Once you receive a diagnosis for your lower back pain, therapy options might include OTC or prescription pain relievers, manual therapy, physical therapy, or electrotherapy. A combination of therapies is also possible.
Sacroiliac joint dysfunction, also known as sacroiliitis, is inflammation of your sacroiliac (SI) joint.
There are two SI joints — one on each side of your spine. The joints connect the bones at the bottom of your vertebrae with the top part of your pelvis. Sacroiliitis can affect one or both SI joints.
Sacroiliitis can cause pain in your lower back and buttocks, sometimes sending pain down one or both legs. Several therapy options are available to help treat this condition and ease the pain.
The right medication therapy for sacroiliitis will depend on the cause and severity of it.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help relieve acute (short-term) and chronic (long-term) SI pain temporarily. NSAIDs are typically used as initial treatment.
But over-the-counter (OTC) pain relievers aren’t always effective, and they’re generally not recommended to use over the long term.
If OTC medications don’t work for you, ask your doctor about higher dose pain-relieving prescription drugs. Muscle relaxants can help treat muscle spasms from this condition.
Can TNF inhibitors treat sacroilitis?
One type of sacroiliitis is associated with rheumatoid arthritis (RA), called ankylosing spondylitis (AS). Part of AS treatment often includes tumor necrosis factor (TNF)-alpha inhibitors. These are medications that can help reduce inflammation and relieve symptoms. Examples of TNF-alpha inhibitors include:
- infliximab
- adalimumab
- etanercept
Physical therapy (PT) is often used along with medication therapy. PT exercises and stretches can help:
- maintain the flexibility and strength of your SI joint and lower back muscles
- improve your range of motion
- build stability
- strengthen muscles that support your hips and pelvis
Other muscles that PT might target are your:
- abdominals
- pelvic floor
- ipsilateral gluteal
- contralateral latissimus
In PT, you’ll also learn about proper posture. Good posture may help relieve unnecessary strain on your SI joint. You’ll also learn the right ways to bend, lift, and perform other daily actions.
If sacroiliitis is compromising your ability to walk, physical therapists can provide gait training or help you learn how to use walkers or other assistive devices.
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Manual therapy targets a specific area with hands-on techniques to help ease symptoms and improve mobility.
When used for SI joint pain, these hands-on techniques can include a variety of treatments, such as:
- Massage therapy: muscle relaxation
- Joint mobilization: gentle, controlled, and repetitive movements
- Manipulation therapy: single and quick thrusts
- Vibration therapy: stimulation of muscle endings with mechanical oscillations
Manual therapy techniques are associated with the relief of pain in the SI joint in a 2021 randomized controlled trial of 69 women with SIJD.
Electrotherapy involves different methods of sending electrical energy to stimulate soft tissue in joints affected by limited mobility.
One form of electrotherapy is noninvasive and only requires the placement of electrodes on your body. Its goal is to help block pain signals from reaching your brain.
Peripheral nerve stimulation involves a minimally invasive procedure to implant a device that helps block pain signals from reaching your brain.
Before you start therapy, your doctor must first provide a diagnosis of your back pain.
But providing a diagnosis of sacroiliitis based on symptoms alone may be difficult, as this condition also shares some symptoms with a herniated disk and sciatica.
An X-ray or MRI scan of the affected joint can help your doctor provide an accurate diagnosis of your condition.
Another way is to inject a numbing medication into the SI joint to see whether it helps relieve discomfort. If the injections are effective, then it’s likely that SIJD is the problem.
Injections are both a treatment option and a diagnostic test.
Once you have a definitive diagnosis, you can start to explore your treatment options.
SIJD causes pain in your lower back. Your treatment options depend on the severity and cause of the condition.
Common therapeutic treatments for SIJD include medication therapy, with either OTC pain relievers or higher dose prescription NSAIDs.
Physical therapy, manual therapy, or electrotherapy might also help relieve pain. But you’ll need to speak with your doctor for a diagnosis first to ensure you’ll get the most out of treatment.