Even though it’s a common health problem, it can be tough to figure out what’s causing your back pain. Anything from sleeping in the wrong position to overdoing it with yard work to an underlying problem with your spine and joints could cause it.
One cause of back pain you may not have heard of is a condition called sacroiliitis. “It’s a painful inflammation of the sacroiliac joints, which connect the lower spine to the pelvis,” said Tajdip Sandhu, MD, an orthopedic spine surgeon with Banner Health.
When these joints get inflamed, you can feel discomfort, back pain or pain that radiates down to your hips and buttocks. The pain might be worse after you’ve been sitting or standing for a long time, or when you climb stairs. You may notice stiffness, clicking or catching in your back.
It’s essential to understand the symptoms of sacroiliitis and get it diagnosed properly so you can treat it.
What causes sacroiliitis?
“Sacroiliitis can have many different causes,” Dr. Sandhu said. “It’s most common in people who are middle-aged.”
You’re more likely to have sacroiliitis if you have:
- Arthritis (including ankylosing spondylitis)
- Chronic repetitive stress, which could come from exercise
- A history of spinal or pelvic injuries
- Pregnancy-related changes
- Certain autoimmune conditions
How is sacroiliitis diagnosed?
If your back pain is persistent, getting worse or affecting your daily life, seeking professional medical advice is important. Trying to diagnose or treat yourself may not be effective and could possibly make your back pain worse.
If you have back pain and your health care provider suspects sacroiliitis, they might take these steps to make a diagnosis:
- Medical history: Your provider will ask about your symptoms, how long they’ve lasted and any factors that could be contributing to them. Be sure to tell your provider about any back or pelvic injuries you’ve had in the past, your medical conditions and any inflammatory diseases in family members. These factors can help your provider narrow in on what might be causing your back pain.
- Physical examination: Your provider will want to check your lower back, pelvis and hips for tenderness, swelling and range of motion issues. They may also observe how you walk (gait assessment) to see if they notice any issues or abnormalities.
- Imaging studies: These tests can confirm your diagnosis and how much inflammation is present. X-rays can show structural changes, such as erosion (wearing away) or fusion (joining together) in the sacroiliac joints. MRI (magnetic resonance imaging) can show soft tissues in detail, which can help identify inflammation and structural issues. CT scans (computed tomography) provide images in cross-sections that are especially useful for showing bony structures.
- Blood tests: These tests can help in diagnosis and may also help rule out other conditions that could be causing back pain. Specific blood markers, such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), may be signs of inflammation in the body.
These steps can help your doctor determine whether you have sacroiliitis or another condition. Sacroiliitis and other causes of back pain (such as lumbar spine issues or hip problems) can have similar symptoms. It’s important to have an accurate diagnosis so your provider can develop an effective treatment plan.
How is sacroiliitis treated?
If you’re diagnosed with sacroiliitis, your provider will talk to you about your treatment options so you can work together to develop the best plan. In some cases, your provider may refer you to a rheumatologist or orthopedic specialist with expertise in diagnosing and treating sacroiliac joint disorders.
Treatment will depend on your overall health and the severity of your condition. Not every option is right for everyone, and most people will benefit from a combination of treatments. Most of the time, sacroiliitis gets better and the back pain disappears.
Some options include:
- Physical therapy
- Improvements to your posture
- Core and pelvic muscle strengthening exercises
- Ergonomic adjustments to reduce stress on your back
- Losing weight or maintaining a healthy body weight
- Physical activity
- Pain-relieving medications
- Heat or cold packs
- Corticosteroid injections to reduce inflammation
- In some cases, a minimally invasive surgical procedure called sacroiliac joint fusion
- In people with autoimmune disorders, treatment for those conditions
With sacroiliitis, you might have flare-ups. You can often manage them with gentle stretches, alternating periods of rest and activity and over-the-counter pain relievers.
Be sure to stay in contact with your provider as you’re following your treatment plan. They can help you manage your condition, control your symptoms and improve your quality of life.
The bottom line
If you have back pain, sacroiliitis could be causing it. That’s when the joint that connects your spine and pelvis becomes inflamed. Your provider can consider your medical history, physical exam, imaging studies and possibly blood tests to figure out if you have the condition. If you do, it usually resolves with treatment.
Be sure to see your provider if your back pain isn’t easing up, is getting worse or is interfering with your quality of life. Getting care quickly can help you get back to the pain-free life you want to lead.
If you would like to connect with a health care provider who can diagnose your back pain and help you put together a treatment plan, reach out to Banner Health.