Sacroiliitis - symptoms and treatment

Chronic inflammation of the sacroiliac joint

In medicine, chronic inflammation of the sacroiliac joint is called sacroiliitis. The joint is located in the lower part of the spine between the ilium and the sacrum. Only very rarely does a sacroiliitis appear as an independent disease. In most cases, it is the result of other diseases such as ankylosing spondylitis, Reiter's disease or Crohn's disease. Here is a short summary:

• definition: Sakroiliitis is a chronic inflammation of the sacroiliac joint, which in most cases occurs as a result of certain diseases.
• symptoms: Back pain, severe pain in the back, sometimes radiate into the buttocks or in the groin, movement restrictions, postural damage.
• causes: Commonly, sacroiliitis is a secondary disease of ankylosing spondylitis, Reiter's disease or Crohn's disease. The exact causes are so far unclear.
• treatment: Physiotherapy, pain therapies, anti-inflammatory and pain-relieving drugs, in serious cases an implant is surgically used.

contents

• Chronic inflammation of the sacroiliac joint
• The sacroiliac joint
• disease
• Is sacroiliitis curable?
• causes
• symptoms
• diagnosis
• Sacroiliitis treatment

The sacroiliac joint

The sacroiliac joints have a shape like a boomerang and only a range of motion of 5 to 7 degrees. In many people, the joint stiffens with advanced age and has only a minimum of agility. The joint sits between the sacrum, the penultimate end of the spine, and the ilium, which forms the pelvic blades.

The sacroiliac joint captures both the pressure of the legs and the upper body. Inflammation results in severe pain, restricted mobility and posture damage. (Image: bilderzwerg / fotolia.com)

The burden on the sacroiliac joint

The joints between the two pelvic bones and the sacrum have a great burden to bear. At this point, the pressure from below created by the legs and the load from the upper body are compensated. This creates a great burden in the region. If this joint is inflamed, it can cause significant pain and other unpleasant consequences.

disease

Mostly, the course of sacroiliitis is lengthy and worsens in the course of the disease. There are strong lumbar vertebrae, which radiate into the buttocks or in the groin (groin pain). In addition, there are often restrictions on movement and posture damage.

Is sacroiliitis curable?

The disease is classified medically as a chronic progressive inflammation. This means that a total cure is not possible. The severity of the disease tends to increase. Consistent and consistent treatment, especially through physiotherapy, mitigates the effects and allows for a better quality of life.

causes

The exact causes are considered insufficiently understood. Experts suggest that a genetic predisposition triggers this suffering. Sacroiliitis is very rare on its own but often occurs as a result of certain diseases. These include, for example:

• ankylosing spondylitis,
• Reiter's disease (reactive arthritis),
• Behçet's disease,
• rheumatism,
• Psoriatic arthritis, a specific type of psoriasis
• inflammatory bowel disease such as Crohn's disease or ulcerative colitis.

Violent low back pain is a typical symptom of sacroiliitis. (Image: Kzenon / fotolia.com)

symptoms

Typical symptoms of inflammation of the sacroiliac joints include:

• Low back pain and buttocks pain, which are often more intense at night or in the morning than during the day,
• pain in the groin or legs,
• Movement restrictions in the cross,
• stiff legs,
• Pain while sitting,
• Problems walking, standing and climbing stairs.

diagnosis

To diagnose this disease physicians often use the following methods:

• Anamnesis (history of the patient),
• detailed physical examinations,
• "Stuhlsteigeversuch" or similar tests,
• Imaging procedures.

Chair platforms trial

In cases of suspected sacroiliitis, physicians often use the "chair lift test". Patients try to climb onto a chair with one leg. In this movement, the typical complaints of the disease are triggered.

Imaging process

Inflammation of the sacroiliac joint can be well visualized by imaging techniques on the lumbar spine and pelvis. In addition, other diseases can be excluded by the recordings. This is why procedures such as x-rays, computed tomography (CT) and magnetic resonance imaging (MRI) are frequently used in diagnosis. While sacroiliitis on radiographs is only in an advanced state, an MRI scan allows a much earlier diagnosis.

Constant and consistent physiotherapy is one of the most common and promising treatments for sacroiliitis. (Image: Kzenon / fotolia.com)

Sacroiliitis treatment

The type of treatment depends on the severity of the disease. In most cases, physiotherapeutic measures are taken in the early stages, which are supported by applications of heat, cold or electrotherapy. In addition, anti-inflammatory and analgesic drugs are often used. When these measures reach their limit, there is the option of surgically inserting a titanium implant that supports the sacroiliac joint.

Physiotherapeutic methods

As an early measure it is often tried to relieve the pain by regular physiotherapy and to improve the mobility, or to receive. The learned exercises can then be carried out partly at home. The application of heat, cold or electrotherapy can support this process. In acute phases, however, heat treatment should be avoided in particular, as it worsens the symptoms in the acute state.

drugs

In sacroiliitis, analgesics and anti-inflammatory drugs are often prescribed. Non-steroidal anti-inflammatory drugs (NSAIDs), for example, are suitable as anti-inflammatory agents. To relieve pain, ibuprofen or diclofenac are often used. However, care should be taken that the painkillers are taken only in phases and not permanently. For particularly severe pain, a pain medication is injected directly into the sacroiliac joint.

Pain therapies such as stimulation current treatments have shown good results in sacroiliitis. (Image: Ralf Geithe / fotolia.com)

pain Management

Another aspect in the treatment is relief of severe pain. In addition to the use of painkillers complementary methods come into question here. This includes, for example:

• acupuncture,
• high tone,
• autogenic training,
• progressive muscle relaxation.

implant

If all other methods fail to achieve the desired results, it is possible to stabilize the sacroiliac joint with an implant. The triangular titanium implant is inserted into the sacroiliac joint in a minimally invasive surgery to support it. (tf, vb; updated April 25, 2018)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)