Sacroiliac Joint Inflammation

The sacroiliac joints are located at the bottom of the back, on each side of the spine. The joint connects the sacrum and the iliac crest to form the rear part of the pelvic girdle that supports the spine and hips. Unlike the rest of the movable vertebrae of the spine, the sacrum can only rotate within a circumference of four degrees and 2 mm of translation, as its five vertebrae are fused together. The sacrum is the triangular shaped bone located below the lumbar spine. The sacroiliac joint is a strong joint that holds the sacrum and the iliac bones together with strong fibrous ligaments. However, these joints do not have the capacity to support the entire weight of the upper body (which it usually has to) because of the normal activities carried out by the rest of the body. And the constant twisting and compressing while performing activities, places a large amount of stress on the sacroiliac joints, leading to wear and tear of the cartilage of the joints and ultimately leading to inflammation. In medical parlance, this inflammation is known by the following terms: sacroiliac joint dysfunction, sacroiliac joint strain, sacroiliac joint pain and sacroiliac joint syndrome.

Inflammation of the Sacroiliac Joint

Causes
There are a variety of causes leading to sacroiliac joint pain and inflammation, the most common being the development of osteoarthritis, a form of degenerative arthritis. Damage to the cartilage that works as a shock absorber between the bones leads to friction and wearing out of the bones. Other forms of arthritis, like, rheumatoid arthritis, spondylitis, gout, etc. can also cause sacroiliac joint syndrome. Sacroiliac joint strain may sometimes be the result of an accident or injury caused by sudden impact to the spine, hip or pelvis. Chronic stress fractures, muscle imbalance, hormonal changes or dislocations are other causes. Pregnancy is seen as a common cause of sacroiliac joint dysfunction. Hormonal changes in the pregnant woman's body relax all the connective tissues, to facilitate the pelvis stretching capacity to allow birth. Relaxed ligaments in the sacroiliac joint, combined with additional weight and altered walking patterns places excessive stress on the joints. Bad posture is also associated with this condition.

Symptoms
One of the most common signs of sacroiliac joint inflammation is excruciating pain, described by some as a searing, shooting pain in the lower back or back of the hips, that either travels upwards or downwards to the legs. Stiffness is another symptom experienced, especially after a period of restricted hip and back movement, like, after long car journeys, periods of sitting still, when waking up in the morning, turning over in the bed, etc. Pain in lower back, hips and thighs after a period of some activity, like walking or sexual activity, is also a sacroiliac joint pain symptom.

Diagnosis
It is often confusing for an individual to pinpoint the exact location of the pain, however, modern diagnostic tests not only help to determine the location but also play a part in its treatment. After a physical examination and studying the history of other medical problems, most doctors recommend X-ray, Computed Axial Tomography Scan (CAT/CT scan) or a Magnetic Resonance Imaging (MRI) of the pelvis, hips or lumbar spine to identify fractures, bone abnormalities / tumors or soft tissues like muscles and ligaments.

Treatment
Treatment includes therapy and medications. Physical therapy helps to stabilize the spine, relax the muscles and de-stress the nerves around the joints. It is done by identifying localized trigger points and using the techniques of compressing and stretching to ease the pain. A sacroiliac belt is also part of the physical therapy: it is wrapped around the hips to help stabilize the joints and prevent it from receiving shocks while performing any activity. A physical therapist may suggest specific exercises for sacroiliac joint pain that will aid in relieving pain. Medications include both steroidal as well as non-steroidal anti-inflammatory drugs (NSAIDs) and injections. To reduce inflammation in and around the joints, cortisone injections are sometimes prescribed. Surgical treatment is recommended in extreme cases. Surgery involves fusion of the sacroiliac joints by removing the surface cartilage and holding the bones together with the help of plates and screws, until the connective tissues grow back and are fused together.

One must immediately consult a doctor or an orthopedic if one experiences any of the above mentioned symptoms. Sacroiliac joint dysfunction can never be completely cured, however, with good management that includes maintaining a good body weight, healthy diet, physical therapy and medication, it is possible to help alleviate pain and lead a normal healthy life.