Managing back pain
Concerning Your Health
By Dr. Thomas Thorson
What is the difference between lower back pain and sacroiliitis?
Sacroiliitis can be difficult to diagnose because it is similar to lower back pain. Sacroiliitis is actually an inflammation of one or both sacroiliac joints, which is where the lower spine and pelvis connect. While sacroiliitis may cause pain in the lower back, it is also often accompanied by pain in the buttocks and down one or both legs. This pain gets worse when you stand for prolonged periods, climb stairs, run or do activities where you bear more weight on one leg.
What causes sacroiliitis?
Arthritis and injury are the two most common causes. A sudden impact injury, such as a hard fall or motor vehicle accident, can damage the sacroiliac joints. Osteoarthritis, which develops with normal wear and tear on joints, or inflammatory arthritis that infects the spine also contribute to sacroiliitis diagnoses. Women who are pregnant may experience sacroiliac problems because the joints loosen and stretch for childbirth. Weight gain and changes in gait during pregnancy add additional stress to the joints. Occasionally, infection in the joints is responsible for development of sacroiliitis.
How should I treat the pain?
Use over-the-counter pain medications and alternate ice and heat packs to relieve the pain. Rest the affected joints to reduce inflammation.
Should I see a doctor?
If you have pain for two or more weeks or your pain interferes with your ability to work and sleep, make an appointment with a primary care doctor or orthopedic specialist. It’s important that the cause of your pain is identified. If you have the inflammatory arthritic condition known as ankylosing spondylitis, you could develop very serious complications. Even if your diagnosis is unrelated to this condition, your doctor can help relieve the pain by prescribing stronger pain medications, muscle relaxants and/or physical therapy to maintain joint flexibility and strengthen muscles. Corticosteroid joint injections, electrical stimulation and radio-frequency energy application are other medical methods a doctor can order to reduce pain. Surgery is rarely used to treat sacroiliitis.
(Thomas Thorson, MD, is a board certified family medicine physician at Sanford East Mandan Clinic. A graduate of the University of North Dakota School of Medicine at Grand Forks, Dr. Thorson completed his residency at the University of North Dakota Center for Family Medicine in Bismarck. He is proficient in Spanish and has special medical interests in mental health, chronic disease management and preventative care.)