Sacroiliitis

In sacroiliitis the joint between sacrum and pelvis is inflamed. This can result from a rheumatic condition such as axial spondyloarthritis or ankylosing spondylitis, from a bowel or skin condition, and rarely from an infection.

The difference with sacroiliac joint dysfunction matters. Mechanical overload improves with rest, inflammation does not. Recognising it is important, because a rheumatic cause requires a completely different treatment.

• Pain in the buttock and lower back that is worst at night and in the early morning
• Morning stiffness lasting longer than thirty minutes
• Improvement with movement, not with rest
• Pain that alternates between left and right
• Sometimes additional complaints such as inflamed eyes, psoriasis or bowel problems
• Onset usually before the age of forty

With fever, feeling generally unwell and severe pain, an infection must be ruled out urgently.

Diagnosis relies on blood tests, an MRI of the pelvis showing the inflammation, and assessment by the rheumatologist.

• Anti-inflammatory medication as a first step
• Physiotherapy focused on mobility and posture
• Referral to the rheumatologist for targeted medication
• Antibiotics and further follow-up in case of an infectious cause

We first rule out a hip cause and refer you appropriately. Make an appointment for a thorough assessment.