What is Sacroiliitis?

Sacroiliitis is an inflammation of the sacroiliac joints at the bottom of the spine. Sacroiliitis is not necessarily a form of arthritis, but rather a presentation of it. It is a diagnosis which describes the area of symptoms. Sacroiliitis can present with similar symptoms as other conditions and an accurate diagnosis is very important in order to determine the best treatment strategy. A condition that is similar to Sacroiliitis is a pure Sacroiliac Dysfunction. SI joint Dysfunction is more of a mechanical issue while Sacroiliitis is a systemic condition. SI Dysfunction can affect only one SI joint at a time while Sacroiliitis will generally cause symptoms to be felt on both sides of the body, although it is possible to have just one inflamed SI joint. These are two distinctly different diagnoses and need to be differentiated.

Causes of Sacroiliitis

The cause of Sacroiliitis is mainly from a form of arthritis that affects the spine. Some examples of these are:

● Ankylosing Spondylitis: a form of arthritis that affects your spine and can lead to an eventual fusion of the entire spinal column
● Psoriatic Arthritis: A condition that affects the skin, and causes inflammation and pain in the vertebrae and SI joints.
Osteoarthritis: wear and tear of the sacroiliac joints
● Some non-arthritic factors can also be responsible for causing inflammation in the SI joints. These include:

Trauma to the sacroiliac joints
● Pregnancy: this happens because ligaments become lax during pregnancy leading to increased pressure being placed on the sacroiliac joints
● Infection in the area near the SI joints, such as a Urinary Tract Infection
● Endocarditis
● IV drug use

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What are Symptoms of Sacroiliitis?

Symptoms of sacroiliac are similar to other symptoms of back pain, and especially SI joint Dysfunction. A differential diagnosis is mandatory. Sacroiliitis symptoms may include:

● Pain in the low back, buttocks, hips, or legs
● Stiffness in the above areas mentioned
● Sometimes a low-grade fever will be present as the body’s attempt to fight infection
● Pain that is aggravated with walking or standing for prolonged periods of time
● Difficulty walking, specifically taking long strides
● Increased pain when negotiating stairs
● Pain that is present even at rest and is exacerbated by actions such as rolling over in bed

Sacroiliitis Treatments

Treatments for Sacroiliitis involve correctly diagnosing the problem and then attempting to decrease inflammation in the area. Some of the intervention for Sacroiliitis include:

● Resting the area and frequent icing may be suggested as a first line of defense.
● Medications to control pain and inflammation
● Muscle relaxers
● TNF (tumor necrosis factor) inhibitor drugs: TNF contributes to the inflammatory process, and these drugs are in a newer class that have been approved for the treatment of all arthritic conditions
● Physical therapy: this will consist of education on which movements should be avoided so as not exacerbate the pain. Also, strengthening and stretching exercises will be prescribed in order to maintain strength and flexibility in order to restore any function that may have been lost
● Steroid joint injections may be considered
● Ablation: this is a procedure in which your doctor uses radio waves to damage and or destroy the nerves causing the pain
● In very advanced cases, surgery may be indicated involving a fusion of the joints, but this is rare.
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