Do you experience constant pain in your lower back, buttocks, or hips? Does it get worse when you sit or stand for long periods of time? This could be a symptom of sacroiliitis, an inflammation of the sacroiliac joints. This condition can be difficult to diagnose because its symptoms are similar to other types of back pain. Don’t delay seeing a specialist.
Sacroiliitis: what kind of disease is this?
Sacroiliitis is an inflammation of one or both sacroiliac joints, which are located at the junction of the sacrum and pelvic bones. These joints are responsible for transferring weight from the spine to the lower extremities.
Depending on the cause and spread, sacroiliitis can be:
- Unilateral (one joint affected) or bilateral (both joints affected).
- Infectious (caused by infections, such as tuberculosis) or non-infectious (caused by injuries, overuse, arthritis, or pregnancy).
Manifestations of the disease
Sacroiliac joint dysfunction occurs after a minor injury:
- falling on the buttocks,
- slipping when pushing heavy objects.
Increased pain occurs during daily activities:
- getting up from a chair,
- climbing stairs,
- getting out of the car, etc.
Characteristic increase in pain with asymmetric loads:
- ice skating,
- gymnastics,
- aerobics.
The most common location of pain is in the lower extremity, as shown in the figure below. The pain can originate from the many muscles, ligaments, and bones that make up this joint.
Sacroiliitis: How to Recognize Symptoms and Get Diagnosed
The main symptom of sacroiliitis is pain in the lower back, buttocks, or thighs, which often radiates into the leg.
Pain can:
- worsen after prolonged sitting or standing;
- appear after physical exertion;
- to give in the groin or lower abdomen.
Diagnosis of sacroiliitis begins with a physical examination and history taking. To confirm the diagnosis, the following may be prescribed:
- X-rays — to detect structural changes in the joints.
- MSCT (Multislice Computed Tomography) — for detailed visualization of bone structures.
- MRI (Magnetic Resonance Imaging) — to assess the condition of soft tissues and detect inflammation.
- Diagnostic blocks — to accurately determine the source of pain.
Development factors
Factors for the development of sacroiliac joint dysfunction are:
- degenerative joint diseases,
- weakness of joints and ligaments (pregnancy),
- minimal trauma in history (fall on buttocks).
Modern methods of treating sacroiliitis
Treatment always begins with conservative methods. Our goal is to eliminate pain, inflammation, and restore joint mobility.
- Injection therapy: blockades This is one of the most effective methods for rapid pain relief. Under X-ray or ultrasound guidance, we inject anesthetics and corticosteroids into the joint, which instantly relieve inflammation and pain.
- Radiofrequency denervation This procedure is used when the effect of the blockade is temporary. Using radiofrequency energy, we affect the nerve endings that transmit pain impulses from the joint. The procedure is minimally invasive, blocks the transmission of pain for a long time and allows the patient to return to a full life.
- Surgical treatment In rare cases, when conservative methods do not help or there are significant degenerative changes in the joint, surgical stabilization may be recommended . This is a minimally invasive operation, during which the joint is fixed with special implants.
Intra-articular blockades are used primarily for diagnostic and therapeutic purposes. In this case, anesthetics and corticosteroids are injected into the joint cavity .
- The first ones have an anesthetic,
- and the second – anti-inflammatory effects, thanks to which the symptoms of the affected joint are reduced for a long period of time.
The introduction of anesthetics helps to differentiate whether the cause of the pain is indeed the sacroiliac joint. Blockades of the nerves belonging to the joints are performed at specific points using local anesthetics. This allows for regression of the pain syndrome for the duration of the anesthetic effect.
Radiofrequency joint denervation
This is a method in which the conduction of pain impulses along the nerves innervating the joint is altered for a long period of time (from 6 months to 2-10 years).
The procedure is performed under local anesthesia using special insulated needles. The nerve trunks are not destroyed, but only the conduction of pain impulses through them is stopped.
In the postoperative period, it is recommended to limit physical activity on the joint, while maintaining daily household activities.
Surgical treatment
In case of severe joint damage, it involves stabilizing the joint with the help of special implants or metal structures. The operation is quite minimally traumatic and minimally invasive.
When should you consider injection or surgical treatment?
Conservative methods, such as physical therapy and medication, are important, but they may not always completely resolve the problem. More radical treatments may be considered if:
- The pain does not go away for several weeks or months.
- The pain worsens despite treatment.
- Numbness, weakness, or other neurological symptoms begin.
- Your quality of life is significantly impaired and you are unable to perform normal activities.
Recovery and rehabilitation: the path to full recovery
Our work does not end after the procedure. We provide full support to the patient during rehabilitation, which is key to a stable result. We will develop an individual exercise program and provide recommendations for physical activity that will help you quickly return to a full life.
Why choose us? Key benefits
When it comes to spinal health, experience and precision are crucial. We understand your concerns and offer more than just treatment.
- Expert experience . Neurosurgeon Alexei Leontiev has many years of experience in diagnosing and treating spinal diseases, including complex cases of sacroiliitis.
- Using modern technologies . In our work, we use only proven, minimally invasive methods, such as radiofrequency denervation, which guarantees maximum effectiveness with minimal trauma.
- Individual approach . We develop a treatment plan that is tailored to your condition, taking into account all the features of the disease and your needs. We never start with surgery if there is a possibility of helping with conservative methods.
- Comprehensive support . From the first consultation to full recovery, we provide full support, providing support and recommendations at every stage of treatment.
Don’t let pain control your life! Contact neurosurgeon Alexei Leontiev for an accurate diagnosis and an individual treatment plan. We will help you return to freedom of movement and an active life.
Frequently asked questions and answers about sacroiliitis
What are the main symptoms of sacroiliitis?
Sacroiliitis most often presents with pain in the lower back, buttocks, or thighs. The pain may worsen after prolonged sitting, standing, or exercise. Sometimes there may be a fever.
Can sacroiliitis be cured without surgery?
Thus, in most cases, treatment begins with conservative methods, such as physiotherapy, anti-inflammatory drugs, therapeutic exercises and injection therapy (blockades). Surgical intervention is considered only if these methods are ineffective.
How effective are blockades for sacroiliitis?
Injection blocks with anesthetics and corticosteroids are very effective in quickly relieving pain and inflammation. They also help confirm that sacroiliitis is the cause of the pain.
What types of sacroiliitis are there?
Depending on the cause, sacroiliitis can be infectious or non-infectious. By localization, there are unilateral (most common) and bilateral sacroiliitis, which affects both joints.
Before and after: patient stories
Patient story Igor, 45 years old
Before: Constant pain in the buttock and leg that kept him awake. Igor could not work normally and gave up his favorite jogging. Conservative treatment did not help.
After: Thanks to timely radiofrequency denervation, the pain disappeared. Igor is enjoying an active life again and plans to participate in a marathon.
Sources used:
- Apollo Hospitals. Sacroiliitis: Symptoms, Causes, Treatment, Home Remedies and Exercises.
- https://www.apollohospitals.com/uk/diseases-and-conditions/sacroiliitis-symptoms-causes-treatment-home-remedies-exercises
- MEDICOM Clinic. Sacroiliitis ~ Symptoms, causes, treatment in Kyiv.
- https://medikom.ua/sakroileit/
- Smart Clinic. Sacroiliitis: treatment, causes, diagnostics.
- https://smartclinicspb.ru/zabolevaniy/sakroileit/
Neurosurgeon Leontiev O.Yu.
