...less medical jargon in a 'Quick Glance' format!
Sacroiliitis is an inflammation of one or both of the sacroiliac joints, which connect your lower spine and pelvis.
The sacroiliac joints, also called SI joints, have a limited range of motion compared with other major joints in your body, such as your knee or elbow. Even the slightest movements of your spine can be extremely uncomfortable or even painful.
Sacroiliitis is difficult for doctors to diagnose, and it may be mistaken for other causes of low back pain, including sciatica, herniated disks and strained muscles. Sacroiliitis is often associated with a group of diseases called spondyloarthropathies, which cause inflammatory arthritis of the spine.
Treatment for sacroiliitis may involve a combination of rest, physical therapy and medications.
Many rheumatic diseases aren't limited to inflammation of the joints and extend to other organs of your body, such as your skin, blood vessels, eyes, heart, lungs, kidneys and nervous system. Signs and symptoms of sacroiliitis may include:
Pain and stiffness in your lower back, thighs or buttocks, especially in the morning or when sitting for a long period of time
Pain affecting your hips and shoulders
Pain that worsens with walking because the swinging motion of your hips strains your sacroiliac joints
Inflammation in one or both of your eyes
Psoriasis, an inflammatory skin condition
A low-grade fever that appears quickly
Heavy lifting, especially if you lift incorrectly or your muscles aren't prepared for the activity
A traumatic injury or sudden impact, such as a motor vehicle accident or a fall, affecting your spine, lower back, pelvis or buttocks
Spondyloarthropathies, which include ankylosing spondylitis, arthritis associated with psoriasis and others
Degenerative arthritis, also called osteoarthritis of the spine, causing degeneration of the sacroiliac joints, which can cause mild inflammation and pain
Pregnancy, because the pelvis must stretch to accommodate childbirth
Infection of the sacroiliac joint, sometimes caused by bacteria in food
Treatment depends on the signs and symptoms as well as the underlying cause. Medications to treat sacroiliitis may include:
Nonsteroidal anti-inflammatory drugs (NSAIDs). These pain-relieving drugs reduce swelling and inflammation. NSAIDs include indomethacin (Indocin ), ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Anaprox, others). Taking NSAIDs can lead to side effects, such as indigestion and stomach bleeding. Other potential side effects may include damage to your liver and kidneys, ringing in your ears, fluid retention and high blood pressure. Except for aspirin, NSAIDs may also increase your risk of cardiovascular events, such as heart attack or stroke.
Corticosteroids. These medications, such as prednisone and methylprednisolone (Medrol), reduce inflammation and pain and slow joint damage. Cortisone injections can be used for localized pain relief that lasts a period of months. In the short term, corticosteroids can make you feel dramatically better. But when used for many months, they may become less effective and cause serious side effects. Side effects may include easy bruising, thinning of bones, cataracts, weight gain, a round face and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication.
Disease-modifying antirheumatic drugs (DMARDs). These medications include sulfasalazine (Azulfidine) and methotrexate (Rheumatrex). Doctors prescribe DMARDs to limit joint damage. Taking these drugs at early stages in the development of a joint condition is especially important to slow the disease and save the joints and other tissues from permanent damage. Because many of these drugs act slowly — it may take weeks to months before you notice any benefit — DMARDs typically are used with an NSAID or a corticosteroid. While the NSAID or corticosteroid handles your immediate symptoms and limits inflammation, the DMARD modifies the disease itself.
Tumor necrosis factor (TNF) inhibitors. These therapies, which include etanercept (Enbrel) and infliximab (Remicade), block a cell protein (cytokine) that acts as an inflammatory agent. Blocking the TNF cytokine may help reduce pain, stiffness and tender or swollen joints.
Treatment may also involve physical therapy and rest to help manage pain and stiffness. Your doctor or physical therapist can help you learn range-of-motion and stretching exercises to maintain joint flexibility, and strengthening exercises to give your muscles additional stability.