HWN Suggests

Sacroiliitis: It’s still the seat of my chronic pain

The time has come for me to talk about my rear end again. Here come the “sit on it,” jokes. It’s sort of a good thing to have a condition that makes people smile. I went to a Uro-Gyno. specialist in Portland last week and every time I talked about my “ass” she smiled. She felt she had to apologize for reacting that way and I said, “Oh, don’t worry about it. When you’ve had pain in your sitter for 23 years you’ve heard and probably said it all. It is funny. That’s just one of those things our society laughs at.”

I guess it’s a kind of conditioning we carry around with us from childhood potty jokes, etc. It’s also a great ice-breaker. Not my bottom, heaven knows, but the wisecracks.…

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Articles of Interest

The Back Pain Most Surgeons Won't Find

Studies have found that 20 to 25% of all chronic lower back pain comes not from the spine but from the sacroliac, or SI, joint, which bears and transfers weight and movement from your upper body to your legs. When the ligaments wear out and the SI joint becomes unstable, it can generate a similar kind of sharp back pain -- or sciatica-like pain down your leg -- as a ruptured disc.

79-year-old man with right hip pain

The diagnosis of sacroiliitis is supported by the posterior location of this patient’s hip pain and a positive FABER test, in which the hip is Flexed, ABducted, and Externally Rotated and gentle downward pressure is applied to the knee. This test has a high specificity for sacroiliitis and a somewhat lower sensitivity.

Am I Hip? (Sacroiliitis and Ankylosing Spondylitis)

What a couple of tongue-twisters, eh? I learned about these two conditions recently while looking into possible causes for my recent bouts of pain in my left hip area.

Diagnostics of Sacroiliitis According to ASAS Criteria

Our research confirmed MRI to visualize early inflammatory lesions. Application of MRI in patients not disclosing lesions by radiographs according to the modified NY criteria allowed us to diagnose sacroiliitis in 38% of patients in a pre-radiographic stage and ruled out inflammation in 50% of patients with sacroiliitis by radiographic examination according to modNY criteria.

Seronegative spondyloarthropathies & inflammatory low back pain - Part 1

If I asked you what percentage of patients with low back pain have a 'mechanical problem' or 'non-specific problem' your answer might be about ~85%. To my knowledge that answer fits with what we know about the prevalence of serious and sinister pathology masquerading as low back pain. What we don't often talk enough about is that remaining ~15%.

Resources

4 Types of Arthritis That Cause Sacroiliac Joint Pain

Symptoms in the SI joints can be the calling cards of several types of arthritis, including the following...

6 Best Sacroiliac Joint Pain Exercises, and 5 to Avoid

While not all instances of sacroiliac injury can be treated, for some, sacroiliac exercises can be very helpful toward relieving sacroiliac joint pain, curing lower back pain and even preventing SI joint dysfunction from reoccurring.

SI-Bone

After 10 years of suffering with lower back symptoms, Dr. James Mamary was diagnosed with degenerative sacroiliitis.

SImmetry

SI Joint Dysfunction symptoms can mimic those of other low back problems, making it difficult for physicians to diagnose. But some simple tests may be effective in getting to the bottom of what’s causing the pain.

Ainsworth Institute

SIJ pain is more likely to be one-sided rather than typical low back pain that is difficult to localize and may involve both sides or be situated in the midline of the low back. SIJ pain can be referred to various regions of the back, buttock and even the lower extremity making it difficult to tell apart from sciatica or a herniated disc.

Ortho Bullets

Commonly part of ankylosing spodyliitis or Reiter's syndrome - most commonly presents in teen to middle aged individuals, males > females. FABER test - pain with flexion, abduction, and external rotation of hip.

Spine-Health

Sacroiliitis is often found as part of a feature of inflammatory conditions of the spinal column. As a group, these conditions and diseases are termed a "spondyloarthropathy" and include conditions such as ankylosing spondylitis, psoriatic arthritis, and reactive arthritis, among others. Sacroiliitis may also be a component of other types of arthritis, such as ulcerative colitis, Crohn’s disease, or osteoarthritis.