ASK AN EXPERT
Got a question about a health story in the news or a health topic? Here's your chance to get an answer. Send us your questions about general health topics, diet and fitness and mental health. If your question is chosen, it could be featured on CNN.com's health page with an answer from one of our health experts, or by a participant in the CNNhealth community.




* CNN encourages you to contribute a question. By submitting a question, you agree to the following terms found below.
You may not post any unlawful, threatening, libelous, defamatory, obscene, pornographic or other material that would violate the law. By submitting your question, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your questions(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. CNN Privacy Statment.
Thank you for your question!

It will be reviewed and considered for posting on CNNHealth.com. Questions and comments are moderated by CNN and will not appear until after they have been reviewed and approved. Unfortunately, because of the voume of questions we receive, not all can be posted.

Submit another question or Go back to CNNHealth.com

Read answers from our experts: Living Well | Diet & Fitness | Mental Health | Conditions
updated January 09, 2013

Sacroiliitis

Filed under: Boomer's Health
Sacroiliitis (say-kroe-il-e-I-tis) is an inflammation of one or both of your sacroiliac joints — the places where your lower spine and pelvis connect. Sacroiliitis can cause pain in your buttocks or lower back, and may even extend down one or both legs. The pain associated with sacroiliitis is often aggravated by prolonged standing or by stair climbing.

Sacroiliitis can be difficult to diagnose, because it may be mistaken for other causes of low back pain. It's been linked to a group of diseases that cause inflammatory arthritis of the spine. Treatment of sacroiliitis may involve a combination of rest, physical therapy and medications.

©1998-2013 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

The pain associated with sacroiliitis most commonly occurs in the buttocks and lower back. It can also affect the legs, groin and even the feet. Sacroiliitis pain can be aggravated by:

  • Prolonged standing
  • Bearing more weight on one leg than the other
  • Stair climbing
  • Running
  • Taking large strides

©1998-2013 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

A wide range of factors or events may cause sacroiliac joint dysfunction, including:

  • Traumatic injury. A sudden impact, such as a motor vehicle accident or a fall, can damage your sacroiliac joints.
  • Arthritis. Wear-and-tear arthritis (osteoarthritis) can occur in sacroiliac joints, as can ankylosing spondylitis — a type of inflammatory arthritis that affects the spine.
  • Pregnancy. The sacroiliac joints must loosen and stretch to accommodate childbirth. The added weight and altered gait during pregnancy can cause additional stress on these joints and can lead to abnormal wear.
  • Infection. In rare cases, the sacroiliac joint can become infected.

©1998-2013 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Sacroiliitis may be part of an inflammatory arthritic condition known as ankylosing spondylitis. Complications of this condition can be very serious, including difficulty breathing, spine deformities, lung infections and heart problems.

©1998-2013 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

You're likely to start by seeing your family doctor. However, he or she may refer you to a rheumatologist or an orthopedic surgeon.

What you can do
Before your appointment, you may want to write a list of answers to the following questions:

  • Has anyone in your immediate family had similar symptoms?
  • Have you fallen or been in a car accident recently?
  • What medications and supplements do you take regularly?

What to expect from your doctor
Your doctor may ask some of the following questions:

  • When did your symptoms start?
  • Where exactly does the pain occur?
  • Does any type of activity worsen or lessen the pain?

©1998-2013 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

During the physical exam, your doctor may try to pinpoint the cause of your pain by pressing directly on various places on your hips and buttocks. He or she may also move your legs into a variety of positions that will gently stress your sacroiliac joints.

Imaging tests
An X-ray of your pelvis can reveal signs of damage to the sacroiliac joint. If ankylosing spondylitis is suspected, your doctor might recommend magnetic resonance imaging (MRI) — a test that uses radio waves and a strong magnetic field to produce very detailed cross-sectional images of both bone and soft tissues.

Anesthetic injections
Because low back pain can be caused by so many different types of problems, your doctor may suggest using injections of anesthetics to help pinpoint the diagnosis. For example, if an injection of numbing medicine into your sacroiliac joint stops your pain, it's likely that the problem is in your sacroiliac joint. However, the numbing medicine can leak into nearby structures, and that can reduce the reliability of this test.

©1998-2013 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

The type of treatment your doctor will recommend depends on the signs and symptoms you're having, as well as the underlying cause of your sacroiliitis.

Medications
Depending on the cause of your pain, your doctor may recommend:

  • Pain relievers. If over-the-counter pain medications don't provide enough relief, your doctor may prescribe stronger versions of these drugs. Occasionally, a short course of narcotics may be prescribed. Narcotics are habit-forming and shouldn't be used for long periods of time.
  • Muscle relaxants. Medications such as cyclobenzaprine (Flexeril, Amrix) may help reduce the muscle spasms often associated with sacroiliitis.
  • TNF inhibitors. Tumor necrosis factor (TNF) inhibitors — such as etanercept (Enbrel), adalimumab (Humira) and infliximab (Remicade) — often help relieve the type of sacroiliitis that's associated with ankylosing spondylitis.

Therapy
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.

Surgical and other procedures
If other methods haven't relieved your pain, you doctor might suggest:

  • Joint injections. Corticosteroids can be injected directly into the joint to reduce inflammation and pain. But you can receive only a few joint injections a year because the steroids can weaken your joint's bones and tendons.
  • Radiofrequency denervation. Radiofrequency energy can damage or destroy the nerve tissue causing your pain.
  • Electrical stimulation. Implanting an electrical stimulator into the sacrum may help reduce pain caused by sacroiliitis.
  • Joint fusion. Although surgery is rarely used to treat sacroiliitis, fusing the two bones together with metal hardware can sometimes relieve sacroiliitis pain.

©1998-2013 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Home treatments for sacroiliitis pain include:

  • Over-the-counter pain relievers. Drugs such as ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others) may help relieve pain associated with sacroiliitis. Some of these drugs can cause stomach upset, or kidney or liver problems.
  • Rest. Modifying or avoiding the types of activities that aggravate your pain may help reduce the inflammation in your sacroiliac joints. Proper posture is important.
  • Ice and heat. Alternating ice and heat may help relieve sacroiliac pain.

©1998-2013 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Please wait while we retrieve your data
Please wait while we retrieve the data

MayoClinic.com Features

Ask a Question

Want to know more about this article or other health related issues? Ask your question and we'll post some each week for CNN.com reader to discuss or for our experts to weight in.

Ask a Question button
advertisement
Quick Job Search :
keyword(s):
enter city: