Sacroiliac Joint Arthritis: What You Need To Know

What is Sacroiliac Joint Arthritis or Sacroiliitis?

Sacroiliac joint (SIJ) arthritis or sacroiliitis is a painful condition of the lower back (also known as sacroiliitis in broader terms). The inflammation and degenerative changes of one or both sacroiliac joints lead to pain in the lower back and buttocks. The pain may also extend down into the legs. About 15 to 30 percent of lower back pain is due to sacroiliitis, with arthritis being the leading cause.

What are the causes of Sacroiliac Joint Arthritis?

Various forms of arthritis that affect other joints also affect the sacroiliac joints. These types include

  • Osteoarthritis: It is caused by the degeneration of cartilage on the articular surface of bones forming the joints—including SIJ.
  • Ankylosing spondylitis: Autoimmune arthritis, ankylosing spondylitis inflames joints, tendons, and ligaments. One of its initial symptoms is SIJ pain.
  • Rheumatoid arthritis: In this rare condition, the immune system attacks the delicate lining of the joints and causes inflammation and pain. It may also affect the SIJ.
  • Psoriatic arthritis: It is another autoimmune arthritis and affects the spinal joints, including the sacroiliac joint.
  • Gouty arthritis: This is also very rare. In this condition, small crystals deposit in the soft joint tissues. It can affect the SIJ as well.
  • Reactive arthritis: It is followed by a past infection. The condition may also affect the SIJ.

Other factors that increase the risk of getting SIJ arthritis are:

  • Traumatic injury to the sacroiliac joint
  • Stress and excessive use of the sacroiliac joint such as manual labor
  • Pregnancy: It leads to stress and loosening of the sacroiliac joint
  • Cancer metastasis into the SIJ
  • Infection like tuberculosis may also affect SIJ

What are the symptoms of Sacroiliac Joint Arthritis?

In SIJ arthritis, you may experience the following symptoms:

  • Pain in the buttocks, lower back, thighs, and pelvis
  • Usually pain aggravates with prolonged standing, sitting, running, or rotating hips
  • Pain may be dull, achy, sharp or stabbing
  • Stiffness in the lower back, especially in the morning or after sitting for a while
  • Tender, warm, red, and swollen lower back
  • Loss of motion of the hips

How to make a diagnosis of Sacroiliac Joint Arthritis?

The diagnosis of SJ arthritis is quite difficult to make since many conditions present with similar symptoms. The doctor will make the diagnosis on the following:

  • Symptoms such as pain, tenderness, stiffness, etc
  • Medical history to check for any recent injury, pregnancy, an activity involving excessive SJ use, or any other arthritis.
  • Physical examination: It involves checking for various hip movements
  • Imaging tests like X-rays may helps in diagnosis
  • MRIs to look at the condition of joints. This is most sensitive
  • An anesthetic injection such as lidocaine injection: If it relieves pain immediately, you most likely have SJ arthritis. This is called diagnostic SIJ intervention of block

What is the prognosis of Sacroiliac Joint Arthritis?

Prognosis depends on the cause of your sacroiliac joint arthritis. Most types of arthritis do not have a cure, and the focus of treatment is to manage lower back pain and other symptoms. If non-surgical options fail, surgery may be necessary.

What are the treatments of Sacroiliac Joint Arthritis?

Your doctor may recommend the following treatments:

  • Resting and modifying the activities that aggravate pain
  • Apply ice and heat alternatively to relieve pain
  • Pain relievers: These include over-the-counter such as naproxen as well as strong medications prescribed by the doctor.
  • TNF alpha inhibitors: Tumor necrosis inhibitor drugs relieve pain associated with ankylosing spondylitis.
  • Steroid injection: It reduces pain and inflammation in the sacroiliac joint temporarily to allow daily activities.
  • Radiofrequency or Cryoneurolysis to block pain carrying lateral branches. This is most modern and safe tecnique to reduce SIJ pain.
  • Physical therapy to increase the range of joint motion and maintain flexibility. A therapist may help you devise an individualized stretching and strengthening exercise plan for your muscles. Massage and yoga may also prove effective helpful.
  • Surgery: It is the last resort in which two bones are fused with small plates to relieve pain.