Sacroiliitis

Last reviewed by Dr.Mary on January 1st, 2012.

What is Sacroiliitis?

Sacroiliitis is an orthopedic medical condition involving the inflammation of the sacroiliac joints, the medical term referring to either one of the joints on both sides of the body that link the lower ends of the spine to the pelvic bone. The condition is one that entails a considerable amount of pain located in the lower regions of the back due to the internal irritation of the joint structure. The pain experienced by patients with sacroiliitis is also easily exacerbated by several aggravating activities that apply pressure or force upon the sacroiliac joints, such as standing for long periods of time for example. The disorder is classified under the family of diseases referred to as spondyloarthropathies, which includes any medical condition that results in the inflammation of any region of the spine’s structure.


The condition is not easily distinguishable from other sources of pain in the lower back as sacroiliitis shares its symptoms with various other conditions, but adequately thorough diagnostic testing can determine the existence of the condition. Once diagnosed, the condition can be treated through a full regimen consisting of combined efforts of drugs, rest, and physical therapy. Detection and treatment is especially important as the condition can produce severe complications if the irritation is not resolved.

Sacroiliitis Symptoms

The central feature of sacroiliitis is the pain that accompanies the condition. The pain is distinguished due to its nature of being localized in the region of lower back as well as in the buttocks in certain instances. The following are the specific characteristics of sacroiliitis.

  • Pain, generally occurring in the lower back or buttocks
  • Pain may also radiate to the lower limbs, affecting the groin, legs, or the feet
  • Difficulty engaging in some types of activity such as sitting, standing, walking, and bending
  • Pain is exacerbated by several activities, such as standing for long periods of time, climbing stairs, running, and focusing one’s weight on one side of the body by supporting oneself up more on one leg. Generally any action that requires increased force and effort from the sacroiliac joints stirs up the painful sensations.

If the sacroiliitis is able to progress, complications may develop. Watch out for symptoms such as difficulty breathing, heart problems, or difficulty with posture and gait as these are possible signs of complications of the illness.

Sacroiliitis Causes

The disorder can be caused by several possible factors, each one affecting the sacroiliac joints in a way. A possible source of the irritation in the sacroiliac joints can be brought about by sustaining an injury to the area. Common triggers of the sacroiliitis can come in the form of a vehicular accident or even a simple fall. Any extreme force applied to the sacroiliac joints can cause injury to the connective tissues in the region, impairing their ability to be fully made use of in movement and support.

Osteoarthritis as a part of the process of aging can also bring about the irritation. The mechanism of the condition is similar to that of any physical trauma, involving the destruction of tissues in the joints necessary to maintain the body’s mobility.

Some pregnant women may also experience sacroiliitis as a consequence of the physical changes a woman’s body undergoes during pregnancy. Over the period of the 9 months it takes for a baby to fully develop within the mother’s womb, the mother’s own body adjusts to the presence of the new life by adapting. These adjustments involve the stretching of the sacroiliac joints in order to allow the accommodation of the baby during childbirth. These changes in the bone structure of the woman’s hips are not meant to produce debilitating results, but in combination with the woman’s increased weight, the already loosened joints may suffer from the increased pressure and become worn out.

In addition to all the previously mentioned causes, infection is another possible source of sacroiliitis. The bacterial growth may be one that was able to migrate from an originally different location, eventually reaching the joints of the sacrum and the pelvis and proceeding with their proliferation in this location.

Sacroiliitis Treatment

Treatment for sacroiliitis is aimed at controlling symptoms and eliminating the source of the irritation in order to improve and recover the utility of sacroiliac joints. Several types of drugs are prescribed by doctors to address the symptoms of the condition. Pain relievers are an obvious element in the course of treatment to get rid of the severe pain. Over-the-counter painkillers can be used but if pain is much too great and is unresolved by these, the doctor can prescribe stronger analgesics such as tramadol, for instance. Some doctors may prescribe narcotics for extreme pain but these are used cautiously and only for short periods of time as patients can develop addictions to these medications.

Injectable drugs are also used for patients. These include betamethasone or triamcinolone. The medications are injected directly into the affected joints to reduce inflammation and subsequently help with pain as well. These shots are however limited to only a few per year as they can eventually be unhealthy for the bones if used continuously.

Exercises

Physical therapy is also necessary for patients with sacroiliitis. These consist of range-of-motion exercises and stretching routines to improve the joints’ performance and endurance. These are especially necessary if the sacroiliitis has already produced degradation in the patient’s ability to tolerate physical activity.

Diagnosis

Because sacroiliitis can often be difficult to distinguish from other causes of lower back pain, imaging tests are necessary to obtain an internal view of the bone structure to verify the presence of an inflammation. The most basic imaging test used is the x-ray, which is usually enough to detect the presence of irritation and inflammation in the sacroiliac joints. More comprehensive and detailed imaging tests however are also available; these include CT scans and MRIs which produce cross-sectional images of the internal structure of the bones, allowing more in depth observation.

Prognosis

Recovery for patients suffering from sacroiliitis will vary depending on the severity of the condition as well as the patient’s ability to religiously comply with his or her treatment regimen. Ideally, once treatment for the condition has begun, the pain may be resolved within a short period of a few days. In other instances, the pain may take several weeks to disappear, typically taking 2 or 3 weeks.

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