"Why does it hurt?"... Sacrum inflammation and pain, is this lifestyle habit the cause?

Mr. A, a middle-aged man with high blood sugar and blood pressure who spends most of the day sitting at work, recently experienced severe pain in the sacrum below the lower back and the iliac bones. He applied a patch to the painful area for two days, but the pain did not subside. Suspecting an issue with the hip joint (the joint where the pelvis and legs meet), he visited a hospital. However, he was diagnosed with sacroiliitis (sacroiliac joint inflammation), a condition he had not heard of before.

 

People who are at high risk of chronic inflammation and sit at desks for long periods should be especially cautious as they may suddenly develop sacroiliac joint arthritis as they age. According to medical information from the Cleveland Clinic in the United States, sacroiliac joint arthritis occurs when the joint where the spine and pelvis meet (sacroiliac joint) is stimulated. It is primarily treated with physical therapy and anti-inflammatory drugs (NSAIDs).

 

Feeling very stiff upon waking up, with symptoms lasting more than an hour

 

According to previous research, it is estimated that about one-quarter of patients with back pain suffer from sacroiliitis. When affected by sacroiliitis, individuals experience pain in the lower back, hips (hip muscles), and legs. The sacroiliac joint, which connects the sacrum (also called the tailbone) and the ilium (hip bone), is quite large. This joint is used every time the hips and lower back move. When the sacroiliac joint is irritated or damaged, inflammation occurs, leading to severe pain in the lower back and hips.

According to medical information from the Mayo Clinic in the United States, inflammation of the sacroiliac joint makes it difficult to perform movements such as sitting and standing up, bending the upper body, lifting objects, or maintaining a single posture. Lower back pain worsens when sitting or standing in the same position for a long time or when twisting the hips. It is common to experience a sudden, sharp, pinching sensation as if pricked with a needle, but dull pain may also persist. The pain radiates to the lower back, hips, and thighs. Many people especially feel stiffness in the sacroiliac area in the morning. The stiffness usually lasts for more than an hour. Be cautious, as pain can intensify when standing for a long time, sitting in the same position, climbing stairs, running, putting more weight on one leg, or taking large steps forward.

 

You must tell the doctor exactly about the pain... especially which posture and movement worsen the symptoms.

 

Why do these inflammations and pains occur? All risk factors that cause inflammation in the joints can be potential causes of sacroiliitis. Ankylosing spondylitis, which affects the spinal joints, and psoriatic arthritis are also major causes. Psoriatic arthritis causes inflammation in the joints and psoriasis with scaly skin. Additionally, ulcerative colitis, Crohn's disease, reactive arthritis (Reiter's syndrome), and Behçet's disease can also cause sacroiliitis. Pregnant women may experience inflammation and pain if the sacroiliac joint widens and rotates due to hormonal changes. Falls, car accidents, or infections caused by various viruses and bacteria (bacteria) can also lead to sacroiliitis.

 

Sacral and hip joint arthritis, if left untreated promptly, can lead to complications. In particular, it can worsen into a severe mobility impairment, making it difficult to move even short distances. Persistent pain can make it hard to sleep well and may cause depression. If you feel pain in the sacroiliac joint, it is advisable to see an orthopedic specialist as soon as possible. You should inform the doctor in detail about when the pain started, whether certain activities (postures, movements, types of pressure) worsen the pain, and whether you are taking medication for other illnesses. This helps in accurately identifying the cause and receiving proper treatment. For diagnosis, you may need pelvic X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and blood tests.

Do not neglect stretching and exercises that strengthen the muscles around the joints and physical therapy.

 

The patient should consistently receive physical therapy and not neglect stretching and exercises that strengthen the muscles around the sacroiliac joint. This is also beneficial for increasing the range of motion of the sacroiliac joint. According to a specialist's diagnosis, pain can be managed with medications such as aspirin, ibuprofen, or naphroxen. These non-steroidal anti-inflammatory drugs (NSAIDs) should not be taken continuously for more than 10 days without consulting a doctor. Additionally, muscle relaxants, pain and inflammation relief injections, and radiofrequency ablation (RFA) can be used. Sometimes, assistance from a rheumatology specialist may be necessary. In rare cases, the doctor may recommend surgery, such as joint fusion surgery that permanently fixes the joint with surgical screws.

 

To prevent sacroiliitis, you should quit smoking, engage in consistent exercise that minimizes impact and suits your needs, and maintain a healthy diet. If the patient has inflammatory arthritis, damage to the sacroiliac joint can be permanent. Most patients treat the cause with medication and alleviate symptoms through physical therapy. If symptoms recur or worsen, it is essential to consult with healthcare professionals.

 

Pain can occur without inflammation, but don't jump to conclusions.

 

One important point to note is that even if there is no inflammation in the sacroiliac joint, you may still experience pain inside or near this joint. Lower back pain is a very common symptom. Many people feel pain in the area around the lower part of the back, near the sacroiliac joint. Pain can occur due to poor posture or temporary pressure applied to the sacroiliac joint, even without inflammation.

 

However, if the pain does not subside after a few days (up to a week), you must visit a hospital. Especially for patients with arthritis, diabetes, hypertension, hyperlipidemia, or obesity, it is advisable to see an orthopedic specialist promptly if they experience hip joint pain. These patients are closely related to chronic inflammation.