Sacroiliitis is an inflammation of one or both of the sacroiliac joints, which connect your lower spine and pelvis. With sacroiliitis, even the slightest movements of your spine can be extremely uncomfortable or even painful for you.

Sacroiliitis can be difficult to diagnose, and it may be mistaken for other causes of low back pain, including sciatica, herniated disks and strained muscles. Sacroiliitis may be associated with a group of diseases called spondyloarthropathies, which cause inflammatory arthritis of the spine.

Treatment for sacroiliitis may involve a combination of you resting, receiving physical therapy and taking medications.

Sacroiliitis symptoms may include:

• Pain and stiffness in your lower back, thighs or buttocks
• Pain that worsens with walking because the motion of your hips strains your sacroiliac joints
• Inflammation in one or both of your eyes (uveitis or iritis)
• Psoriasis, an inflammatory skin condition
• Pain radiating down your leg
• Limping
• Decreased range of motion
• A fever that appears quickly
• Typically pain in the hips, low back, thighs and buttocks are presenting symptoms. Pain is typically worse with sitting.

Pain relievers are often prescribed to treat sacroiliitis. However, many patients do not get satisfactory relief with medications.

When medication alone is not working a diagnostic sacroiliac joint injection may be performed to confirm the diagnosis. The diagnosis is confirmed if the pain goes away for a few hours.

Patients who respond well to the diagnostic block may be candidates for a radiofrequency ablation/rhizotomy of their sacroiliac joint(s).

Facet joints are found in the posterior of the spine. There are 24 vertebrae which form the human spine. There are two facet joints between the vertebrae of each spinal segment along the spinal column.

The facet joints and disc space form a three joint complex near each vertebrae. A facet joint has two bony surfaces with cartilage between them and a capsule of ligaments surrounding it. Synovial fluid lubricates the joints as is the case with any joint.

Simply put, facet arthropathy is degenerative arthritis affecting the facet joints in the spine. In the area of the spine where there are facet joints, arthritis pain can develop.

Arthritis in the facet joints can develop from:

• wear and tear (decreases space between vertebrae causing facet joints to rub together)
• previous back injury
• fractures
• torn ligaments
• disc problems

Due to the additional stress caused by these circumstances on the facet joints, bone spurs can develop and cartilage can deteriorate.

Pain is the main symptom associated with facet arthopathy. The pain is typically worse following sleep or rest. Pain associated with facet arthropathy may be exacerbated by twisting or bending backwards. Low back pain is the most frequent complaint but it does not typically radiate down the legs or buttocks, unless spinal stenosis also is involved.

X-rays, CAT scans, and Magnetic Resonance Imaging (MRI) may be used to help diagnose facet arthropathy. Another procedure which is more specific involves performing a guided injection using a fluroscope. Medicine and dye are injected. The dye allows the doctor to view the placement of the needle and injection. If the facet joint is injected and pain relief is the result, that serves to confirm the diagnosis of facet arthropathy.

Initially the doctor may recommend a period of rest in an effort to tame the symptoms. Sleep positions which take pressure off facet joints may be recommeded (i.e. curl up to sleep or lay on back with knees up and pillow underneath).

Some oral medication may be prescribed including:

• Tylenol
• nonsteroidal anti-inflammatory drugs (NSAIDs)
• muscle relaxants
• corticosteroids

Other treatment options include:

• strengthening and aerobic exercise
• water therapy
• spinal manipulation

If conservative measures fail:

• injections of an anesthetic or steroid medicine into the facet joint or nerves that go to the facet joint may be tried
• Facet rhizotomy/ablation which destroys nerves with heat energy may be an option
• surgery is rarely required for facet arthropathy but options do exist

Surgical options to treat facet arthropathy include:

• Fusion – fuse two or more vertebrae to eliminate movement in facet joints (sometimes facet joints are removed during spinal fusion)

Radiculopathy refers to a condition in which the spinal nerve roots are irritated or compressed. Many people refer to it as having a “pinched nerve.”

Lumbar nerve impingement indicates that the nerve roots in the lower spine are involved, while cervical radiculopathy is associated with nerve roots in the neck. Nerve impingement is most often caused by a herniated disc or spinal stenosis.

The spinal vertebrae are separated by flexible discs of shock absorbing cartilage. These discs are made of a supple outer layer with a soft jelly-like core (nucleus). If a disc is compressed, so that part of it intrudes into the spinal canal but the outer layer has not been ruptured, it may be referred to as a “bulging” disc. This condition may or may not be painful and is extremely common.

Herniated discs are often referred to as “slipped” or “ruptured” discs. When a disc herniates, the tissue located in the center (nucleus) of the disc is forced outward. Although the disc does not actually “slip,” strong pressure on the disc may force a fragment of the nucleus to rupture the outer layer of the disc.

If the disc fragment does not interfere with the spinal nerves, the injury is usually not painful. If the disc fragment moves into the spinal canal and presses against one or more of the spinal nerves, it can cause nerve impingement and pain.

If the injured disc is in the low back, it may produce pain, numbness, or weakness in the lower back, leg, or foot. If the injured disc is in the neck, it may produce pain, numbness, or weakness in the shoulder, arm, or hand.