one another. The sacroiliac joint dysfunction happens due to the abnormal motion in the sacroiliac joint region. The too little motion or too much motion is harmful resulting in the condition. Therefore, the condition can result in sacroiliitis.

While the sacroiliitis may or may not contribute to the sacroiliac joint dysfunction. The joints at the lower part of your spine can become inflamed. The region that connects the spine and pelvic area are vulnerable to inflammation. So, sacroiliitis can cause pain in the following areas:

  • Lower back
  • Buttocks
  • Legs
  • Hips
  • Feet (very rare)

Symptoms Of Sacroiliitis

Pain is the most common symptom of the condition. So, with the condition, you can experience lower back issues. Inflammation is the main complication of the disease. But, you may experience one or a combination of the symptoms:

Fever

You can have a low-grade fever that accompanies the pain in the hip, buttocks, or legs.

Worsening Pain

The pain you experience can become worse while climbing the stairs. It can also become severe after standing for a long time or rolling over in bed. So, the pain can escalate when you walk with long strides or run.

Stiffness

You can feel stiffness in the lower back or the hips in the morning after a long night of sleep. The hips and lower back feel stiff after sitting in the same position for a long duration of time.

Causes Of Sacroiliitis

The inflammation in the sacroiliac joints can affect your daily life. But, the condition develops due to certain major causes or underlying health issues. So, the main reasons for the problem affecting your life are:

Traumatic Injury

The sudden impact can affect your sacroiliac joints in an adverse manner. In most cases, an accident or fall can result in damage to the sacroiliac joint. Therefore, the damage progress into inflammation. It finally causes sacroiliitis.

Arthritis

Another common cause of the issue is arthritis. The wear and tear of the sacroiliac joints can lead to the problem. The common types of arthritis resulting in inflammation are:

Ankylosing Spondylitis

It is the type of inflammatory arthritis affecting the spine. The rheumatic disease can result in stiffness and inflammation in the hips and spine region. It is a progressive type of arthritis that needs proper medical care. If you suffer from ankylosing spondylitis, the chances of getting sacroiliitis become higher. Caucasians are more prone to the issue compared to others.

It is a common type of arthritis affecting a large number of people worldwide. Osteoarthritis is a serious condition that can trigger other health issues and disorders in your body. One of the problems that can develop due to osteoarthritis is sacroiliitis. When you suffer from osteoarthritis, your cartilage gets adversely affected. Therefore, the degenerative issue can affect you as you become old.

Pregnancy

Pregnancy can cause a lot of changes in the body. It is to prepare the body to accommodate the growing child and prepare for birth. The sacroiliac joints undergo major changes like loosening and stretching to make it easier during childbirth. So, the joints become loose. The additional weight due to the baby can result in an altered gait. Hence, it results in putting stress on the joints. The abnormal pressure can cause wear and tear of the joints leading to the conditions like sacroiliitis.

Infection

It is a rare condition. The sacroiliac joint can get infected due to the different reasons leading to the problem.

Spine Problems

The preexisting spine or back problems can lead to triggering the inflammation of the sacroiliac joints. So, it results in the condition causing immense pain and discomfort.

Other Health Issues

Other health problems or diseases can trigger inflammation leading to severe stiffness and pain in your lower back. The common issues causing the discomfort are:

  • Gout
  • Endocarditis
  • Drug addiction or IV drug use
  • Urinary tract infection

Complications Due To Sacroiliitis

The inflammation of the sacroiliac joints can cause distress to you. So, you need to get adequate medical help. Not taking the help of a medical professional can result in serious health complications. Therefore, the main issues that you have to experience once the inflammation escalates are:

Depression

Chronic pain causes severe discomfort in your life. You feel the pain is pulling you back from reaching your fullest potential. The day-to-the activities feel strained as the pain can make it impossible for free movement. So, it causes mental issues like depression. The negative feelings and thoughts haunt you. Hence, it makes your life hell.

Insomnia

Chronic pain can result in restlessness. So, you may not get a peaceful sleep. Your sleep gets disturbed due to the distress. Therefore, it results in insomnia.

Other Difficulties

In some cases, the inflammation of the sacroiliac joints can cause breathing problems. It is particularly evident in the sacroiliitis resulting from the ankylosing spondylitis. Inflammatory arthritis triggering the problem can escalate to result in spinal deformities, heart, and lung problems. 

You need to consult your doctor to know the exact reason that can trigger the problem. it can help in developing an ideal treatment plan to overcome the disease. If you avoid getting treatment, then it can affect your health adversely.

Diagnosis Of Sacroiliitis

Once you feel severe pain, you need to seek an appointment with your doctor. The doctor can adopt several diagnostic methods to pinpoint the exact reason that triggers the problem. So, your doctor combines one or more options to get an accurate diagnosis.

Physical Examination

The physical examination can give information to your doctor about the exact location of the pain. You need to move your legs or the doctor can press the areas in the hip or buttocks region. The moving and pressing in different positions can stress the sacroiliac joints. Therefore, it helps identify the exact cause of the pain. As several problems have the same symptoms, it is important to eliminate the other causes. So, your doctor can confidently come to the conclusion that the pain is triggered as a result of sacroiliitis.

Injecting Medication

Another method opted by your doctor to identify the pain in the sacroiliac joint is the injecting of numbing medication. It eliminates the doubts regarding the other causes in the lower back resulting in severe pain. So, the medication can help diagnose the problem. One of the major drawbacks of the method is its accuracy. The injected medication can possibly spread to other areas in the body. Hence, it cannot provide a clear picture to your doctor.

Imaging Tests

To make a confirmation of the exact cause of the pain, more reliable imaging tests can assist. The x-ray of the pelvic region can provide a clear picture of the sacroiliac joint. The x-ray images can shed light on the wear and tear suffered by the joint.

If your doctor suspects you have sacroiliitis triggered by ankylosing spondylitis, then MRI can confirm it. The imaging test using the magnetic field and radio waves to provide images offers a conclusive picture of the problem. The cross-sectional images provided by the MRI of both the soft tissues and bones can help your doctor understand the problem better.

The confirmation of sacroiliitis is necessary to develop the appropriate treatment plan. With the apt treatment plan, your chances of overcoming the issues get higher.

Treatment Of Sacroiliitis

As mentioned before, the exact cause of sacroiliitis is necessary to get the ideal treatment. Depending on the type of issue, your doctor suggests the ideal treatment plans. As the first line of treatment over-the-counter medication can help alleviate your pain. Medications are not advised for pregnancy-related sacroiliac joint inflammation. So, your doctor may suggest resting the joints to eliminate the different symptoms. But, in some cases, it provides you with no relief. So, the medical professional suggest other treatment options like:

Sacroiliac Injection

Depending on the severity of the symptoms, the doctor provides a sacroiliac injection. It is a treatment option adopted depending on your signs and the exact cause of the inflammation of the sacroiliac joints.

Medications

If the over-the-counter medications are not effective, then you need different doses of the drugs. So, the different types of drugs can provide comfort and reduce distress. Your doctor may opt for the following variations of medications depending on the cause of pain:

Pain Relievers

The higher dose of the prescription medication aims to provide you with good relief. A stronger dose can help overcome the distress. It has a higher power to relieve distress compared to over-the-counter medications.

Muscle Relaxants

The drugs coming under the muscle relaxant category reduce the muscle spasms. People affected with sacroiliitis can suffer from frequent muscle spasms. So, the medications like cyclobenzaprine (Fexmid or Amrix) can help relieve the issue.

TNF Inhibitors

If ankylosing spondylitis is the root cause of the inflammation of sacroiliac joints, then your doctor suggests TNF inhibitors. The Tumor Necrosis Factor (TNF) inhibitors can successfully relieve the sacroiliitis triggered by inflammatory arthritis. So, medications like etanercept, infliximab, and adalimumab cab overcome the problem.

Physical Therapy

The problem can cause pain and rigid feelings in your lower back. Therefore, you can opt for physical therapy. It is the ideal method for pregnant women who experience sacroiliitis. The physical therapist can expose you to stretching and range-of-motion exercises. So, it can help you maintain the flexibility of the joint. The physical therapist also suggests strengthening exercises that make the muscle more stable. Physical therapy mainly focuses on providing strength and flexibility to the joint muscles. So, it can help people suffering from sacroiliitis.

Isometric Exercises

The physical therapist suggests isometric exercises to improve mobility and overcome the pain. The exercises are highly effective in people suffering from arthritis, knee pain, hip pain, etc. So, by practicing isometrics, you can overcome the pain and discomfort caused by sacroiliitis. After assessing your pain levels and muscle strength, you can practice the exercises offering maximum gain. It can help your joints and muscles heal quickly from the damage and regain their strength. The two major types of isometric exercise that can relieve the pain are:

  • Hip Flexion
  • Hip Adduction Isometric Hold

The main aim of physical therapy is visible movement. So, the different types of motion and strengthening exercises can make your joints strong and flexible. After getting the right way to practice it, you can try it at your own home. Constant practice can strengthen the joints and increase flexibility. But, you need to consult your doctor or physical therapist before trying it at home. It will help you practice the right ones that may not cause injury. Therefore, the right exercises can relieve discomfort and distress.

Other Procedures

In case the medication and physical therapy do not relieve your symptoms, then your doctor may suggest other procedures. It includes surgery and other sophisticated methods to reduce pain. So, your doctor may suggest it only if other treatment options fail. The different methods available are:

Joint Injections

Your doctor can inject the corticosteroids directly into the joint. So, it can reduce pain and inflammation. The downfall of the method is, you have to restrict the injection to a minimum per year. The steroids have the power to weaken the joints by affecting the bones and tendons.

Electrical Stimulation

The procedure involves implanting an electrical stimulator. It is placed on your sacrum to reduce the discomfort caused by sacroiliitis.

Radiofrequency Denervation

The treatment aims to destroy or damage the nerve tissue causing inflammation.

Joint Fusion

As the name suggests, it fuses the bones. It is the surgical procedure that your doctor may adopt as the last option. So, joint fusion is a rare method to treat the problem. During the procedure, your doctor fuses two bones with the help of metal. So, it relieves the pressure from the joints. You get relief from the pain.

Conclusion

The determination of the exact cause of the issue is essential to get the right treatment. Remember that small injuries or issues leading to sacroiliitis has a good prognosis. You can relieve the pain and distress completely with the ideal medication and physical therapy. So, you can get your mobility back without any problem. But, you cannot completely cure the inflammation of the sacroiliac joint triggered by the ankylosing spondylitis or the joint damage. Surgery or medication cannot help you overcome the problem. So, you need to opt for a treatment plan that helps you manage the symptoms for a long time.

The pain in the joints is a severe issue. Several problems can result in the issue. Therefore, you need to seek our doctor’s help to manage it. Failure to do so can affect your normal life adversely. When you get treatment on time, it has better outcomes.

 

 

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