Sacroiliitis is simply the inflammation of the sacroiliac joint (SI joint). As far as diagnoses goes, it isn’t a very helpful one. What I mean by this is that sacroiliitis can be caused by a multitude of pathologies and thus a diagnosis of sacroiliitis tells us nothing about the prognosis (or how well you will heal). The most common cause of sacroiliitis that I see in my clinic is from repetitive microtrauma. Repetitive microtrauma is responsible for many conditions, probably the most famous one being carpal tunnel from typing. Other notable microtrauma injuries are tennis elbow, shin splints, and plantar fasciitis. The most common microtraumas that I see causing sacroiliitis are leg crossing, wearing a wallet in your back pocket while sitting, and driving. There are of course other microtraumas that cause sacroiliitis, but I think the before mentioned account for 60% of what I see at my clinic.
When sacroiliitis is caused by trauma (microtrauma or acute trauma) it has the best prognosis, meaning it is the easiest to fix. Chiropractors address sacroiliitis by adjusting the sacroiliac joint and balancing the muscles that attach to the joint with muscle work and exercise. Luckily sacroiliitis caused by trauma is the most common kind of sacroiliitis I see in the general population. Other causes of sacroiliitis include autoimmune disorders and infection. Infection is the scariest form of sacroiliitis and should be addressed immediately with antibiotics. Autoimmune related sacroiliitis is managed more than it is fixed. Examples of sacroiliitis that is linked to autoimmune diseases are ankylosing spondylitis and Crohn’s disease. The medical community is making great strides on autoimmune diseases but there is no cure for sacroiliitis caused by an autoimmune disorder as of yet.
Chiropractors will often use the term sacroiliac joint dysfunction interchangeably with what the medical community considers sacroiliitis. For chiropractors there is a distinction, we only call it sacroiliitis if it is related to an autoimmune disease or an infection. Basically, we call it SI joint disfunction if we can treat it and sacroiliitis is when we can only manage it or it is beyond our scope of practice.
Sacroiliitis that is cause by trauma responds well to manual manipulation (chiropractic adjustments) but also responds well to physiotherapy, topical medication, oral medication, and activity modification.1 95% of patients respond to manipulative treatments and show excellent short-term results.1
- Baronio, M., Sadia, H., Paolacci S., et la, 2020 Etiopathogenesis of sacroiliitis: implications for assessment and management, Korean J Pain 2020; 33(4): 294-304