Sacroiliitis and SI joint painBy Nigel Chua
Painful inflammation of our sacro-iliac joint can be a symptom of a range of inflammatory conditions, including:
Also known as osteoarthritis of the sacroiliac joint, degenerative arthritis is primarily caused by wear and tear and breakdown of the joint cartilage. It can also be caused by diseases, injuries and direct impacts.
The wearing and breakdown of our sacroiliac joint cartilage can be caused and/or aggravated by:
- age (the older, generally the more wear and tear)
- obesity (the heavier, the more load is put through the joints)
- direct trauma
- repeated stress on the sacroiliac joints from repetitive movements and strains
- malformed/misaligned joints.
ANKYLOSING SPONDYLITIS (AS)
Ankylosing spondylitis (AS) usually begins as sacroiliitis. Ankylosing spondylitis begins in our sacroiliac joints, before it progresses by traveling upwards along the spine through a vicious cycle of inflammation, erosion and calcification.
To be able to accurately diagnose ankylosing spondylitis, our sacroiliac joints need to be clearly seen to be affected by the inflammation cycle. This detection of AS-related sacroiliitis can be done via
- X-ray imaging
- MRI scans
- CT scans
- Blood tests to detect elevated C-reactive protein (CRP) and/or erythrocyte sedimentation rate (ESR).
PSORIATIC ARTHRITIS (PSA)
Psoriatic arthritis is an auto-inflammatory disease that causes
- pain and swelling in our joints
- scaly skin patches (commonly known as psoriasis).
Psoariatic arthritis can be hard to distinguish from rheumatoid arthritis because their symptoms overlap. That being said, psoriatic arthritis is much more likely to cause spondylitis which is the inflammation of the joints in our spine, which also includes the sacroiliac joints.
If sacroiliitis is amongst the symptoms experienced by a patient, then the patient is more likely to have psoriatic arthritis. Research shows that 10% of patients with psoriasis develop psoriatic arthritis, and 90% of them do not experience any forms of joint pain and swelling.
Gout is a painful condition that is caused when the build up of uric acid forms uric acid crystals that can travel. These uric acid crystals insert painfully into the joints, causing swelling and pain.
Gout is a common form of inflammatory arthritis, and it generally and typically affects one joint at a time (usually the big toe). But unfortunately in some cases, some gout patients may experience pain and inflammation in the sacroiliac joints too.
If the usual and typical gout treatments aren't working for your sacroiliac joint symptoms, and there are no inflammatory conditions identified by a doctor, it is possible that you may receive direct treatment to the sacroiliac joint, such as
- a diagnostic anesthetic injection to confirm the pain
- steroid compound to treat the gouty pain
There are many different causes of sacroiliac joint pain and inflammation, and treating them effectively lies in identifying the main cause of the problem and treating the cause.
NON-ARTHRITIC CAUSES OF SI JOINT PAIN
Not all types of sacroiliac joint pains are caused by or related to arthritis. There are other causes such as direct trauma, pregnancy and even mechanical loads:
- Trauma. The SI joint, which is comprised of the ligaments that surround and support the SI joint, can be injured by direct trauma. Our sacroiliac joint can be easily damaged even with mild or light force trauma. You can damage your sacroiliac joint by something as simple as stepping onto higher ground the wrong way or accidentally "jamming" the joint in a fall.
- Lax ligaments during pregnancy. Pregnant bodies secrete the special hormones relaxin and progesterone to loosen the joints to prepare the body for childbirth. Sometimes, these ligaments get too lax and unfortunately in some cases, the sacroiliac joint can dislodge or slip out of place. Symptoms often decrease after pregnancy and childbirth, as the ligament automatically becomes stronger once the relaxin hormone is no longer secreted, and as patients increase activity levels.
- Mechanical stress. Some people develop very stiff spines because of conditions like severe arthritis or surgical spinal fusion, which can increase the stress experienced at the SI joint due to overload/overcompensatory functions. Over a period of time, this can lead to degenerative changes and pain.
A trained and experienced specialist physiotherapist can assess, diagnose and treat the root cause of your sacroiliac joint pain and customize a specific treatment plan for you.
PHYSIOTHERAPY TREATMENT OF SACROILIAC DYSFUNCTION
Most of the causes of back pain linked to SI dysfunction can be treated with rest, anti-inflammatory medications and spinal physiotherapy.
When sacroiliac joint pain and sacroiliitis are caused by a specific type of arthritis, we always need to diagnose and treat the main cause underneath - there is no point just treating the symptoms only.
Sometimes the inflamed SI joint can be slightly misaligned and our specialist spinal/sacroiliac physiotherapist in Phoenix Rehab Singapore can help to realign the joint with a combination of
- gentle, graded and guided exercise
- joint manipulation
- manual therapy.
At other times, injections are helpful to decrease the inflammation, and in some cases, surgical intervention is required for SI dysfunction that doesn't respond to non-surgical interventions.
Ugonjwa wa Sacroiliac (SIA) ni ugonjwa wa viungo vya mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo wa mkojo. Inaweza pia kusababishwa na magonjwa, majeraha na athari za moja kwa moja. Uharibifu wa cartilage ya sacroiliac inaweza kusababishwa na au kuongezeka na: umri (mzee, kwa ujumla zaidi ya kuvaa na machozi) - uzito (zito zaidi, zaidi ya mzigo ni kuweka kupitia viungo) - trauma ya moja kwa moja - mkazo mara kwa mara juu ya viungo sacroiliac kutoka harakati za mara kwa mara na misuli - misformed misaligned viungo. Ankylosing spondylitis (AS) - ugonjwa wa spondylitis ya ankylosing (AS) unaanza kama sacroiliitis. Ankylosing spondylitis huanza katika viungo vya sacroiliac, kabla ya kuendelea na kusafiri juu kwenye uti wa mgongo kupitia mzunguko mbaya wa uvimbe, uharibifu na calcification. Ili kugundua kwa usahihi ugonjwa wa ankylosing spondylitis, ni muhimu kujua ikiwa viungo vya sacroiliac vinaathiriwa na mzunguko wa uvimbe. Ugonjwa wa saratani ya utumbo unaohusiana na AS unaweza kugunduliwa kwa kutumia uchunguzi wa X-ray, MRI, CT, na vipimo vya damu ili kugundua kiwango cha juu cha protini ya C-reactive (CRP) na kiwango cha sedimentation ya erythrocyte (ESR). Psoriasis (Psyoriasis) ni ugonjwa wa auto-inflammatory ambao husababisha maumivu na uvimbe katika viungo vyetu, na pia huunda madoa ya ngozi (ya kawaida inajulikana kama psoriasis). Huenda ikawa vigumu kutofautisha ugonjwa wa arthritis ya psoariatic na ugonjwa wa arthritis ya rheumatoid kwa sababu dalili zao hufanana. Kwa sababu ya ugonjwa wa psoriasis, ugonjwa wa arthritis unajulikana kama spondylitis, ambayo ni ugonjwa wa kuambukizwa kwa viungo vya uti wa mgongo, pamoja na viungo vya sacroiliac. Ikiwa ugonjwa wa sacroiliitis ni moja ya dalili zinazopatikana na mgonjwa, basi mgonjwa ana uwezekano mkubwa wa kuwa na ugonjwa wa arthritis ya psoriatic. Utafiti unaonyesha kwamba asilimia 10 ya wagonjwa wanaopatikana na ugonjwa wa psoriasis hupata ugonjwa wa psoriatic arthritis, na asilimia 90 ya wagonjwa hawapati maumivu yoyote ya viungo na uvimbe. Gout ni ugonjwa wa ugonjwa wa kibofu cha kibofu unaosababishwa na kuunganishwa kwa asidi uric ambayo huunda fuwele za asidi uric ambazo zinaweza kusafiri. Kioo hicho cha asidi uriki huingia kwenye viungo kwa maumivu, na kusababisha uvimbe na maumivu. Gout ni aina ya kawaida ya arthritis ya uchochezi, na kwa kawaida huathiri sehemu moja kwa wakati (kwa kawaida kidole kikubwa cha mguu). Kwa sababu ya hali hii, wagonjwa wa gout wanaweza kupata maumivu na uvimbe katika viungo vya sacroiliac. Ikiwa matibabu ya kawaida ya gout hayafanyi kazi kwa dalili zako za pamoja na hakuna hali ya uchochezi iliyotajwa na daktari, kuna uwezekano kwamba unaweza kupokea matibabu ya moja kwa moja kwa pamoja na sacroiliac, kama vile - sindano ya anesthetic ya utambuzi ili kuthibitisha maumivu - kiwanja cha steroid kutibu maumivu ya gout kuna sababu nyingi tofauti za maumivu na uvimbe wa pamoja na viungo vya sacroiliac, na kutibu kwa ufanisi iko katika kutambua sababu kuu ya tatizo na kutibu. Kwa sababu ya maumivu ya viungo vya mkojo, sio aina zote za maumivu ya viungo vya sacroiliac husababishwa na au kuhusiana na ugonjwa wa viungo. Kuna sababu nyingine kama vile majeraha ya moja kwa moja, ujauzito na hata mizigo ya mitambo: - Majeraha. Sehemu ya SI, ambayo inajumuisha ligaments zinazozunguka na kusaidia sehemu ya SI, inaweza kuharibiwa na majeraha ya moja kwa moja. Pamoja sacroiliac yetu inaweza kuwa kwa urahisi kuharibiwa hata na upole au mwanga nguvu trauma. Unaweza kuharibu kiungo chako cha sacroiliac kwa kitu rahisi kama vile kutembea juu ya ardhi ya juu kwa njia isiyofaa au kwa bahati mbaya "kuficha" kiungo wakati wa kuanguka. - Kufungua viungo wakati wa ujauzito. Mwili wa mwanamke mjamzito hutokeza homoni za pekee za relaxin na progesteroni ili kuondoa misuli na kutayarisha mwili kwa ajili ya kuzaa. Wakati mwingine, viungo hivi huwa na lax sana na kwa bahati mbaya katika baadhi ya kesi, pamoja sacroiliac inaweza dislodge au kuingizwa nje ya mahali. Mara nyingi dalili hupungua baada ya mimba na kuzaa, kama ligament moja kwa moja inakuwa imara mara moja homoni relaxin ni tena secreted, na kama wagonjwa kuongeza viwango vya shughuli. - Mkazo wa mitambo. Watu wengine huendelea na misuli ngumu sana kwa sababu ya hali kama arthritis kali au upasuaji wa mshipa wa mgongo, ambayo inaweza kuongeza mkazo unaopatikana katika sehemu ya SI kwa sababu ya kazi za overload au overcompensatory. Baada ya muda, hilo laweza kusababisha mabadiliko ya kuharibika na maumivu. Mtaalamu wa matibabu ya mwili aliye na uzoefu anaweza kukadiria, kugundua na kutibu kisababishi cha maumivu ya pamoja ya sacroiliac na kuunda mpango maalum wa matibabu kwa ajili yako. Matibabu ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid ya Steroid. Wakati maumivu ya pamoja ya sacroiliac na sacroiliasis husababishwa na aina maalum ya arthritis, tunahitaji daima kugundua na kutibu sababu kuu chini - hakuna uhakika tu kutibu dalili tu. Wakati mwingine, kiungo cha SI kilichochomwa kinaweza kuwa na mtiririko mdogo na mtaalamu wetu wa spinal-sacroiliac physiotherapist katika Phoenix Rehab Singapore anaweza kusaidia kurekebisha kiungo kwa mchanganyiko wa mazoezi ya upole, ya kiwango na ya kuongozwa, udhibiti wa pamoja, na matibabu ya mwongozo. Wakati mwingine, sindano ni muhimu kupunguza uvimbe, na katika baadhi ya kesi, upasuaji inahitajika kwa dysfunction SI kwamba haina kujibu kwa uingiliaji zisizo za upasuaji.