Sacroiliitis is an inflammation of one of the sacroiliac joints. Sacroiliitis pain can originate in the buttocks or lower back and can extend down one or both legs.
Sacroiliitis can be difficult to diagnose because it may be mistaken for other causes of lower back pain. Treatment might involve medications or physical therapy.
Sacroiliitis is inflammation in one of the sacroiliac joints. The sacroiliac joint links the iliac bone (the pelvis) to the sacrum (the bottom of the spine, above the tailbone). This joint transfers weight between your upper body and legs, and is essential to many activities such as walking, climbing stairs, jumping, or anything that requires your legs.
There is a network of ligaments and muscles that stabilize the sacroiliac joint, binding the two bones together and attaching them to muscle. This limits motion in the pelvic region.
The normal sacroiliac joint allows a small amount of motion, approximately 2-4 mm of movement in any direction.
The sacroiliac joint is less stiff in women than in men to allow mobility for childbirth.
Inflammation in these joints can cause low back and spine, pelvis, leg or buttock pain.
What causes sacroiliitis pain?
There are various causes of inflammation in the sacroiliac joint. Some of them may involve acute pain in the area, while others may involve pain that builds gradually. Causes of sacroiliitis pain include:
- Traumatic injury. A sudden impact like a car accident or a fall can damage your sacroiliac joints, leading to inflammation and sacroiliitis pain.
- Arthritis. Osteoarthritis can occur in the sacroiliac joint. Ankylosing spondylitis, a type of inflammatory arthritis that affects the spine, can also occur in the sacroiliac joints.
- Pregnancy. The sacroiliac joint must loosen and stretch to accommodate childbirth. The added weight and altered gait during pregnancy can cause wear and tear on the sacroiliac joint, leading to sacroiliitis pain.
- Infection. In rare cases, an infection can occur in the sacroiliac joint
WHAT ARE THE SYMPTOMS OF SACROILIITIS PAIN?
Sacroiliitis pain commonly occurs in the buttocks and lower back, as well as the legs, groin, and even the feet. Those who suffer from it may notice an increase in the symptoms after:
favoring one leg
taking large strides
Pain may also get worse over time as inflammation and irritation increases. Sitting for long periods of time might make the pain worse as well. If the inflammation is particularly bad, you may also have a fever.
How is Sacroiliitis Pain Diagnosed?
Your doctor will probably conduct a physical exam by pressing on your hips and legs to pinpoint the cause of your pain. They might also ask you to move your legs into different positions that will place stress on your sacroiliac joints.
Typically, a physical exam and a description of your symptoms are enough to diagnose your sacroiliitis pain. Your doctor may also use other methods to confirm your diagnosis to ensure they are providing you with the proper treatment.
An X-ray of your pelvic area can reveal signs of damage in the sacroiliac joint.
If your we suspect ankylosing spondylitis, an MRI might be necessary. An MRI is an imaging test that uses a magnetic field to produce images of bone and soft tissues.
Because lower back pain may have many other causes besides sacroiliitis pain, your doctor can use numbing injections to aid your diagnosis.
For example, if an anesthetic injection into your sacroiliac joint stops your pain, it’s likely that your pain is due to inflammation in the sacroiliac joint.
Most of the time when diagnosing spinal stenosis, doctors will order an MRI or a CT scan, or sometimes both. CT scans can reveal abnormal growth in the bone, like bone spurs, which may cause spinal stenosis, while MRIs are designed to reveal soft tissue damage. MRIs can reveal the soft tissue causes of spinal stenosis such as disc bulges and disc herniations.
Some forms of cervical spinal stenosis can be also be diagnosed with a selective nerve root block. In this procedure, a small dose of local anesthetic will be injected into the nerve that is suspected to be compressed by the narrowing spinal canal. If the patient experiences relief, the diagnosis of cervical stenosis is confirmed.
How is Sacroiliitis Pain Treated?
Treatment for sacroiliitis pain depends on your signs and symptoms, as well as the origin of your sacroiliitis pain.
There are surgical and nonsurgical treatments available to help heal spinal stenosis. Surgical treatments will usually only be necessary is nonsurgical treatments do not provide any relief.
- Pain relievers. If over-the-counter pain medications don’t provide any relief, your doctor can prescribe some stronger pain relievers.
- Muscle relaxants. Medications such as cyclobenzaprine can help reduce muscle spasms. People experiencing sacroiliitis also often experience muscle spasms.
- TNF inhibitors. If your sacroiliitis pain is due to ankylosing spondylitis, tumor necrosis factor inhibitors, or TNF inhibitors, might help relieve it.
Your doctor and your physical therapist will teach you range of motion and stretching exercises to help maintain joint stability. They can also teach you strengthening exercises to make your muscles more stable.
SURGICAL & OTHER PROCEDURES
If less invasive methods don’t relieve your pain, there are invasive methods, including surgery, that can relieve sacroiliitis pain.
- Joint injections. A doctor can inject corticosteroids into your sacroiliac joint to reduce inflammation and pain. But you can only get a few injections a year because the steroids can weaken your bones and tendons.
- Radiofrequency denervation. Radiofrequency energy can damage or destroy the nerve tissue causing your pain.
- Electrical stimulation. Implanting an electrical stimulator into the sacrum can reduce sacroiliitis pain.
- Joint fusion. Although surgery is rare in cases of sacroiliitis pain, fusing the bones together with metal hardware can sometimes relieve sacroiliitis pain.
LIFESTYLE & HOME REMEDIES
- Over-the-counter pain relievers. Drugs such as ibuprofen and acetaminophen can help relieve sacroiliitis pain. However, it’s important not to take too many, even if they aren’t prescription-strength drugs. The FDA has recently strengthened its warning about an increased risk of heart attack with overuse of these medications.
- Rest. Modifying or avoiding the activities that worsen your pain might help reduce the inflammation in your sacroiliac joints.
- Ice and heat. Alternating ice and heat can relieve sacroiliitis pain.
- Sleep position. Changing your sleeping position can alleviate sacroiliac pain. Many patients find it helpful to sleep on one side with a pillow between their knees. This keeps the hips in alignment.
Pain Stops Here: Call the Pain Relief Center
At the Pain Relief Center in Plano, Texas, our pain management experts can create an individualized plan tailored to your specific needs.
Dr. Rodriguez is a board-certified anesthesiologist who has dedicated his medical career to the eradication of pain. At the Pain Relief Center, Dr. Rodriguez and his team can optimize your pain management to help you overcome your pain.
To contact us, or for more information about sacroiliitis pain, call 214.709.1904. You can also send us a message to start your journey to relief.