Sacroiliitis

Alternative Names

Sacroiliitis joints, SL joints

What is Sacroiliitis

Sacroiliitis is an inflammation of one or both of your sacroiliac joints, which connect your lower spine and pelvis. It causes pain in your buttocks or lower back, and may even extend down one or both legs. The pain associated with sacroiliitis is often aggravated by prolonged standing or by stair climbing.

Sacroiliitis belongs to a group of diseases called spondyloarthropathies, which cause inflammatory arthritis of the spine. It can be difficult to diagnose, because it may be mistaken for other causes of low back pain. Sacroiliitis treatment may include a combination of rest, physical therapy and medications.

Signs and symptoms

Between 75 and 85% of all people experience some form of back pain during their lifetime.

Below are some common symptoms:

• Back Pain
• Acute Back Pain (short-term back pain)
• Chronic Back Pain (long-term back pain)
• Radiating Pain/Sciatica
• Numbness and Weakness
• Stiffness and Tightness
• Bowel and Bladder Dysfunction

If you have noticed any of these symptoms, contact your doctor immediately:

• Pain is worse when you cough or sneeze
• Pain or numbness travels down one or both legs
• Pain awakens you from sleep
• You are finding it difficult to pass urine or have a bowel movement
• Pain is accompanied by loss of control of urination or bowel movements

Such important symptoms could signal nerve damage or other serious medical problems. There are many other conditions that could be causing these problems, but an early and accurate diagnosis is vital for successful treatment.

Possible complications

These sacroiliitis complications may occur depending on the severity of the pain, and they can make it difficult for you to:

• Sit
• Stand
• Walk
• Sleep
• Bend

Sacroiliitis may also be a part of an inflammatory arthritic condition known as ankylosing spondylitis. Complications of this condition can be very serious, including difficulty breathing, spine deformities, lung infections and heart problems.

What causes

Most of factors and events may cause sacroiliac joint dysfunction, including:

• Traumatic injury. A sudden impact, such as a motor vehicle accident or a fall, can damage your sacroiliac joints.
• Arthritis. Wear-and-tear arthritis (osteoarthritis) can occur in sacroiliac joints, as can ankylosing spondylitis — a type of inflammatory arthritis that affects the spine.
• Pregnancy. The sacroiliac joints must loosen and stretch to accommodate childbirth. The added weight and altered gait during pregnancy can cause additional stress on these joints and can lead to abnormal wear.
• Infection. In rare cases, the sacroiliac joint can become infected.

Prevention

To prevent sacroiliitis that is caused by an inflammatory arthritis condition such as psoriatic arthritis, early diagnosis and treatment should be taken with your doctor. If the condition is diagnosed and treated before sacroiliitis has set in, there is a chance that this condition may be avoided.

Avoiding traumatic injuries such as falls or car accidents will avoid a traumatically induced sacroiliitis.

During the pregnancy, it may be avoided by ensuring the muscles of the pelvis and lower back are strong. This can be seen to by a physiotherapist that is specialized in exercise therapy.

Treatment

Treatment depends on the signs and symptoms. Medications to cure sacroiliitis may include :

• Nonsteroidal anti-inflammatory drugs (NSAIDs). These pain-relieving drugs reduce swelling and inflammation. NSAIDs include indomethacin (Indocin), ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Anaprox, others). Taking NSAIDs can lead to side effects, such as indigestion and stomach bleeding.
• Corticosteroids. These medications, such as prednisone and methylprednisolone (Medrol), reduce inflammation and pain and slow joint damage. Cortisone injections can be used for localized pain relief that lasts a period of months.
• Disease-modifying antirheumatic drugs (DMARDs). These medications include sulfasalazine (Azulfidine) and methotrexate (Rheumatrex). Doctors prescribe DMARDs to limit joint damage. Taking these drugs at early stages in the development of a joint condition is especially important to slow the disease and save the joints and other tissues from permanent damage.
• Tumor necrosis factor (TNF) inhibitors. These therapies, which include etanercept (Enbrel) and infliximab (Remicade), block a cell protein (cytokine) that acts as an inflammatory agent. Blocking the TNF cytokine may help reduce pain, stiffness and tender or swollen joints.