Sacroiliitis

Treatment depends on symptoms and the cause of the sacroiliitis. Stretching and strengthening exercises and nonsteroidal antiinflammatory pain relievers you can get without a prescription are often the first treatments used.

Medicines

Depending on the cause of the pain, these might include:

• Pain relievers. Nonsteroidal antiinflammatory pain relievers you can get without a prescription include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). If these don’t provide enough relief, a health care provider might prescribe a stronger pain reliever.
• Muscle relaxers. Medicines such as cyclobenzaprine (Amrix) might help reduce the muscle spasms that often go along with sacroiliitis.

• Biologics. Biologic medicines treat many autoimmune conditions. Interleukin-17 (IL-17) inhibitors include secukinumab (Cosentyx) and ixekizumab (Taltz). Tumor necrosis factor (TNF) inhibitors include etanercept (Enbrel), adalimumab (Humira), infliximab (Remicade) and golimumab (Simponi).

  Both types of biologics are used to relieve sacroiliitis.

• Disease-modifying antirheumatic drugs (DMARDs). DMARDs are medicines that decrease swelling, known as inflammation, and pain. Some target and block an enzyme called Janus kinase (JAK). JAK inhibitors include tofacitinib (Xeljanz) and upadacitinib (Rinvoq).

   

Therapy

A health care provider, such as a physical therapist, can teach range-of-motion and stretching exercises. These exercises are designed to ease pain and to keep the low back and hips more flexible. Strengthening exercises help protect the joints and improve posture.

Surgical and other procedures

If other methods haven’t relieved pain, a health care provider might suggest:

• Shots into the joint. Corticosteroids can be put into the joint to reduce swelling and pain. You can get only a few joint injections a year because the steroids can weaken nearby bones and tendons.
• Radiofrequency denervation. Radiofrequency energy can damage or destroy the nerve causing the pain.
• Electrical stimulation. Implanting an electrical stimulator in the lower spine might help reduce pain caused by sacroiliitis.
• Joint fusion. Although surgery is rarely used to treat sacroiliitis, fusing the two bones together with metal hardware can sometimes relieve sacroiliitis pain.