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Treatments and drugs

By Mayo Clinic staff

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Illustration showing placement of sacroiliac injection 
Sacroiliac injection

The type of treatment your doctor will recommend depends on the signs and symptoms you're having, as well as the underlying cause of your sacroiliitis.

Medications
Depending on the cause of your pain, your doctor may recommend:

  • Pain relievers. If over-the-counter pain medications don't provide enough relief, your doctor may prescribe stronger versions of these drugs. Occasionally, a short course of narcotics may be prescribed. Narcotics are habit-forming and shouldn't be used for long periods of time.
  • Muscle relaxants. Medications such as cyclobenzaprine (Flexeril, Amrix) may help reduce the muscle spasms often associated with sacroiliitis.
  • TNF inhibitors. Tumor necrosis factor (TNF) inhibitors — such as etanercept (Enbrel), adalimumab (Humira) and infliximab (Remicade) — often help relieve the type of sacroiliitis that's associated with ankylosing spondylitis.

Therapy
Your doctor or physical therapist can help you learn range-of-motion and stretching exercises to maintain joint flexibility, and strengthening exercises to give your muscles additional stability.

Surgical and other procedures
If other methods haven't relieved your pain, you doctor might suggest:

  • Joint injections. Corticosteroids can be injected directly into the joint to reduce inflammation and pain. But you can receive only a few joint injections a year because the steroids can weaken your joint's bones and tendons.
  • Radiofrequency denervation. Radiofrequency energy can damage or destroy the nerve tissue causing your pain.
  • Electrical stimulation. Implanting an electrical stimulator into the sacrum may 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.
References
  1. Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-6/0/1678/0.html. Accessed Nov. 20, 2012.
  2. Vora AJ, et al. Functional anatomy and pathophysiology of axial low back pain: Disc, posterior elements, sacroiliac joint and associated pain generators. Physical Medicine & Rehabilitation Clinics of North America. 2010;21:679.
  3. Anderson BC. Evaluation of the adult with hip pain. http://www.uptodate.com/index. Accessed Nov. 20, 2012.
  4. Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Mosby Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-4/0/1584/0.html. Accessed Nov. 20, 2012.
  5. Bope ET, et al. Conn's Current Therapy. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4377-0986-5..C2009-0-38984-9--TOP&isbn=978-1-4377-0986-5&about=true&uniqId=236797353-5. Accessed Nov. 20, 2012.
  6. Yu DT. Clinical manifestations of ankylosing spondylitis in adults. http://www.uptodate.com/index. Accessed Nov. 20, 2012.
  7. Imboden JB, et al. Current Rheumatology Diagnosis & Treatment. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2007. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=38. Accessed Nov. 21, 2012.
  8. Wu DT. Assessment and treatment of ankylosing spondylitis in adults. http://www.uptodate.com/index. Accessed Nov. 21, 2012.
DS00726 Jan. 9, 2013

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