Last reviewed by Dr. Raj MD on January 12th, 2022.
What is Sacroiliitis?
Sacroiliitis is a condition characterized by an inflammation of either one or both of the joint that connects the lower spine and the pelvis or the sacroiliac joints. The condition is marked by a severe back pain in the lower back or at the buttocks. The condition of Sacroiliitis is often associated with other inflammatory condition of the spine which can be debilitating. Such inflammatory condition of the spine are grouped into a condition known as spondyloarthropathy which includes conditions such as ankylosing spondylitis, reactive arthritis and psoriatic arthritis to name a few.
Sacroiliitis is also interchangeably termed with sacroiliac joint dysfunction as both conditions are similar with causing pain to the lower back as both conditions have originated from the sacroiliac joint. Although Sacroiliitis belonged to a group of inflammatory disease, it is also part of the other form or type of arthritis such as Crohn’s disease and ulcerative colitis.
Sacroiliac joint is located on both sides of the pelvis joined by sacrum and the iliac. It is bound by strong and thick ligaments to facilitate its function in distributing the weight in the upper body and spine to the pelvis and the legs although the sacroiliac joint offers a little movement that a misalignment or any aberration can result to pain such as that in the case of Sacroiliitis. The hub of sacroiliac joint is vital in allowing movement in upright position as the joint is for provision of stability in facilitating mobility in human.
Symptoms of Sacroilitis
Sacroiliitis occurs when the sacroiliac joint becomes inflamed which could be due from a lot of factor such as that of infection. The most common complaint of patient suffering from the condition is the perception of extreme lower back pain and buttocks which can be debilitating. The pain can also radiate to the areas of the groin, legs and feet. The perception of lower back pain is worse at night that is sometimes associated with stiffness in the back.
The pain in Sacroiliitis is made worse or aggravated by the following:
- Prolonged standing
- Prolonged sitting
- Weight bearing in one leg instead of two
- Constant climbing of stairs
- Prolonged and long distance running
- Sudden standing from seated position
Pain in Sacroiliitis can be felt in one side of the buttocks which can go from mild to moderate although the pain is usually bilateral.
Sacroiliitis occurs when there is an inflammation within the sacroiliac joint which can be the result of a lot of incident considered to be factors contributing in the inflammation of the sacroiliac joint.
Pregnancy is among the contributory factors in sacroiliac joint inflammation. The ligaments binding the joint is softened and stretched during the course of pregnancy which also increases the movement within the sacroiliac joint. Additional weight as a result of growing fetus can also alter the gait of pregnant woman thereby putting on stress in the sacroiliac joint and can later on tear the ligaments and cause it to inflame.
Infection can also cause inflammation of the sacroiliac joint although this case seldom happens.
Trauma in the sacroiliac joint can result to misalignment of the joint. Trauma can be in the form of a forceful injury such as that from vehicular accident and any damage directed towards the joint.
Arthritis can result to wear and tear of the ligaments binding the joints. Any type of inflammatory spine condition can result to this wear and tear and causes inflammation of sacroiliac joint. Such conditions can include osteoarthritis and ankylosing spondylitis among the few of the group of inflammatory disease of the spine.
Diagnosing Sacroiliitis is initially done with physical examination where pressure point is being placed on the hips and buttocks of the patient in determining the cause of pain. Sacroiliac joint will also be put on gentle stress through moving the legs of patients in range of position.
Imaging test is reliable in determining inflammation of the sacroiliac joint. X-ray is being utilized although the revelation can be quite vague in diagnosing the disease as the proof of the condition can only become visual after many years. Active inflammation within the joint on the other hand can be seen with the use of magnetic resonance imaging with its modern technique. Gadolinium T1 MRI is another common technique utilized in diagnosing Sacroiliitis although this type of imaging test will require patient to take in dye via injection. CT scan can also be utilized in diagnosing Sacroiliitis although MRI alone is enough to diagnose and verify the condition.
Blood test is recommended for diagnosing Sacroiliitis when there is suspicion on an existing infection contributing to the inflammation in the joint and pain in the lower back. It is rather important that lower back pain is consulted to a doctor as the pain in the lower back is an indication of an existing or underlying medical condition which should be taken seriously.
Another test that can be done in diagnosing Sacroiliitis is through numbing test where an anesthetic injection is applied in the sacroiliac joint in pinning down the cause of lower back pain. The test however is not hundred percent reliable as the injected anesthesia can leak into adjacent part and diminish the confirmation of the disease. This test however is seldom utilized.
Treatment of Sacroiliitis is dependent on the underlying condition causing the inflammation including the manifested signs and symptoms. The goal of treatment is geared towards the relief of symptoms, diminution of disease progression while improving and restoring the function of the joints.
Pain relievers are often prescribed to help relieve the symptom of pain. Over-the-counter pain relievers can also help for the temporary relief of pain.
Muscle relaxants such as cyclobenzaprine helps through reducing muscle spasm associated in Sacroiliitis.
Physical therapy is recommended to restore the mobility and flexibility including strength of the sacroiliac joint. Range of motion and stretching exercises are especially taught by licensed practitioners to help patient in restoring mobility and functionality of the joint.
Other procedures are also utilized such as application of corticosteroid through injection directly to the inflamed joint. Surgery is seldom prescribed although can be utilized especially if symptoms of pain cannot be relieved with non-invasive treatment.