Do you often have pain in your lower back, or buttocks, and sometimes down your legs? Most of the time we think of it as just a backache, but it could actually be due to inflammation, or swelling, in your sacroiliac joints. Today, we'll talk about a condition called sacroiliitis.
Simply put, what is this sacroiliitis?
Okay, let's first look at what these sacroiliac joints are. Imagine, the sacroiliac joints are where the bottom end of our spine, the triangular-shaped bone (we call it the sacrum) , and the largest bone at the top of our pelvis (we call it the ilium) meet. These are two of the largest and most important joints in our body. Every time we move our hips, when we walk, when we run, when we get up from sitting
So, Sacroiliitis is when one or both of these joints become inflamed for some reason, causing swelling and pain. It's like when we sprain our knee, it swells and hurts. This swelling is what causes you to feel pain in your lower back and buttocks.
If you have persistent lower back pain, it could be due to a number of reasons. So it's best to see a doctor to find out exactly what's causing it. That way, you can start treatment quickly and minimize the disruption to your daily activities.
Are there different types of this?
Yes, there are several ways doctors call this condition, depending on how many of your joints are affected.
- Unilateral Sacroiliitis: This means that only one of your sacroiliac joints is inflamed.
- Bilateral Sacroiliitis: In this, inflammation can occur in both joints at the same time.
How common is this situation?
Back pain is actually quite common. Anyone who works in an office chair for long periods of time, lifts heavy weights, sleeps incorrectly, and more can develop back pain. Since back pain can be caused by many different things, it's hard to know exactly how many people have sacroiliitis. However, some studies suggest that up to 25%, or about one in four, of people with back pain may have sacroiliitis.
What are these symptoms? Do you feel this way too?
The main and most common symptom of sacroiliitis is pain in the lower back. You may experience this pain in one of the following ways:
- The pain increases when you stay in the same position (sitting or standing) for a long time. Imagine sitting in front of a computer for hours at a time, and then you may feel the pain more acutely when you get up.
- The pain increases when you turn or twist your hip.
- The pain can be a sharp, stabbing pain that comes on suddenly , or it can be a dull ache that is constant .
- This pain can start in the lower back and radiate down the buttocks, hips, and sometimes thighs .
Another thing is that people with sacroiliitis often feel stiffness in their joints when they wake up in the morning . It's normal to feel a little stiffness when we first get up from sleep or after standing for a long time. However, the stiffness caused by sacroiliitis usually lasts for more than an hour .
Why do we get Sacroiliitis? What are the causes?
Anything that can cause inflammation in our joints can also affect these sacroiliac joints and cause sacroiliitis. The main cause is arthritis . Among them:
- Ankylosing Spondylitis: This is a type of arthritis that specifically affects the joints of the spine. Sacroiliitis can often be an early symptom of this disease.
- Psoriatic Arthritis: This is a skin condition in which psoriasis, a condition that causes scaly, flaky skin, is accompanied by arthritis in the joints.
In addition to these types of arthritis, sacroiliitis can also be caused by other conditions that cause inflammation in the body. For example:
- Crohn's disease
- Ulcerative colitis
- Reactive arthritis (Reiter's syndrome)
- Behçet's disease
Another special issue is that some women can develop sacroiliitis during pregnancy . Due to the effects of hormones that cause changes in the body during pregnancy, these sacroiliac joints can become slightly wider and rotated. Although this is normal, it can be painful for some people.
Also, very rarely, a bacterial infection , such as Staphylococcus aureus, can cause sacroiliitis if it enters the sacroiliac joints.
What complications can occur if left untreated?
If this condition is not treated quickly, the pain can interfere with your ability to move. Imagine how difficult it is when you can't bend over properly, get up from a chair, or walk because of back pain. Also, the constant pain can cause sleepless nights, mood swings, and even mental health problems like depression .
How do doctors diagnose this?
A doctor will diagnose sacroiliitis by doing a physical exam and some imaging tests. The doctor will examine your back, hips, and legs.
You are asked:
- How long has this pain been there?
- What kinds of things (e.g., sitting, walking, sleeping) make the pain worse?
- They will also ask about other medical conditions you have (e.g., arthritis, psoriasis). All of this information will help in the diagnosis.
Then, your doctor will do some exercises to check your range of motion , which is how far you can move a joint without pain. You may also need to apply pressure to your sacroiliac joints. If any movement, position, or pressure increases your pain, tell your doctor .
What kind of tests are done for this?
Your doctor may use tests like these to take pictures of your sacroiliac joints:
- Pelvis X-rays
- CT scan (Computed Tomography - CT scan)
- MRI (Magnetic Resonance Imaging - MRI)
These imaging tests can clearly show swelling and damage to the joints. Sometimes, blood tests are also done to check for inflammation and infection in the body.
So, what are the treatments for this?
Physical therapy is one of the main treatments for sacroiliitis. A physical therapist will teach you specific exercises and stretches that strengthen the muscles around your sacroiliac joints. When done correctly, these exercises can help reduce stress on your joints and help keep them more stable. These exercises can also increase your range of motion.
In addition, the doctor may also suggest medications such as:
- NSAIDs (Nonsteroidal Anti-inflammatory Drugs): These are non-steroidal anti-inflammatory drugs. Examples include aspirin, ibuprofen, and naproxen. However, do not take these medications for more than ten days at a time without consulting a doctor.
- Muscle relaxants: These are prescription medications that work by reducing muscle pain and blocking pain signals from the nerves to the brain.
- Corticosteroids: These are also powerful prescription medications that reduce inflammation and pain. Your doctor may also give you an injection directly into the painful joint. This can provide quick relief.
Rarely, a treatment called radiofrequency ablation (RFA) may be recommended to control pain. This permanently disables the nerves that carry pain signals to the brain, stopping the feeling of pain.
You may also need to see a rheumatologist , a doctor who specializes in inflammatory diseases.
Will surgery be necessary?
Surgery is rarely necessary for sacroiliitis. A doctor may consider surgery if physical therapy, other medications, and treatments like RFA don't help with the pain for a long time. If that's the case, your surgeon may perform a joint fusion . This involves inserting surgical screws to permanently fasten the joint together. Your surgeon will explain what type of surgery you need and what your recovery time will be like.
Is there a way to prevent this from happening?
In fact, there is no surefire way to completely prevent sacroiliitis, as the underlying conditions, such as arthritis, are difficult to control.
However, you can do the following to reduce your risk of developing diseases like arthritis:
- Avoid using tobacco products.
- Do low-impact exercise . Examples: walking, swimming.
- Follow a healthy diet and exercise plan that suits you.
Will this situation last forever?
If you have sacroiliitis due to a type of inflammatory arthritis, the damage to the joints may be permanent. However, for those who develop it during pregnancy, it is usually only temporary and often gets better after the baby is born.
Many people can manage the underlying condition that causes sacroiliitis with medication and physical therapy. If your symptoms recur or worsen, be sure to tell your doctor.
When should we seek medical advice?
If you have new lower back pain, or if the pain is getting worse, see a doctor immediately. Also, if you are already being treated for sacroiliitis, tell your doctor if your pain seems to be getting worse, or if your treatment is not helping you as much as it used to.
What questions should you ask the doctor?
When you go to see a doctor, you can ask questions like these:
- Do I have sacroiliitis, or just sacroiliac joint pain, or is there another cause of back pain?
- Do I have arthritis? If so, what type is it?
- Will I need physical therapy?
- What kind of medicine will I have to take?
- Will I need surgery?
Are Sacroiliitis and Sacroiliac joint pain the same thing?
Yes, this is important. You can still have pain in your sacroiliac joint without sacroiliitis. Lower back pain is very common. Many people experience pain in the sacroiliac joint.
The difference is that sacroiliitis is a type of inflammation that has been accurately diagnosed by a doctor. If you have pain that doesn't go away on its own after about a week, you should definitely see a doctor. He or she will be able to explain to you what is causing the pain and how to avoid it.
So, what are the most important things we need to remember from this story?
Sacroiliitis is a type of lower back pain caused by inflammation of the joints where our spine connects to our hips. Any pain is annoying, especially when it prevents us from moving or doing normal activities.
The good news is that no matter what the cause of your pain is, a doctor can help you find ways to manage your symptoms, such as physical therapy. While physical therapy may require some effort, don't forget to celebrate any small improvements you make and be proud of your efforts. Wishing you a speedy recovery!
` sacroiliitis, back pain, hip pain, joint inflammation, arthritis, physical therapy, sacroiliac joint pain
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