Sacroiliitis: causes, symptoms and treatments

Sacroiliitis is an inflammatory condition that causes pain and discomfort in the lower back. Its early approach offers rapid relief of symptoms.

Lower back pain is a common cause of medical consultation worldwide. The origins of low back pain are very varied and range from conditions in the internal organs to problems in the bones and joints. Here we tell you everything you need to know about sacroiliitis.

When we speak of sacroiliitis we refer to the inflammation of the sacroiliac joint. There are two such joints and they are located in the lower part of the back.

They are responsible for joining the sacral bone of the spine with the iliac bones of the pelvis on each side. Its function is to compensate for the pressure of the legs during movement and the load of the body when standing.

This inflammatory process not only compromises the structures located in the joint, but also affects the surrounding ligaments, muscles and nerves. The causes are multiple and are associated with excessive overload of the joint.

Symptoms of sacroiliitis

Currently, studies estimate a prevalence of sacroiliitis ranging from 23% to 63%, being more common in older adults. In general, it affects one of the sacroiliac joints, with discomfort on the right side in 45% of cases and on the left side in 35%.

Compromise on both sides occurs in up to 20% of people.

Sacroiliitis usually presents as a continuous, localized and persistent pain in the lower back. It can extend to the buttocks, the groin and the back of one or both legs, without reaching the knees. It is described as oppressive, dull and burning.

Similarly, this discomfort is often intensified by standing for a long period of time, climbing stairs, running and walking on uneven surfaces. It decreases when sitting, however, in advanced cases the pain appears even at rest.

The discomfort occurs in the early hours of the morning, accompanied by lumbar strain and joint stiffness. The morning stiffness in sacroiliitis usually lessens throughout the day with movement.

Causes

Physical overload and repetitive compression and traction forces on the joint apparatus are the main causes. of sacroiliitis, according to scientific studies. Ligamentous, bone and cartilaginous compromise promotes the release of chemicals that stimulate pain receptors.

Among the most common causes we find the following:

• Osteoarthritis.
• repetitive trauma.
• ankylosing spondylitis.
• Dismetria between the legs.
• Joint infections.
• Sacral bone deformity.
• Falls and car accidents.
• Weakness of abdominal and gluteal muscles.

On the other hand, during pregnancy there are changes in the woman’s body that can cause sacroiliitis. This is the result of relaxation of the ligaments that stabilize the joint, added to weight gain and gait disturbance.

Risk factor’s

Sacroiliac inflammation is more common in older men. Similarly, the following conditions increase the risk:

• Bad posture.
• Overweight or obesity.
• Carry heavy objects.
• Fractures and previous dislocations.
• Alterations in the alignment of the spine, such as hyperlordosis and scoliosis.

How is it diagnosed?

In most cases, the diagnosis is made through clinical assessment by a health professional. The doctor will consult the onset of symptoms, the form of presentation and the situations that trigger the pain. During the physical exam, the lower back will be inspected and palpated.

It is usual for the specialist to assess the muscle strength and mobility of the lumbar and sacral spine. Furthermore, he can apply different tests, such as the Gaenslen and Patrick test.

On the other hand, it is possible that additional studies and imaging tests are indicated to confirm the diagnosis. Radiography and magnetic resonance imaging of the pelvis and spine usually provide interesting data on joint involvement. Similarly, the injection of anesthetics with a positive response allows the origin to be identified.

Treatment of sacroiliitis

The therapeutic plan for sacroiliitis depends on the underlying cause and the severity of symptoms. In mild cases, the doctor usually indicates the use of analgesics, muscle relaxants and non-steroidal anti-inflammatory drugs (NSAIDs). In addition, the belt brace supports pelvic alignment and stabilizes the joint.

Physiotherapy plays a fundamental role in the management of sacroiliitis. It offers movement and stretching exercises that strengthen, stabilize and improve flexibility.

Other recommendations include relative rest, avoiding excessive exertion, and the application of alternating heat and cold therapy.

If discomfort persists, intra-articular corticosteroid injections may be given to relieve pain and reduce inflammation. In severe cases, surgical correction is necessary through the following procedures:

• Arthrodesis: the sacroiliac joint is permanently attached with titanium rods.
• Radiofrequency denervation: the nerve pathways that transmit pain are eliminated.
• Implantation of electrical stimulator: a device is attached to the sacrum that reduces pain transmission.

Is it possible to prevent sacroiliitis?

Sacroiliitis is a fairly common painful condition in elderly people. In general, the appearance of this condition can be stopped and the risk of developing it reduced with some changes in our lifestyle:

• Keep a healthy weight.
• Avoid sedentary lifestyle.
• Perform stretching exercises and low joint impact.

The same way, it is advisable to consult a specialist in rheumatology Suspecting sacroiliitis. Doctors are the only ones trained to treat this disease and provide the best guidance.

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