Sacroiliitis – Diagnosis and Treatment
Diagnosis
Pictures of the Joints
Doctors use imaging tools like X-rays to view the pelvis and look for damage in the sacroiliac (SI) joint. MRI scans help doctors detect changes that may suggest conditions like ankylosing spondylitis.
These pictures show swelling or other problems in the lower back, buttocks, and nearby areas.
Using Numbing Medicine
A doctor may inject a numbing shot, called a local anesthetic, directly into the sacroiliac joint.
If pain in the lower back, buttocks, or legs goes away after the shot, the doctor can confirm the sacroiliac joint as the source. This approach helps find out if the SI joint causes the pain and weakness.
Treatment
Medications for Managing Symptoms
Doctors use several types of medicine to reduce inflammation, manage pain, and treat sacroiliac joint problems:
| Type | Purpose |
|---|---|
| Nonsteroidal Anti-Inflammatories (NSAIDs) | Pain relief, decrease inflammation |
| Muscle Relaxants | Reduce muscle spasms |
| Biologics | Manage autoimmune arthritis disorders |
| Disease-Modifying Antirheumatic Drugs (DMARDs) & Janus Kinase (JAK) Inhibitors | Lower inflammation and joint pain |
Doctors often recommend over-the-counter drugs like ibuprofen and naproxen first. If these do not relieve symptoms, doctors may prescribe stronger pain medication.
People with chronic conditions such as ankylosing spondylitis or rheumatoid arthritis might use biologic medications or DMARDs to target the immune system. These medicines help slow joint damage and control swelling.
A healthcare provider will discuss possible side effects and risks, especially for people with other health problems.
Exercises and Rehabilitation
Physical therapists play a key role in improving quality of life for people with sacroiliitis.
Therapists use:
- Range-of-motion activities to keep hips and lower back mobile
- Stretching routines to reduce stiffness
They also add strength exercises to protect the joint and improve posture. A routine matched to the person’s needs can limit pain and lower the risk of further injury.
Physical therapy helps with many kinds of joint pain, including pain from chronic inflammation, trauma, or mechanical back issues.
Procedures and Surgical Strategies
If medicines and therapy do not control symptoms, doctors may suggest advanced treatments.
- Corticosteroid Injections: Doctors inject these directly into the sacroiliac joint to reduce swelling. Only a few injections should be given each year because too many can weaken bones and tendons.
- Radiofrequency Nerve Treatment: Doctors use radio waves to damage or turn off the nerve causing pain.
- Electrical Pulse Devices: A doctor can implant a device in the lower back to send electrical signals and block pain.
- Joint Fusion Surgery: In rare, severe cases, a surgeon fuses the bones of the joint together with metal.
Each procedure has risks, like infection, bleeding, or nerve problems. Doctors use these options when other treatments provide little relief. They choose procedures based on the cause of the joint problem and the person’s overall health.
Everyday Ways to Ease Sacroiliac Joint Discomfort
People can support their bodies at home while managing sacroiliac joint pain. Applying ice and heat for 15-20 minutes at a time may reduce pain.
Simple pain relievers like acetaminophen or ibuprofen can also help, but should be taken as directed. Resting and avoiding activities that increase pain, such as long periods of standing, climbing stairs, or heavy lifting, can help.
Practicing good posture, doing gentle stretching and strengthening exercises, and staying active with easy aerobic activities like walking may help over time. Not smoking and eating a balanced nutrition can support healing.
Getting Ready for Your Visit
Steps You Can Take Beforehand
Bringing someone with you, such as a family member or friend, can make it easier to remember information from your appointment.
It helps to create a list that includes:
- All symptoms and when each one started
- Important personal information, like recent life changes or if a close relative has had similar symptoms
- Medications and supplements you use, including doses
- Questions for the healthcare provider
Some helpful questions to consider:
| Possible Questions to Ask |
|---|
| What might be causing my symptoms? |
| Are there other possible reasons for my pain? |
| What tests might I need? |
| Is this condition short-term or long-lasting? |
| What treatments are available? |
| How do I manage this with other health issues? |
| Are there any restrictions I should follow? |
| Should I see a specialist? |
Write down any other concerns you have so you do not forget.
What Your Healthcare Provider May Discuss
The healthcare provider or specialist may ask:
- Whether your pain is always present or comes and goes
- Where the pain is located and how severe it feels
- If anything helps or makes your discomfort worse
If you prepare your answers ahead of time, your visit may go more smoothly. Giving a clear medical history and honest answers helps your provider choose the best next steps.
These steps may include further testing or a referral to a rheumatologist or spine specialist.
