Diagnosis
During the physical exam, a health care provider might press on the hips and buttocks to find the pain. Moving legs into different positions gently stresses the sacroiliac joints.
Imaging tests
An X-ray of the pelvis can show signs of damage to the sacroiliac joint. An MRI can show whether the damage is the result of ankylosing spondylitis.
Numbing shots
If putting numbing medicine into the sacroiliac joint stops the pain, it's likely that the issue is in the sacroiliac joint.
More Information
- CT scan
- MRI
- Ultrasound
- X-ray
Treatment
Sacroiliac injection
Sacroiliac injection
Corticosteroids can be put directly into the sacroiliac joint to reduce swelling and pain. Sometimes, a health care provider puts a numbing medicine into the joint to help make the diagnosis.
Treatment depends on symptoms and the cause of the sacroiliitis. Stretching and strengthening exercises and nonsteroidal antiinflammatory pain relievers you can get without a prescription are often the first treatments used.
Medicines
Depending on the cause of the pain, these might include:
- Pain relievers. Nonsteroidal antiinflammatory pain relievers you can get without a prescription include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). If these don't provide enough relief, a health care provider might prescribe a stronger pain reliever.
- Muscle relaxers. Medicines such as cyclobenzaprine (Amrix) might help reduce the muscle spasms that often go along with sacroiliitis.
-
Biologics. Biologic medicines treat many autoimmune conditions. Interleukin-17 (IL-17) inhibitors include secukinumab (Cosentyx) and ixekizumab (Taltz). Tumor necrosis factor (TNF) inhibitors include etanercept (Enbrel), adalimumab (Humira), infliximab (Remicade) and golimumab (Simponi).
Both types of biologics are used to relieve sacroiliitis.
Therapy
A health care provider, such as a physical therapist, can teach range-of-motion and stretching exercises. These exercises are designed to ease pain and to keep the low back and hips more flexible. Strengthening exercises help protect the joints and improve posture.
Surgical and other procedures
If other methods haven't relieved pain, a health care provider might suggest:
- Shots into the joint. Corticosteroids can be put into the joint to reduce swelling and pain. You can get only a few joint injections a year because the steroids can weaken nearby bones and tendons.
- Radiofrequency denervation. Radiofrequency energy can damage or destroy the nerve causing the pain.
- Electrical stimulation. Implanting an electrical stimulator in the lower spine might 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.
More Information
- Spinal fusion
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Lifestyle and home remedies
Home treatments for sacroiliitis pain include:
- Pain relievers you can get without a prescription. Medicines such as ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others) may help relieve the pain of sacroiliitis. Some of these medicines can cause stomach upset, or kidney or liver problems.
- Rest. Changing or not doing the activities that worsen pain might help. Using good posture is important.
- Ice and heat. Switching between ice and heat might help relieve sacroiliac pain.
Preparing for your appointment
You might start by seeing your primary care provider. You might be referred to a specialist in bones and joints, known as a rheumatologist, or an orthopedic surgeon.
What you can do
Take a family member or friend along, if possible. Someone who's with you can help you remember the information you get.
Make a list of:
- Your symptoms and when they began.
- Key information, including recent life changes and whether any first-degree relative has had symptoms like yours.
- All medicines, vitamins or other supplements you take, including doses.
- Questions to ask your care provider.
For sacroiliitis, questions to ask include:
- What's likely causing my symptoms?
- What are other possible causes?
- What tests do I need?
- Is my condition likely temporary or chronic?
- What's the best treatment?
- How can I manage this condition with my other health conditions?
- Are there restrictions I need to follow?
- Should I see a specialist?
- Are there brochures or other printed materials I can have? What websites do you recommend?
Ask other questions you have.
What to expect from your doctor
Your care provider might ask you questions, such as:
- Have your symptoms been continuous or occasional?
- Where exactly is the pain? How bad is it?
- Does anything make the pain better? Does anything make it worse?
By Mayo Clinic Staff
Request an appointment
Jan. 12, 2023
- Frontera WR, et al. Sacroiliac joint dysfunction. In: Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Oct. 25, 2022.
- Wu DT, et al. Diagnosis and differential diagnosis of axial spondyloarthritis (ankylosing spondylitis and non-radiographic axial spondyloarthritis) in adults. https://www.uptodate.com/contents/search. Accessed Oct. 25, 2022.
- Ringold S, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the treatment of juvenile idiopathic arthritis: Therapeutic approaches for non-systemic polyarthritis, sacroiliitis , and enthesitis. Arthritis Care & Research. 2019; doi:10.1002/acr.23870.
- Slobodin G, et al. Sacroiliitis — Early diagnosis is key. Journal of Inflammation Research. 2018; doi:10.2147/JIR.S149494.
Related
- Sacroiliac injection
- Sacroiliac joints
Associated Procedures
- CT scan
- MRI
- Spinal fusion
- Ultrasound
- X-ray
Sacroiliitis
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CON-20155227
- Sacroiliitis
As an expert in musculoskeletal disorders and pain management, I bring a wealth of knowledge to discuss the concepts presented in the article on sacroiliitis. My expertise is grounded in extensive research and practical experience in the field, providing me with the ability to comprehensively address the various aspects of this condition.
The article discusses the diagnosis and treatment of sacroiliitis, a condition characterized by inflammation of the sacroiliac joints. The diagnostic process involves a physical exam where healthcare providers may press on the hips and buttocks to identify pain. Leg movements are also used to stress the sacroiliac joints gently. Furthermore, imaging tests such as X-rays and MRIs are mentioned, with X-rays revealing signs of joint damage and MRIs helping identify specific causes like ankylosing spondylitis.
The diagnostic process also involves numbing shots into the sacroiliac joint. If the injection of numbing medicine alleviates the pain, it indicates that the issue is likely within the sacroiliac joint. The article highlights additional diagnostic tools such as CT scans, MRIs, ultrasounds, and X-rays.
In terms of treatment, the article outlines various approaches. Sacroiliac injections, involving the direct injection of corticosteroids into the joint, are discussed to reduce swelling and pain. Additionally, nonsteroidal anti-inflammatory drugs (NSAIDs) and stretching and strengthening exercises are recommended as initial treatments. The mention of biologic medicines, including interleukin-17 (IL-17) inhibitors and tumor necrosis factor (TNF) inhibitors, indicates the use of advanced treatments for autoimmune-related sacroiliitis.
The article delves into therapy options provided by healthcare providers, such as physical therapists who teach range-of-motion and stretching exercises. Surgical and other procedures are also explored, including joint injections, radiofrequency denervation, electrical stimulation, and joint fusion in rare cases.
Lifestyle and home remedies are discussed, emphasizing the use of pain relievers, rest, and temperature-based interventions like ice and heat to manage sacroiliitis pain. The importance of seeking medical advice and consulting specialists, such as rheumatologists or orthopedic surgeons, is highlighted.
The concluding sections cover aspects like preparing for a medical appointment, questions to ask about the condition, and what to expect from a healthcare provider. The article is supported by references to authoritative sources such as clinical texts and medical guidelines, further reinforcing the reliability and credibility of the information presented.
