One cause of lower back pain that is often overlooked is inflammation of the sacroiliac joints. At the base of our spine, or sacroiliitis. The term sacroiliitis is a combination of sacrum, the bone that the sacroiliac joint connects to, and -Itis, which is a Latin suffix meaning inflammation.
The sacroiliac joint is one of the largest joints of the body, located at the junction of the sacrum the triangular bone at the bottom of our spine, and the ilium, which makes up the largest part of our pelvis. This C-shaped joint is 1 to 2mm wide, lined by a thin layer of tissue that produces a lubricating fluid called synovial fluid. Synovial fluid helps reduce friction and allows for smooth movement between joint surfaces.
Sacroiliitis typically causes pain in the lower back, buttocks, and legs. Research suggests that 10 to 25% of lower back pain may be caused by SI joint inflammation. The pain can range from mild to severe, symptoms can vary. Often, A patient will feel a dull, achy pain across their low back and yet for some it may extend into the buttock or leg, and for some it can be sharp and stabbing and quite debilitating.
There are many causes of sacroiliitis. It may be due to injury, infection or autoimmune disorders for example, the joint may develop inflammation after a fall or secondary to ankylosing spondylitis or arthritis, or other conditions that cause inflammation. It may also develop during pregnancy, as the joints become more lax and this can persist after pregnancy.
Treatment is usually driven by the underlying cause of the inflammation and centers on a combination of reducing that inflammation, pain management, and rehabilitation to heal the joints. Surgery is an option, but usually nonsurgical therapies are highly effective.
There are many conditions that mimic the symptoms of sacroiliitis, such as a herniated disc or ankylosing spondylitis. Getting an accurate diagnosis to determine the underlying cause of your lower back pain is essential to finding the right treatment.
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