1. What is sacroiliitis?
An inflammation of one or both the sacroiliac
joints is termed as Sacroiliitis. This is situated where the lower spine and
pelvis connect. In other words, we can say that sacroiliac joint is a union of
sacrum and ilium. The Latin word denoting inflammation is called “ltis”. The
sacroiliac joints disorder can either be unilateral or bilateral affecting one
or both the joints. One can experience pain in lower back or buttocks which
further extends down to one or both the legs. Any pain caused by sacroiliitis
means that there is either too much or not enough motion in the sacroiliac
joints.
2. Causes of sacroiliitis
The various causes for sacroiliac joints pain are
mentioned below:
- · Infection
- Arthritis
- Pregnancy
- Injury
- Lifting heavy objects
- Obesity
3. Symptoms of
Sacroiliitis
An individual suffering from sacroiliitis
may come across the below signs;
- Individuals complaining of sacroiliac joint
pain also experience pain and stiffness in thighs, lower back and
buttocks.
- The pain also extends to hips and shoulders.
- Fever
- While walking the pain may worsen since the
swinging motion causes strain in the sacroiliac joints.
- Skin inflammation
- One may experience inflammation in one or
both the eye.
The pain in the sacroiliac joints can worsen due
to the below:
- Running
- Standing for longer durations
- Climbing stairs constantly
- Sitting at one place for longer duration.
- Bearing the weight of your body completely on one leg
- Running for longer periods
- Suddenly changing the position from being seated to standing
4. Diagnoses of Sacroiliitis
The doctor
will try to identify the cause of pain by moving your legs in different
positions to gently stress on the joints. They may also press the places of
your hips and buttocks. During the initial stages it becomes difficult for the
doctors to diagnose sacroiliitis because the conventional methods of
radiographs may show normal. Various techniques currently used to diagnose
sacroiliitis are:
Anaesthetic or numbing injections – A numbing injection is given into your
sacroiliac joints; if this injection stops the pain then the problem lies in
your sacroiliac joints. However, this test is not completely reliable since
there are chances of this medicine getting leaked into nearby structures.
Imaging tests – The doctor would suggest an X-Ray of your pelvis
to identify the damage in the joints. The doctor may recommend MRI if its
suspects ankylosing spondylitis. The sacroiliac joints are located deep in the
buttock region which is covered with thick muscle hence X-ray is conducted to
visualise the joint. Imaging tests is reliable in determination of any
inflammation of sacroiliac joints.
Magnetic resonance imaging (MRI) – The MRI has the ability to differentiate the
degrees of inflammation and localise edema. It’s a good visualisation of the
complex anatomy of the sacroiliac joint. MRI at times is enough to diagnose and
verify the severity of the condition.
Blood Tests – This is usually recommended by the doctor if
they suspect an existing infection contributing to the inflammation.
5. Treatment of Sacroiliitis
The treatment
for sacroiliitis helps the individual in mobility to a great extent hence there
should not be any delay in starting the course of treatment. The treatment completely depends on the root
cause of sacroiliitis and the various signs and symptoms associated with it. However,
there are certain medications and therapy your doctor might recommend:
Pain Relieving Medicines – Pain killers provided at over the counter are
not strong enough to relieve the pain hence doctors would suggest a stronger
version of such drugs.
Muscle relaxants – The muscle spasms often linked with
sacroiliitis can be reduced with the help of cyclobenzaprine.
Tumor necrosis factor (TNF) - This therapy includes etanercept and infliximab
which block certain cell protein and acts as an inflammatory agent. This helps
reduce pain, stiffness and swollen joints.
Physiotherapist – A physical therapist can help you in various
light stretching and strengthening exercises which would main the flexibility
of the joints as well as make your muscles more stable. Specific pelvic
exercises, training muscles of the trunk are useful in patients dealing with
sacroiliitis. Strengthening of the pelvic floor muscles is very important
because they oppose movements of the coxal bones. This stabilises the sacrum
position.
One can also
go in for light low-impact aerobic exercises which are designed to prevent
recurrence.
If the above
procedures do not help in relieving the pain, the doctors would then prescribe
surgical or other procedures:
Electrical stimulation – An electrical stimulator is implanted into the
sacrum. This helps in reducing pain caused by sacroiliitis.
Joint Injections – There are certain steroids which reduce the
joint pains. One of them is corticosteroids. This injection is taken with
fluoroscopic guidance. It is a type of live x-ray machine which shows the
physician the correct placement of the needle in the joint. This injection
includes a numbing agent and a steroid which is an anti-inflammatory
medication.
There are
certain home remedies for the pain;
Alternating ice and heat treatment – Ice and heat alternation helps in easing the
pain down. This is also called as passive treatment.
Rest – Take adequate rest when such pain arises. Avoid
carrying out any heavy activities which can further worsen the case. Maintain
proper posture and do not bear weight on one leg specially the one which hurts.
Sleeping posture – Maintaining the
correct sleeping position has also helped relieve pain.
