Most of us have experienced back pain at some point in our lives, right? Sometimes it's normal, but sometimes there may be another reason behind this pain. Especially if it's pain that comes from the area where your lower back and hips meet, it could be Sacroiliitis. Although the name may sound a bit strange, it's a condition we should be aware of.
Simply put, what is Sacroiliitis?
Think of the place where your lower spine meets your hipbone. To be precise, there are two joints that connect the triangular bone at the end of our spine (sacrum) and the top of our hipbone (ilium). These joints are called the sacroiliac joints. These joints balance the weight of our upper and lower bodies when we walk, swing our hips, and lift weights.
Sacroiliitis is a condition where one or both of these joints become inflamed , or swollen, for some reason. This inflammation can cause pain in your lower back, buttocks, and sometimes down your legs.
If this condition occurs in only one joint, it is called Unilateral Sacroiliitis. If it occurs in both joints, it is called Bilateral Sacroiliitis.
It is very important to have a doctor examine you to determine the exact cause, rather than just assuming it is a backache.
What are the symptoms of Sacroiliitis?
Lower back pain is the main symptom. But this pain can be felt in a few different ways. Let's take a look at what these symptoms are.
| Symptom | Description |
|---|---|
| Where the pain comes from | Pain in the lower back, buttocks, and hip area. Sometimes this pain can also travel down the thigh. |
| Times when the pain increases | The pain increases when you stand up after being in the same position (sitting or standing) for a long time. The pain can also increase when you rotate your hips, climb stairs, or put too much weight on one leg. |
| Nature of pain | Sometimes the pain can be sharp, like a knife stabbing you. Other times, it can feel like a dull, constant, stabbing pain. |
| Morning Stiffness | This is a very important symptom. When you wake up in the morning, you may feel a stiffness or tightness in your lower back. While this stiffness will subside after a while in a normal backache, in Sacroiliitis it can last for more than an hour . |
What are the causes of Sacroiliitis?
There are several reasons for this. The main ones are these.
- Types of Arthritis: Sacroiliitis can be caused by arthritis, which causes inflammation of the joints.
- Ankylosing spondylitis: This is a type of arthritis that affects the joints of the spine. Sacroiliitis can be one of the first symptoms of this disease.
- Psoriatic arthritis: This is an arthritis condition that occurs along with psoriasis.
- Other inflammatory conditions: This condition can also be caused by other diseases that cause inflammation in the body.
- Crohn's disease
- Ulcerative colitis
- Pregnancy: Some women may also experience this condition temporarily due to changes in their bodies during pregnancy. This is because these joints become slightly wider and looser due to hormonal influences.
- Infection: Very rarely, a bacterial infection, such as Staphylococcus aureus, can cause sacroiliitis if it enters these joints.
How do you find this, Doctor?
When you go to see your doctor, he or she will first ask you about your symptoms. It's important to be specific about how the pain feels, when it's worse, and what you do to make it worse.
Then, the doctor will examine you.
- Physical examination: Your back, hips, and legs will be examined. Your hips and back will be bent and twisted in different directions. You may also be asked to press on the joints with your fingers.
- Tests: To confirm the diagnosis, the following tests can be performed:
- X-ray tests
- CT (Computed Tomography) scan
- MRI (Magnetic Resonance Imaging) scan
- Blood tests may also be done to check for other infections or other things that could be causing the inflammation.
What are the treatments for this?
The best thing is that there are good treatments to control this condition.
Physical Therapy
The main and most common treatment for this is physical therapy . A physical therapist will teach you exercises and stretches that strengthen the muscles around these joints. This reduces stress on the joints and stabilizes them. These exercises also help increase your range of motion.
Medications
To control pain, your doctor may prescribe medications such as:
- Painkillers: Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., Ibuprofen, Naproxen). But remember, it is not recommended to take these continuously for more than 10 days without consulting a doctor.
- Muscle relaxants: These help reduce pain and muscle stiffness.
- Steroid injections (Corticosteroids): Sometimes, an injection can be given directly into the joint to quickly reduce pain and inflammation.
Other treatments and surgeries
Very rarely, if the pain is beyond control, a treatment such as radiofrequency ablation (RFA) may be considered, which blocks pain signals from reaching the brain through the nerves in the joint.
Surgery is rarely performed. Surgery is only performed if no other treatment has been successful. This involves inserting surgical screws to permanently connect the joint (joint fusion).
When should I see a doctor?
If you have new lower back pain that doesn't go away after a week, definitely see a doctor. Also, if you're already taking treatment but the pain seems to be getting worse or if the treatment doesn't seem to be helping you as much as it used to, tell your doctor.
If left untreated, this pain can interfere with your daily activities, walking, and sleeping. So don't ignore the pain.
Take-Home Message
- Sacroiliitis is an inflammation (swelling) of the joints that connect your spine to your hips. This causes pain in the lower back, buttocks, and hips.
- If you feel stiffness in your lower back for more than an hour after waking up in the morning, it may be a key symptom of this disease.
- Arthritis, pregnancy, and other inflammatory conditions can cause this.
- Don't ignore lower back pain, see a doctor to find out the exact cause.
- Physical therapy is the main treatment for this. In addition, there are medications and other treatments.
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