To understand what the sacroiliac joint (SIJ) is, as well as to understand why it is susceptible to arthrosis and other diseases, we will give the minimum necessary explanations on the anatomy and biomechanics of the iliosacral joint.
We will also consider the possibilities for diagnosing and treating diseases in this area.
First of all, it should be understood that what is sometimes briefly called a joint is not such at all - there is no sliding of one surface over another, providing a certain freedom and range of movements.
On the contrary, the function of the paired semi-joints between the sacral bone and the iliac sections of the pelvic bones is to maintain an extremely close distance between them. Leaving, however, some freedom to be separated from each other by an extremely small distance in such a natural physiological situation as childbirth. In no other position is weakening the connection between the spine (represented by the sacrum) and the “funnel ring” of the pelvic bones acceptable.
The fact that these are precisely semi-joints is indicated by the presence of flat, truly articular surfaces on all of these structures, above each of which there is a real articular capsule.
In addition to the very short and extremely tightly stretched joint capsules, the strength of the sacroiliac joint is provided by two rows (one on each side) of powerful sacroiliac ligaments, essentially inextensible, and skeletal muscles, which further strengthen amphiarthrosis.
So, thanks to the almost monolithic nature of these two joints, the inner surface of the sacral “wedge”, which fastens the
The female and male pelvis are different in terms of anatomy
between themselves, the pelvic bones, without any visible transition, become a continuation of their wide, flat internal surfaces.
And the entire structure of the area most closely resembles a ladle - the pelvis seems to be attached to the handle-spine by “welding and soldering” in the sacrum area. It creates a reliable and durable support for the skeleton and at the same time serves as a container for the internal organs, without interfering with their movement relative to each other.
In accordance with the anatomical features, the ileosacral joints (usually both at once) can be susceptible to the same diseases and conditions as full-fledged, real joints:
A pelvic fracture is a dangerous injury with unclear consequences.
Common diseases that affect the sacroiliac joint are:
Symptoms of the most common diseases affecting the sacroiliac joint.
Osteoarthritis is a pathology manifested by degeneration of cartilage tissue, causing a change in the shape of the sacroiliac joints and a decrease in the already limited mobility of the formations. The disease is characterized by pain both in the semi-joints themselves and in the sacrum, becoming more intense with significant load and prolonged stay in the same position (sitting, standing) or from walking. The intensity of pain in a supine position decreases, they do not bother you at night, and in the morning the patient feels rested.
Other manifestations characteristic of joints with a greater degree of mobility, such as clicking and crunching, are not observed in this condition.
Inflammation of the sacroiliac joints, which is otherwise called sacroiliitis, is the development of arthritis of the SIJ with painful manifestations of varying degrees of intensity and with a large arena of their distribution. It includes the entire lower back, the entire sacrum, and the pain radiates not only to the buttocks, but also to the hips and legs.
The intensity of the sensations increases with pressure on the joint area (or both), with lateral abduction or rotation of the hip, when walking, squatting and changing posture, and, conversely, weakens in a position without tension, especially with the legs brought towards the body and bent.
A “duck gait” with waddling walking is very characteristic of sacroiliitis.
Inflammation caused by an infection (specific or vulgar) is, as a rule, unilateral in nature; with a rheumatic or similar nature of the disease, it is bilateral.
In addition to infection, the cause of the disease can be a malfunction of the immune system (autoimmune etiology) or a disordered metabolism. In the first variant, the condition is characterized by “morning stiffness”, the appearance of pain at night and in the early morning, and decreased mobility of the lumbar segment of the spine.
Another very common disease of the sacroiliac joint is its dysfunction, which usually occurs in middle-aged people or during pregnancy. In the second case, the pathology is caused by the hormonal effect on the connective tissue of the semi-joints themselves and their ligamentous apparatus with an increase in the compliance of the ligaments.
Among people of the described age, this dysfunction in various forms accounts for up to 53% of all diseases with pain in the lower back.
The peculiarities of pain manifestations in such cases are varying degrees of intensity and dependency on the time of day - pain is maximum in the first half of the day with a decrease towards the night. Their localization is the sacrum area with possible irradiation to the hip joint or to the thigh or groin.
A less significant proportion in the structure of morbidity is made up of arthritis of infectious etiology and damage due to fractures of the pelvic bones with ruptures of ligaments and joint capsules due to the following factors:
Painful manifestations from injuries are very strong, with an even greater increase in pain both when performing normal movements and when changing posture.
To determine the severity of sacroiliac joint dysfunction, a number of test tests have been developed and used, in addition to the flexion test, including a test for:
The Mennel and Patik tests are also valid.
Among the instrumental methods for diagnosing diseases of the sacroiliac joint, the following methods are used:
The use of these studies makes it possible to identify not only radiological (MRI, CT) signs of rupture of the joint capsule or fracture of the pelvic bones, because they provide a clear picture of deformation of the articular zone or displacement of one half of the pelvis in relation to the other, but also changes specific to a particular type of pathology of the semi-joint .
The infectious process demonstrates an expansion of the joint cavity, a picture of resorption in the form of a slight decrease in the density of the substance of all involved bones near the joint.
With inflammation caused by tuberculosis, MRI shows zones of destruction of adjacent bones with loss of clarity of the contours of the joint, or a picture of complete fusion of the joint space.
Normal condition of the joint on x-ray
Degeneration (in addition to narrowing of the joint space) is characterized by the presence of tissue compactions of the articular surfaces and osteophyte growths.
A study of autoimmune sacroiliitis (in addition to periarticular changes in the form of osteopenia and osteoporosis) reveals varying degrees of sclerosis of the articular cartilage. The position of the joint space depends on the duration of the process: at the beginning of the disease it is widened, at a later stage it is narrowed, or there will be a picture of ankylosis (complete fusion of the surfaces that make up the joint).
The cause and degree of activity of the inflammatory process can be determined by laboratory data:
Leukocytosis and acceleration of ESR in cow tests speak in favor of the infectious nature of the inflammation, and the detection of rheumatoid factor speaks in favor of the rheumatoid nature. Pus obtained by puncture of the joint reveals microbes that cause the pathology; ankylosing spondylitis can be established by identifying HLA-B27.
Diagnostic blockades with the use of anesthetics also contribute to the recognition of inflammation of the sacroiliac joints and its differentiation from similar pathologies.
This is a chronic, long-term disease that progresses in waves into exacerbation.
Arthrosis of the lumbosacral spine develops according to the same laws as the same process in other joints, characterized by the same symptoms: pain, limited freedom of movement, dysfunction of nearby organs.
Exacerbation of the pain syndrome occurs due to episodes of hypothermia or due to overstrain of the structures that form the joint, or the spinal column as a whole. The area affected by pain includes not only the ileosacral joints themselves, but also the entire sacrum; pain is also noted when palpating the lumbar segment of the spine and in the pelvic area.
The area of the iliosacral joints damaged by arthrosis is shown by an arrow on MRI
The intensity of the syndrome increases with increasing physical activity (including fast walking) or when maintaining the same body position for a long time, and, conversely, decreases in a lying position, so forced restriction of freedom of movement helps to improve well-being.
Night pain is uncharacteristic of the disease, as well as crunching and “clicking” sounds typical of arthrosis of other joints.
The chronic course of the disease leads to degeneration of cartilage tissue and an increase in the dysfunction of amphiarthrosis, up to a sharp limitation of the mobility of bones relative to each other, which cannot but affect the patient’s gait and posture.
Diagnosis of sacroiliac osteoarthritis is based on:
For women, it is mandatory to undergo a gynecological examination.
Treatment of arthrosis of the sacroiliac joints includes the use of the entire complex of anti-inflammatory measures and rehabilitation measures, including the use of:
Taking medications, carried out both orally and parenterally, includes the entire arsenal of available drugs from NSAIDs to narcotic analgesics.
For severe pain, drug blockades using Hydrocortisone, Lidocaine, Diprospan, Kenalog are most effective.
In order to reduce the intensity of pain, swelling and inflammation in the joint, as well as to increase muscle tone and expand the range of motion in the spine, physiotherapy techniques are used, including:
In the absence of contraindications, the use of manual therapy and massage, which improve blood supply to tissues and their trophism, helps to restore the structure of cartilage tissue, is a serious aid in healing.
Treatment of osteoarthritis involves performing movements in accordance with their natural biodynamics. Following the prescribed orthopedic regimen during an exacerbation of the disease requires the need to restrain movements with a reasonable limitation of the degree of mobility in the sacroiliac region while simultaneously creating support for the spine.
This is achieved by wearing a special bandage to fix the lumbar region, which allows you to relieve the lumbosacral segment of the back, especially during pregnancy.
The same functions are inherent in a semi-rigid lumbar corset (which allows you to reduce pain, relieve spasms in the muscles of the gluteal area and back), if it is recommended for use by an orthopedist who selects the product individually and stops wearing it after the need for it no longer exists.
During periods of exacerbation of arthrosis, limit the duration of walking and avoid sitting for many hours.
In the absence of measures to treat diseases of the sacroiliac joint, serious harm to health can be caused, which can ultimately lead to a decrease in the degree of mobility of the spine, in severe cases, confining the patient to a wheelchair.
To avoid trouble, it is necessary to maintain an active lifestyle, monitor body weight, prevent the development of chronic infections and timely treatment of acute ones. If problems arise in this area of the skeleton, you must immediately seek help from a specialist doctor (neurologist, therapist, vertebrologist or chiropractor).
Despite the apparent powerlessness of doctors in resolving issues related to the spine, modern treatment methods can effectively help millions of people around the world today.
The sacral vertebrae, numbering 5, fuse in an adult into a single bone - the sacrum. Fusion of the sacral vertebrae occurs relatively late: at the 18-25th year of life. After 15 years, the three lower sacral vertebrae begin to fuse, and by the age of 25, the two upper sacral vertebrae begin to fuse. The sacrum in men is longer, narrower and more curved than in women.
The sacral vertebrae of a newborn child are not fused.
In the case of incomplete fusion of the sacral vertebrae with a congenital malformation of spina bifida, sacralization or lumbarization, splitting of the vertebral arch with the formation of meningocele or meningomyelocele may be detected. The lateral surfaces of the sacrum have auricular-shaped articular surfaces (auricular joints), with the help of which the sacrum articulates with the surfaces of the same name of the iliac bones.
Sacrum, coccyx and sacroiliac joints (joints), rear view.
The sacroiliac joint is a low-moving joint, which doctors often call the sacroiliac joint.
The sacrum in men is longer, narrower and more curved than in women.
Arthrosis of the sacroiliac joint (joint) is a chronic degenerative process in the sacroiliac joint (joint), occurring against the background of its long-term inflammation with impaired mobility in it. Pain in the sacrum (sacrodynia) is of the same aching nature as in patients with sacroiliitis, in the form of constant heaviness and discomfort after exercise (walking, sitting or dancing). It can go away on its own and worsen again with overload or hypothermia.
Anatomy of the sacrum and sacroiliac joint (articulation) in an adult.
Diagnosis of arthrosis of the sacroiliac joint (joint), as well as with sacroiliitis, consists of examining the patient, studying his history (anamnesis) of the disease, assessing biomechanical changes (gait, muscle tone and strength, range of motion in the joints of the lower shoulder girdle) .
Locally, with arthrosis of the sacroiliac joint (joint), pain on palpation on the side of the inflamed sacroiliac joint (joint) is possible.
Gynecological diseases of the pelvic organs in women can result in pain (sacrodynia) in the sacrum.
Blood tests for arthrosis of the sacroiliac joint (joint) may reveal signs of inflammation in the form of an increase in erythrocyte sedimentation rate (ESR). X-ray of the pelvic bones allows us to exclude traumatic injuries and osteomyelitis in the patient.
Computed tomography (CT) of the lumbosacral spine and pelvic bones helps to exclude sacroiliitis of the sacroiliac joint (joint). Also, computed tomography (CT) of the pelvic bones and lumbosacral spine allows one to exclude the oncological nature of the lesion of the pelvic bones or vertebral bodies in the patient.
Computed tomography (CT) of the lumbosacral spine allows the patient to exclude oncological lesions of the pelvic bones or vertebral bodies.
Treatment of arthrosis of the sacroiliac joint (joint), as well as with sacroiliitis, includes, if possible, complete or partial limitation of excessive physical stress on the sacroiliac joint (joint). For unloading in pregnant women, for example, a special bandage can be used, which creates unloading of the lumbosacral region. It is advisable to limit the patient to prolonged sitting or walking.
Drug therapy, as well as for sacroiliitis, is prescribed depending on the severity of a particular symptom in a patient with arthrosis of the sacroiliac joint (joint). These can be non-steroidal anti-inflammatory drugs (NSAIDs) for external and internal use, analgesics, glucocorticoids.
In the treatment of arthrosis of the sacroiliac joint (joint), the elimination of swelling, inflammation, pain, restoration of range of motion of the joint (joint) and lower back muscles is accelerated by the use of physiotherapy.
If the pain symptom (sacrodynia) is severe in a patient with arthrosis of the sacroiliac joint (joint), blockades (with lidocaine, hydrocortisone, diprospan, Kenalog, etc.) can be performed.
Manual therapy is mandatory (if the patient has no other contraindications), which improves regional blood circulation and restores the lost range of motion in the sacroiliac joint (joint) affected by arthrosis.
Additionally, for arthrosis of the sacroiliac joint (joint), physiotherapy is prescribed on the side of the inflammation of the sacroiliac joint (joint). These can be UHF, SMT and infrared irradiation therapy.
Depending on the severity of the manifestations of arthrosis of the sacroiliac joint (joint), the following therapeutic actions are possible for the patient:
Wearing a semi-rigid lumbosacral corset helps limit the range of motion in the sacroiliac joint (joint). This helps reduce pain in the area of inflammation of the sacroiliac joint (joint) and relieve excessive protective tension and spasm of the muscles of the back and gluteal region.
Wearing a lumbosacral bandage helps in the treatment of pain in the sacrum with sacroiliitis and arthrosis of the sacroiliac joint (joint) in pregnant women.
In such a corset, the patient can move independently at home and on the street, sit in the car and at the workplace. There is no need to wear a corset as soon as the pain in the sacrum goes away.
There are several types of lumbosacral semi-rigid corsets and bandages. All of them are selected according to size and can be used repeatedly in case of recurrence of pain in the sacrum.
A variant of a semi-rigid lumbosacral corset that helps in the treatment of pain in the sacrum.
In the human musculoskeletal system, not all joints have a structure that fits the typical idea of a joint. But to fit this concept, the joint does not have to have two moving parts, fastened together by ligaments and a capsule. Therefore, most of the joints of the pelvis are created by nature to be motionless, although, at first glance, it seems to be a monolithic structure. This feature allowed him to withstand the vertical load transmitted from the spine.
At the same time, at the junction of the sacrum and iliac bones on both sides there are fixed joints, securely connected by strong ligaments. The question arises - why are they needed then? And these formations, along with the spine, perform an important shock-absorbing function, softening shocks during movements. Therefore, arthrosis of the sacroiliac joint – a degenerative lesion of articular cartilage – often occurs.
Along with this pathology, a similar lesion of the sacrococcygeal joint should be considered, which is due to their some similarities in terms of manifestations. The first, and often the only symptom of both diseases is characteristic pain in the lower back. Since the causes, and therefore the treatment tactics, differ for them, it is necessary to consider the features inherent in each disease separately.
This joint has virtually no functional significance, connecting the last part of the spine (coccyx) to the sacrum. It is a vestigial part of the skeleton, since in many animals this segment is where the connection to the tail is located. In the process of evolution, man lost this part of the body - only a small joint remained from it.
Despite the anatomical security - the joint is projected in the lower part of the gluteal fold, it is characterized by a very variable structure. Therefore, only its typical version should be considered:
The protected position of the joint does not always save it from damage, which is the only reason for the development of degenerative changes in it.
The basis of the lesion is always trauma - it becomes a triggering factor for the launch of pathological processes. A typical situation is a sharp fall on the buttocks, which leads to a blow to the area of the ischial tuberosities of the pelvis, sacrum and coccyx. Usually soft tissue dampens the impact, but in some cases it still reaches the joint. This triggers the following pathological processes:
Manifestations of the disease are caused by gross deformation, which mechanically irritates the surrounding structures. The most commonly observed symptoms are:
Prevention of arthrosis is timely assistance in case of injury - if after a fall pain is felt in the indicated place, then you should spend several days on full treatment.
The main principle affecting pathological mechanisms is the complex nature of therapy. It involves a combination of medication and physical methods to suppress inflammation. Therefore, it is necessary to adhere to the following scheme:
During treatment, it is necessary to avoid the use of warming ointments - their application in the area of the gluteal groove will lead to severe burning.
This paired joint is located in the lower part of the lower back - its external contours and boundaries can be easily seen in thin people in a standing position. It can rightfully be called the strongest joint of the skeleton, which is due to the special structure of the articular surfaces and ligamentous apparatus:
Arthrosis of the sacroiliac joint can be caused by many factors, which are divided into two large groups - inflammatory and traumatic causes.
Degenerative processes leading to the development of the disease are always based on a chronic inflammatory process. But its occurrence in these joints can be caused by both banal injuries and rather rare systemic diseases. Therefore, their mechanisms should be considered separately:
The clinical picture of the disease is very poor - intermittent pain in the lower back is usually observed, so the diagnosis is confirmed only with the help of x-ray methods.
It is rarely possible to catch the disease at an early stage, and it is even more difficult to slow down its progression. The basis of assistance is the maximum suppression of inflammation with the help of medications, followed by maintaining this condition:
It is quite difficult to stop the onset of arthrosis of the sacroiliac joints - treatment gives only a temporary effect. But its regular implementation allows you to slow down the course of the disease, preventing it from progressing.
Deforming arthrosis of the sacroiliac joint, called spondyloarthrosis, is a dystrophic-degenerative lesion of a chronic nature, affecting a tight joint formed by the contacting surfaces of the large ilium and the sacrum. Since at the junction there is a zone of innervation of the branches of the lumbar and sacral plexuses of nerves, arthrosis in the sacroiliac region is manifested by severe pain - sacralgia, often radiating to the coccygeal region. In most cases, the pathomorphological process in the iliosacral joints (the junction of the pelvic and sacral bones) is accompanied by inflammatory reactions or is a consequence of the prolonged presence of a focus of infection.
The sacroiliac joint is a tight, semi-movable, ear-shaped “hinge” with a strong, non-stretchable system of short and wide ligaments. Through these paired joints, located on the sides of the sacral vertebrae, the pelvic bones are connected to the spine.
The sacral region, which includes five vertebrae, S1–S5, follows second to the lower element of the spinal column, the coccygeal area Co1–Co5. At birth, a person's sacral vertebrae are not connected to each other. The process of their alternate fusion begins at the age of fifteen and by the age of 25 the five elements are connected into a single bone of the spinal column.
For information! In a small group of people, natural fusion of the elements of the spine does not occur due to congenital anatomical defects. Lumbarization may be observed - an anomaly in which the first vertebra of the sacral zone is separated from the coccyx or sacralization - a pathology manifested in the fusion of the L5-S1 vertebrae.
In the initial phase of spondyloarthrosis, weakening of blood circulation and deterioration of trophism in the joint area are observed. As a result, the cartilage tissue changes its structure: it loses its elasticity, becomes brittle and thins. Chronic lack of nutrition and regular overload of intervertebral joints lead to degenerative degeneration of cartilage and the formation of bone growths - osteophytes.
Pain syndrome with arthrosis of the sacroiliac joint can be chronic in the form of aching and pulling sensations, a feeling of heaviness and discomfort in the lower spine. Sacrodynia intensifies after prolonged walking, intense running, lifting or carrying heavy objects, or being in a sitting position.
Sacralgia can also occur suddenly, manifesting itself as piercing pain when trying to bend or straighten your back. As a rule, the acute manifestation of pain in arthrosis is preceded by: hypothermia of the body, previous viral infectious diseases, mechanical injuries of the spine.
At the initial stage of spondyloarthrosis, pain goes away on its own after a short rest, but in subsequent phases it is not possible to eliminate pain without the use of analgesics.
With the development of pathology, in addition to increased sacralgia, other unpleasant symptoms are noted, including an increased urge to urinate and decreased potency. Stiffness in the hip joints and a decrease in the range of motion of these joints may be observed, which is visually manifested in a change in a person’s gait. Upon palpation, an increase in the tone of the skeletal muscles in the sacral region is recorded.
To determine the diagnosis and differentiate from other pathologies, they resort to the following:
Attention! Female patients are recommended to consult a gynecologist to exclude genitourinary diseases. If malignant formations in bone structures are suspected, an additional examination by an oncologist is necessary.
The program of therapeutic measures is selected personally for each patient after assessing the clinical characteristics and stage of the disease.
At the first stage, the goal of treatment is to relieve pain. In case of a sharp exacerbation of the disease, the patient is advised to take measures to relieve the damaged joint from the load. At the peak of pain development, it is advisable to use a drug blockade. Its principle is based on local injection into the periarticular tissues of powerful anesthetics and analgesics, which contain Novocaine or Lidocaine. Their action is aimed at blocking voltage-gated sodium channels, thereby destroying the impulse transmission of irritation of sensitive endings along nerve fibers.
Also, therapeutic blockade of the spine reduces muscle tension, eliminates vascular spasm, and eliminates swelling at the site of inflammation. Today, periarticular blockades with hydrocortisone (Hydrocortisonum) are also used in cases where, along with the degenerative process, inflammation of cartilaginous tissue is noted.
For less severe pain, the patient is prescribed oral or parenteral administration of non-steroidal anti-inflammatory drugs. A good answer is shown by a course of intramuscular injections of Dicloberl. Sacrodynia can be eliminated with the help of medications with the active ingredient ketorolacatromethamine, for example: Ketorol.
Attention! NSAIDs have a number of significant side effects, so their use is permissible only for a short period of time.
To activate the process of regeneration of cartilage tissue and improve joint trophism, chondoprotective drugs of a complex composition or containing individual components are used: chondroitinsulfuric acid, glucosamine and others. A rapid effect of treatment occurs when intra-articular administration of chondrolone (Chondrolonum) is performed. It is possible to restore the viscosity of synovial fluid in a damaged joint after using a biopolymer with silver ions TM “Noltrex”.
Today, the positive properties of hyaluronic acid, which can improve joint mobility when administered intra-articularly, are actively used in the treatment of arthrosis. Among the drugs recommended by traumatologists is Hyalubrix, however, due to its rather high cost, it is not available to many citizens.
Oral use of tablet forms of chondoprotectors is possible, for example: Structum, but the result of such therapy is noted after three months after administration.
For information! Chondroxide ointment is a fairly high-quality and affordable product, however, according to traumatologists, local preparations are better used for preventive purposes, and not for exacerbation of pathology.
Physiotherapy techniques have a beneficial effect on arthrosis of the sacroiliac joint. With their help, you can relieve pain, improve muscle tone, reduce swelling, and eliminate the inflammatory process. Common physiotherapeutic methods include:
One of the effective methods of alternative medicine for getting rid of spondyloarthrosis in the absence of severe pain is manual therapy and related methods:
The purpose of this event is to limit mobility in the lumbosacral area. To minimize the load on the lumbar region, doctors recommend using special bandages and corsets.
Also, the orthopedic regime implies a decrease in physical activity and a decrease in loads on the musculoskeletal system. If the symptoms of the disease intensify, you should reduce the duration of walking, stop jogging and cycling, and avoid prolonged standing and sitting. Also, you should not perform strength exercises: do not lift or carry heavy objects. Doctors prohibit active flexion and extension at the stage of exacerbation of spondyloarthrosis, and do not sharply change the angle of the torso.
Daily gymnastics exercises are an excellent preventive measure. Physical therapy includes a variety of movements that involve the muscles of the lower back. This can be turning the torso to the right and left, rotating the torso clockwise and counterclockwise, bending forward, backward and to the sides. All movements should be performed at a slow pace, but with a large number of repetitions, listening to your own sensations.
A balanced diet, excluding or limiting to a minimum foods that are “harmful” to the musculoskeletal system, helps normalize metabolic processes and provides cartilage structures with the necessary “building blocks.”
For arthrosis of the sacroiliac joint, the following should be included in the menu:
Prohibited products include:
Experts also recommend limiting the amount of table salt and not getting carried away with fruit vegetables of the nightshade family: tomatoes, eggplants, sweet and bitter peppers.
To restore the structure of cartilage tissue, healers recommend applying compresses to the lumbosacral area every day. The following formulations are used in treatment:
Horseradish rhizomes and black radish ground in a meat grinder, combined with honey of a liquid consistency.
Powdered eggshells mixed with thick kefir or sour cream.
White cabbage leaves twisted into a pulp with the addition of vegetable oil.
In parallel with external application of compresses in the treatment of arthrosis, herbalists advise taking long-term courses of decoctions from birch and lingonberry leaves, willow and oak bark, hop cones, cinquefoil, nettle, calendula, chamomile, St. John's wort, clover, and dandelions.
Arthrosis of the sacrococcygeal joint is a disease characterized by the gradual destruction of cartilage tissue. If left untreated, the pathological process involves capsules, synovial membranes, ligamentous-tendon apparatus, and then bones. The most common causes of arthrosis are injuries and degenerative diseases of the joints. Its leading symptoms are intense pain, morning swelling and stiffness of movement.
The progression of pathology can lead to the development of serious complications, such as ankylosis and contractures. The diagnosis is made based on the clinical picture, anamnesis, results of radiography, CT, MRI, arthroscopy. In the treatment of arthrosis of the sacrococcygeal joint, conservative treatment methods are used - a course of medications, physiotherapy, therapeutic exercises and physical education.
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In the human musculoskeletal system, most of the joints have the same structure. They are formed by the surfaces of two bones, ligaments, tendons, and synovial bursae that produce a thick fluid. But there are many joints in the body that do not have moving parts.
The sacrococcygeal joint connects the terminal part of the spinal column to the sacrum and does not perform any important functions. This is a vestigial part of the skeleton that has lost its significance (in animals it serves as the attachment point for the tail). The special structure of the articular joint allows a person to withstand vertical static and dynamic loads. In the area where the iliac bones and the sacrum connect, there are fixed sacroiliac joints, which are securely held together by strong ligaments. They have an important functional significance - they soften shocks during human movement.
The sacrococcygeal joint appears to be an anatomically protected structure, but its structure is highly variable. Therefore, under strong external influences, pathological processes can be triggered, provoking:
The sacroiliac joints, located in the lower part of the lower back, are much more vulnerable despite the strength of their ligamentous-tendon apparatus. Therefore, numerous external and internal factors can serve as an impetus for the development of arthrosis.
Some people are diagnosed with a congenital anatomical defect - the elements of the spinal column are not completely fused. The condition when the first vertebra of the sacral region is separated from the coccyx is called lumbarization.
Arthrosis develops several years after injury, usually from a sharp fall on the buttocks. A blow occurs that damages the ischial tuberosities of the pelvis, coccyx and sacrum. Connective tissues soften it to some extent, but in case of strong falls their shock-absorbing effect is not enough. The mechanism of development of degenerative-dystrophic damage is multi-stage:
The pathology extends to ligaments, synovial bursa, and cartilaginous tissue. Scars form, disrupting the functioning of the joint. To stabilize the condition of the spinal column, bone tissue begins to grow in it, forming osteophytes.
The chronic inflammatory process that occurs in the sacroiliac joints, in most cases, causes their destruction. Its development can be provoked by both banal injuries and severe articular pathologies of a recurrent nature. They usually refer to systemic diseases that affect all joints of the musculoskeletal system. Common causes of arthritis:
Premature destruction of the sacroiliac joints can develop in people suffering from metabolic disorders. Joint pain often occurs with diabetes or decreased functional activity of the thyroid gland.
Post-traumatic arthrosis is often detected in this area of the spine. Destruction of cartilage tissue occurs as a result of scar formation after injury to the joint or surgery.
Even “advanced” ARTHROSIS can be cured at home! Just remember to apply this once a day.
The leading clinical sign of arthrosis of the sacroiliac and sacrococcygeal joints is pain, which intensifies with movement or prolonged sitting or lying down. But mild discomfort constantly haunts a person. He experiences discomfort, a feeling of heaviness and compression in the pelvic area. At the initial stage of arthrosis, pain is short-term and occurs after intense physical activity. As ligaments and tendons become involved in the pathological process, the severity of clinical manifestations increases:
Arthrosis is always accompanied by stiffness of movement. The cause of the clinical manifestation is muscle spasms. The sacral region of the spine is innervated by the nerves of the lumbosacral plexus. When they become inflamed or damaged, pain occurs, radiating to the calves, legs, and lower abdomen.
At the last stage of arthrosis, difficulties with defecation may occur, and the urge to empty the bladder may become more frequent. Erectile dysfunction is often one of the complications of the pathology.
An integrated approach to the treatment of arthrosis of the sacroiliac joints is practiced. When diagnosing, the cause of its occurrence is revealed. If the destruction of the joint is provoked by another disease, then its therapy is carried out at the same time. Throughout the treatment, the patient is advised to wear bandages that provide rigid or semi-rigid fixation of the lumbosacral spine. This will not only speed up the recovery of damaged joints, but also prevent their further destruction.
If a patient comes to see a doctor with acute pain, the following methods are used to eliminate it:
Arthrosis of the sacroiliac joint is often a harbinger of such a formidable disease as ankylosing spondylitis. It affects not only older people whose joints are subject to natural wear and tear, but also young people who lead an active lifestyle.
The cartilage tissue of the joints cannot withstand constant load and is destroyed under its influence. Treatment in this case is preventative.
In other words, arthrosis is diagnosed in cases where the cartilage of the joint is destroyed and the vertebrae rub against each other without the “lubrication” that cartilage represents. When you constantly bend your back, such as during handling or lifting heavy objects, the sacral bones of the spine in the lower back are constantly under pressure.
In this case, the cartilage is subjected to mechanical friction and begins to wear out.
Treatment is impossible, so you need to carefully monitor the condition of your back while lifting weights and lift them correctly, focusing on the leg muscles.
Symptoms do not appear visually. Arthrosis of the sacroiliac joints can be determined only by X-ray examination or by visiting a doctor in case of troubling pain or external changes, which are expressed in curvature of posture, gait, decreased tone of the back muscles, and spinal mobility.
An experienced physician will detect symptoms by palpating the lower spine. In the area of inflammation of the sacroiliac joints, pain of varying degrees of intensity will be felt.
Treatment should be carried out under the supervision of a physician.
You can examine the condition of your spine and determine if there is a problem in the sacrolumbar and sacroiliac joints using a simple procedure.
Do the following:
First of all, you need to do a blood test. With inflammation of the sacroiliac joints, an increase in ESR levels will be detected. X-rays will show the condition of the bones and cartilage.
If this is not enough, the doctor will prescribe additional studies using computed tomography and send you to an appointment with a gynecologist and oncologist if it is necessary to exclude female and oncological diseases. After the examination, the doctor will prescribe treatment.
The main causes of arthrosis and diseases of the sacroiliac joints in the back are:
In fact, there are many more reasons for the occurrence of arthrosis of the sacroiliac joints. That is why it is necessary to carefully examine painful areas to avoid complications.
Arthrosis of any joint cannot be completely cured. You can use certain medications, herbal infusions, and massage to alleviate the course of the disease and relieve symptoms.
Treatment includes the following medical procedures:
Since treatment of arthrosis is almost impossible, certain measures must be taken to avoid sacroiliac joint diseases. Preventing a disease is always easier than curing it. You just need to pay attention to the symptoms and take precautions.
Follow these guidelines to keep your back healthy:
Arthrosis is a serious disease that cannot be cured. Therefore, follow all preventive measures to prevent the wear of cartilage on the joints of the spine. This way you will maintain ideal posture and prolong your youth.