What Is Sacroiliitis?
Sacroiliitis is inflammation of one or both of the sacroiliac joints, which connect the lower spine (sacrum) to the pelvis (ilium). This condition can cause pain in the lower back, buttocks, and thighs, and may be associated with various types of arthritis, including ankylosing spondylitis and other spondyloarthropathies. Sacroiliitis may occur due to infection, injury, pregnancy, or autoimmune disorders.

What Are the Symptoms of Sacroiliitis?
The symptoms of sacroiliitis can range from mild discomfort to disabling pain and typically include:

• Pain in the lower back, buttocks, or hips
• Pain that worsens with prolonged standing or stair climbing
• Stiffness in the lower back, especially in the morning
• Pain that radiates down one or both legs
• Discomfort when turning over in bed or standing up after sitting
• Worsening pain with physical activity or long periods of inactivity

What Causes Sacroiliitis?
Several factors can contribute to inflammation of the sacroiliac joints:

• Autoimmune conditions: Such as ankylosing spondylitis, psoriatic arthritis, or reactive arthritis
• Infections: Septic arthritis or bacterial infections affecting the joint
• Trauma or injury: From falls, car accidents, or repetitive stress
• Pregnancy: Hormonal changes and increased joint mobility
• Osteoarthritis: Degenerative changes in the joint
• Inflammatory bowel disease (IBD): Can also involve the sacroiliac joints

How Is Sacroiliitis Diagnosed?
Diagnosis involves a combination of clinical evaluation and imaging:

• Medical history and physical exam: Assess pain patterns and joint function
• Imaging tests: X-rays, MRI, or CT scans to detect inflammation, joint damage, or fusion
• Blood tests: May reveal markers of inflammation (e.g., ESR, CRP) or autoimmune activity (e.g., HLA-B27 gene)
• Diagnostic injections: Local anesthetic injected into the sacroiliac joint to confirm the source of pain

What Are the Treatment Options for Sacroiliitis?
Treatment focuses on relieving pain and inflammation, as well as addressing the underlying cause:

• Medications:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Corticosteroid injections directly into the joint
  • Disease-modifying antirheumatic drugs (DMARDs) for autoimmune-related cases
  • Biologics (e.g., TNF inhibitors) for more severe inflammation
• Physical therapy:
  • Exercises to improve flexibility and strengthen core muscles
  • Posture correction and gait training
• Lifestyle modifications:
  • Avoiding high-impact activities
  • Using supportive footwear and ergonomic seating
• Surgical options (rare):
  • Joint fusion may be considered in severe, treatment-resistant cases

What Is the Prognosis for Individuals with Sacroiliitis?
Prognosis depends on the cause and how early treatment begins:

• Autoimmune-related cases: Often require long-term management but can be controlled with medications
• Injury or pregnancy-related cases: Typically resolve with conservative treatment
• Infectious cases: Require prompt antibiotic treatment to prevent joint damage

Most individuals experience significant improvement with proper therapy and lifestyle adjustments.

How Can Sacroiliitis Be Prevented?
While not all causes are preventable, the risk of sacroiliitis may be reduced by:

• Managing autoimmune conditions effectively with regular medical care
• Avoiding repetitive stress on the lower back and hips
• Using proper techniques when lifting heavy objects
• Staying active to maintain joint health and muscle support
• Early treatment of infections and injuries affecting the sacroiliac area