Sacroiliac joints are located at the base of the spine, and they join the sacrum and the ileum by means of a complex arrangement of bone and ligaments. Sacroiliitis is an inflammation of one or both of the sacroiliac joints, and it may cause severe back pain and loss of mobility. This type of inflammation may be caused by arthritis or by diseases called spondyloarthropathies, which cause inflammation of the spine.
The sacroiliac joints join the very base of the spine, called the sacrum, to the ileum, which is located on the pelvic bone. There are two such joints, one located on either side of the pelvis. If these joints become inflamed, it can be extremely painful. Typical symptoms include severe pain with even a small degree of movement, as well as reduced mobility and range of motion.
Sacroiliitis is not always easy to diagnose. The principal symptom of the condition is lower back pain, and this may be misdiagnosed as a strained muscle, herniated disc, or as sciatica, another type of inflammation. Another complicating factor is that people with sacroiliac inflammation are reluctant to move due to the pain, which may cause a medical professional to overlook the severity of this symptom.
Treating the inflammation may be equally difficult because movement is so painful that many patients are reluctant to undergo any form of physical therapy. This therapy is, however, an extremely important part of treatment, particularly because strengthening muscles helps improve their stability and flexibility, and reduces the pressure put on the joints and bones.
Medications to treat sacroiliitis include non-steroidal anti-inflammatory drugs, corticosteroids, and disease-modifying antirheumatic drugs. Non-steroidal anti-inflammatory drugs are typically the first line of defense, as these have fewer side effects. Even so, these medications do have some possible consequences of long-term use, including indigestion, stomach bleeding, high blood pressure, and damage to the kidneys and liver.
Corticosteroids may be used to treat severe pain, but due to their potentially serious side effects, they are only for short-term use. These are effective anti-inflammatory medications, but they can cause cataracts, bone-thinning, and suppression of the immune system, leaving the patient more vulnerable to infection. These drugs are usually prescribed for acute symptoms only, and only for a short period of time.
Disease-modifying antirheumatic drugs, such as methotrexate and sulfasalazine, are prescribed to reduce the amount of permanent damage done to the joints. When prescribed early in the disease process, these drugs help prevent widespread permanent damage, and help slow down the rate at which the disease progresses. These drugs are slow-acting, however, and are often prescribed in conjunction with corticosteroids. The steroids help manage short-term pain, allowing the antirheumatic medication time to act.
At home, patients can reduce the severity of their symptoms and help prevent a recurrence of the inflammation. It is most important for them to follow a medical professional's recommendations for medication, bed rest, and physical therapy, as instructed. Additionally, patients who smoke can help their body fight the disease by quitting. Cigarette smoking reduces circulation, which means that blood flow to the inflamed area is reduced, making it more difficult for the body to heal itself.