Arthrosis of the sacroiliac joint (joint). Diagnosis and treatment of arthrosis of the sacroiliac joint Osteoarthritis of the sacroiliac joint stem cell treatment

Sacrum and sacroiliac joint (joint)

The sacral vertebrae, number 5, grow together in an adult into a single bone - the sacrum. Fusion of the sacral vertebrae occurs relatively late: at the age of 18-25. After 15 years, the fusion of the three lower vertebrae begins, and by the age of 25 - the two upper sacral vertebrae. The sacrum in men is longer, narrower and more curved than in women.

The sacral vertebrae in a newborn baby are not fused.

In the case of incomplete fusion of the sacral vertebrae with congenital anomaly development - spina bifida, sacralization or lumbarization, splitting of the vertebral arch with the formation of meningocele or meningomyelocele can be detected. The lateral surfaces of the sacrum have ear-shaped articular surfaces (ear-shaped joints), with the help of which the sacrum is articulated with the surfaces of the iliac bones of the same name.

Sacrum, coccyx and sacroiliac joints (articulations), rear view.

The sacroiliac joint is a sedentary joint that is often called the sacroiliac joint by doctors.

The sacrum in men is longer, narrower and more curved than in women.

In case of severity of pain symptom (sacrodynia) in a patient with arthrosis of the sacroiliac joint (joint), blockages (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, with arthrosis of the sacroiliac joint (joint), physiotherapy is prescribed on the side of the inflammation of the sacroiliac joint (joint). This can be UHF, CMT and infrared radiation therapy.

Depending on the severity of the manifestations of arthrosis of the sacroiliac joint (joint) in the patient, the following therapeutic actions are possible:

• drug therapy (NSAIDs, analgesics, hormones)
• blockade - injection of drugs into the sacroiliac joint (joint), spinal canal, trigger points in the muscles

The sacroiliac joint is a joint formed by the surfaces of the sacral spine and the ilium. Thus, this formation connects the axial skeleton, that is, the spinal column, with the pelvic bones. He takes all the load necessary for the free movement of our body in space. The structure of the joint is so strengthened by the wide articular surfaces, capsule and ligaments that such a structure is very strong and at the same time inactive.

Osteoarthritis of the sacroiliac joint is one of the causes of pain in the lower back caused by a chronic process in this joint. The pain brings discomfort, interferes with walking, and complicates the usual way of life. The disease is chronic in nature, so the symptoms bother only for a while, after which they subside and after a while reappear.

Causes of arthrosis of the sacroiliac joint

Sacroiliitis is not considered to be a disease, but only a symptom of degenerative-dystrophic disease. Therefore, it is very difficult to determine how often this disease occurs. The structure of the joint is so "thought out by nature" that it is quite difficult for inflammatory processes to develop here. There must be good reasons for this, such as:

• ankylosing spondylitis;
• congenital malformations of the pelvis;
• tumor processes;
• specific inflammatory processes (tuberculosis, brucellosis, syphilis);
• pelvic bone injury;
• long-term heavy loads leading to osteoarthritis;
• autoimmune diseases.

Sacroiliitis symptoms

There are many causes of joint arthritis, so the symptoms will vary too. For example, with injuries, sacroiliitis is more often purulent. The onset of the disease is acute: body temperature rises, sharp back pains appear. These sensations force a person to take a forced posture: he bends his knees and hip joints... This type is dangerous because pus can spread to other parts of the body: damage to the coccygeal region, muscles of the buttocks, and the spinal canal.

In tuberculosis, sacroiliitis develops quite rarely and is not so difficult. The ilio-sacral joint is affected if the focus is tuberculosis of the sacrococcygeal region or in the articular surfaces of the ilium itself. Pain sensations are not strictly localized. Stiffness of movements is observed, which will immediately be noticeable with a gentle gait. The infection spreads to nearby tissues and causes sagging abscesses in the hips.

Arthrosis can also be a consequence of rheumatic diseases. There is pain of an unexpressed nature, radiating to the thigh and buttocks. They decrease with physical exertion and increase at rest. Also, patients may complain of morning stiffness.

Previous injuries of the spine or pelvis, hard physical labor, osteoarthritis, severe postural disorders can provoke non-infectious sacroiliitis. Patients will complain of spontaneous, paroxysmal pain, aggravated by movement. This can cause discomfort when walking and the formation of a "duck" gait - movements that resemble body rocking.

Diagnostics

Since arthritis of the sacroiliac joint is not a disease, but a symptom, the cause itself must be diagnosed. To do this, you need to get blood tests to find out if there is inflammation in the body. To determine the autoimmune nature of the joint disease, you need to take a blood test for rheumatoid factor and specific antibodies.

Of course, you need to make sure that the pain is caused by sacroiliitis. For this, one of the methods of visual diagnostics is prescribed: X-ray, magnetic resonance imaging, or computed tomography... Images will indicate osteoarthritis, joint space narrowing, or joint deformity.

These methods allow you to find out the exact cause of the symptoms, and they can only be prescribed for you by a qualified doctor. Therefore, it is better not to engage in self-diagnosis.

Treatment

As mentioned above, the underlying disease needs treatment, be it osteoarthritis, spondylitis or tuberculosis. The only disease that requires mandatory surgical treatment - purulent sacroiliitis, other types are amenable to drug treatment and physiotherapy.

Medical treatment begins with the use of non-steroidal anti-inflammatory drugs. They relieve stiffness, ease pain and relieve inflammation.

If arthrosis of the sacral iliac joints was caused by a specific pathogen, then in this case it is necessary to prescribe antibacterial agents... Antibiotics are usually prescribed wide range actions, and when a specific pathogen is identified, the appropriate treatment will be selected. Antibacterial therapy it is also prescribed for pelvic injuries in order to prevent the development of purulent complications.

To drug treatment was more effective and for the speedy recovery of tissues, physiotherapy procedures are prescribed.

Spine laser therapy enhances metabolism, which contributes to rapid tissue regeneration. It is recommended to apply for about 3-4 weeks.

Infrared radiation of the spine is also excellent for the restoration. The procedure has a warming, anti-inflammatory, regenerating effect. Especially useful for osteoarthritis.

Manual therapy helps relieve pain, increases blood flow. If scoliosis is the cause of the symptoms, then manual therapy can help correct it.

Additional methods of treatment include magnetotherapy, acupuncture, remedial gymnastics, electrical stimulation, massage. The main thing is that everything is matched a qualified specialist, and the patient is required to comply with all prescriptions. Then you can recover as soon as possible and without complications.

Osteoarthritis of the sacroiliac joints is a disease of inflammatory pathogenesis, associated with degenerative-dystrophic changes affecting the cartilage tissues of the joints of the lower part of the spinal column, occurring against the background of painful sensations and impaired mobility. A prolonged course of the disease against the background of the lack of adequate therapy can lead to a decrease in working capacity, and in the most severe cases - to disability and loss of the ability to move freely.

Osteoarthritis of the sacroiliac joints is a sluggish chronic illnessdifficult to give in modern methods treatment.

Conservative therapy aimed at restoring cartilage tissue and joint functioning is based on an integrated approach. The effectiveness of treatment depends on the timeliness and correctness of its application.

General information

In order to understand what arthrosis of the sacrococcygeal joint is, what are the main symptoms of this disease, it is necessary to know the anatomical location of the joint and functional tasks.

Anatomical features

The sacroiliac joint, or SIJ, is a kind of bridge that connects the bones of the pelvis, which has the ability to change with age. It is located in the lower parts of the spinal column, and is located between the sacrum and pelvic bones, representing a paired articular ligament.

A joint consisting of cartilage tissue, synovium, feeding arteries leading to lower limbs, has little mobility. Pathological changes occurring against the background of inflammatory and degenerative-dystrophic processes lead to thinning, hardening of cartilaginous tissues, as well as dysfunction.

Functional tasks

Osteoarthritis of the ilio-sacral joints is a disease that does not have a direct negative effect on motor activity. Nevertheless, the development of this pathology significantly reduces the physical capabilities of the patient, which is due to the specificity of the functional tasks of the joint. Such as:

• ensuring a tight connection of individual elements of the bone skeleton;
• stabilizes position in space when performing certain movements, as well as when a person is in sitting position;
• helps to distribute the load that occurs during walking.

Thus, the indirect functions of the element perform an important task, providing full-fledged motor activity. Arthrosis of the sacroiliac joints or sacrum leads to pathological changes in the tissues of the joint, preventing the full functioning of the body.

The manifestation of the disease

In the early stages of development, osteoarthritis of the sacroiliac joints occurs against a background of mild clinical picture, which somewhat complicates the possibility of timely diagnosis and the adoption of appropriate therapeutic measures. It is important to recognize early signs that may indicate pathological changes affecting the cartilaginous joints.

Symptoms and course

Degenerative-dystrophic changes occurring in the area of \u200b\u200binflammation lead to a decrease in physical activity, the manifestation of a characteristic clinical picture. Symptoms of arthrosis of the sacroiliac joints can manifest as follows:

• with a long stay in an uncomfortable position, the appearance of blunt aching pains in the area of \u200b\u200bthe lower spine;
• acute cutting pain in the lower back, manifested mainly against the background of significant physical exertion;
• the appearance of discomfort when making certain movements of the body, for example, when bending;
• pronounced tissue edema, seizing the back in its lower parts.

Signs of arthrosis of the coccygeal joint can be expressed in gait disorders. The patient's movements become less measured, the gait is more wobbly, uneven.

Causes of occurrence

According to practicing doctors, osteoiliac arthrosis is considered to be female disease, which is due to the specifics of the anatomical structure female body, as well as the illness of old age. There are a lot of factors that predispose to the development of pathology, for example:

The exclusion or limitation of the negative influence of the factors listed above will significantly reduce the risk of developing inflammatory processes. For example, at later stages of gestation, women are advised to wear special bandages that significantly reduce the colossal loads experienced by the spine and contribute to their even distribution.

Ignoring this rule can lead to the development of inflammatory processes affecting the tissues of the joint.

Video

Sacroiliac joint warm-up

Diagnostic methods

Diagnostic procedures for sacroiliac joint inflammation include overall assessment the patient's condition, existing physiological changes, the study of anamnesis, test results. Predominantly inflammatory processes are detected by general analysis blood, radiography.

Also, the method of palpation of painful areas is often practiced, which makes it possible to identify the area of \u200b\u200blocalization of pathological processes. To exclude more serious diseases, for example, oncological lesions, the method of computed tomography is used.

Treatment methods

The methods of therapy aimed at treating arthrosis of the sacroiliac joints are selected taking into account the individual physiological characteristics of the patient, the general clinical picture, the factors that most likely contributed to the onset of the disease. Mainly used a complex approach, including drug therapy, physiotherapy methods, as well as correction of the patient's usual behavior pattern.

Drug therapy

The main method of treating arthrosis is conservative therapy based on taking medications that help eliminate inflammation and restore the cartilage tissue of the joints. The treatment regimen used most often for a disease such as coccyx arthrosis includes the following groups of medicines:

• analgesics or pain relievers. Effectively relieve pain syndrome, have a calming effect. In this case, analgesic drugs can be presented in the form of tablets, ointments made on the basis of substances of natural origin, for example, bee or snake venom.
• Chondroprotectors. Strengthen and restore the natural functioning of cartilage tissue.
• Hormonal or non-steroidal drugs that have anti-inflammatory properties.

Besides medications effective treatment arthrosis involves taking biologically active additives, contributing to the saturation of the body with important vitamins, microelements. The use of drugs of this group helps to speed up the process of tissue repair, to strengthen the result obtained in the course of therapeutic treatment.

Physiotherapy

In the sphere modern medicine effective treatment of osteoarthritis of the sacroiliac joints includes the mandatory use of physiotherapy procedures. Similar methods therapies provide curative action directly to the area of \u200b\u200blocalization of inflammatory processes, contributing to their rapid elimination, pain relief and restoration of cartilage tissue. The following types of physiotherapy are most commonly used:

Physiotherapy methods help not only to eliminate pathological processes in the sacroiliac joints, but also to restore mobility and physical activity. For warning possible complications ailment, stopping its further development, doctors also recommend that patients constantly wear supporting corsets and bandages, which help eliminate discomfort and relieve inflammation.

Physiotherapy

Moderate physical activity with arthrosis of the sacroiliac joints - effective method relieving painful sensations, restoring the functioning of the affected joints and general motor activity. It is possible to perform elements of medical gymnastics both in a hospital setting and while undergoing home treatment. It is recommended to choose the exercises most suitable for performing in a particular clinical case with arthrosis of the sacroiliac joints in accordance with the recommendations of the attending physician.

Manual therapy

Manual therapy or a kind of therapeutic massage is the provision of a direct action of a specialist's hands on the area of \u200b\u200blocalization of painful sensations. This method is an important element of the overall medical complex, aimed at eliminating the consequences of arthrosis of the sacroiliac joints.

Already after the first session, patients feel a significant relief, increased physical activity.

However, during the procedure, severe painful sensations may appear at the time of the specialist's influence on the inflamed areas. Manual therapy is especially effective in the early stages of the development of the disease.

Folk remedies

Unfortunately, it is almost impossible to restore cartilage tissue, mobility, eliminate pain and inflammation by using alternative medicine. However, the involvement of such methods in the general therapeutic complex will help speed up the healing process, get positive results in the shortest possible time.

As effective folk ways, with which you can treat coccyx arthrosis, can be called:

Despite the fact that the funds traditional medicine are completely natural and relatively safe; in exceptional cases, their use can aggravate the patient's condition. It is recommended to use home remedies only after consultation with your doctor.

Preventive measures

It is much easier to prevent any disease than to deal with its consequences. Preventive measures, aimed at preventing the development of arthrosis of the sacrococcygeal joint, include compliance with a number of specific rules.

First of all, lifting weights and exhausting physical activity should be excluded. Leading a sedentary lifestyle is no less harmful. Moderate physical activity will help reduce the likelihood of developing inflammation. In addition, you should pay attention to the diet. One of the reasons for the development of pathology is the lack of vitamins and minerals necessary for the body.

A common factor leading to the development of arthrosis of the sacroiliac joints is pregnancy, when the load on the spine increases significantly. Effective prophylactic measures during gestation include wearing a support band, controlling body weight, and taking vitamin complexes. Finally, it is especially important to identify the disease at an early stage of development.

With age, constant overload and unhealthy diet, diseases can develop that interfere with a quiet life. Joint pain is often caused by arthrosis - thinning of the cartilage, deformation of the joint. Osteoarthritis of the sacroiliac joints develops in the lower part of the spinal column, in the area of \u200b\u200bthe junction of the sacrum and pelvic bones. This is a chronic process, but with the help correct treatment and prevention can achieve long-term remission.

Osteoarthritis of the sacroiliac joint.

The junction of the sacral and iliac bones of the pelvis is very much formed by their articular surfaces. Own and additional ligaments of the joint, the capsule and the complex relief of the bone surfaces make the connection strong and inactive. Both articular surfaces have their own cartilage that prevents friction. The joint capsule is a dense, tight sac. There are only 2 ligaments of the sacroiliac joint - anterior and posterior, but it is also strengthened by 3 additional ligaments that connect the pelvis to the spine.

Symptoms of arthrosis

The main manifestations of arthrosis of the sacroiliac joints are:

• aching pain in the lower back, radiating when moving to the buttocks;
• swelling of the lower back;
• traffic restrictions;
• change in gait ("penguin gait").

Osteoarthritis requires quick, correct treatment. When the first signs of the disease appear, you should contact a specialist as soon as possible. Diagnostics and correct diagnosis are the basis for successful treatment!

Diagnosis of the disease

Osteoarthritis of the sacroiliac joints is placed after a series of examinations. The doctor conducts a survey, examination, prescribes laboratory examinations.

• x-ray;
• magnetic resonance imaging;
• blood biochemistry;
• Ultrasound of the vertebral arteries;

Based on the tests performed, an orthopedist can differentiate coccyx arthrosis from other diseases with similar manifestations, primarily from arthritis.

How is arthrosis of the iliac joints treated?

After passing all the examinations, the specialist prescribes treatment. Basic goals:

• removal of pain syndrome;
• removal of inflammation;
• cartilage support;
• return of mobility to the lower extremities.

For these purposes is used drug therapythat gives good results. Besides medicines, the doctor prescribes physiotherapy, physiotherapy exercises, home procedures using folk remedies.

Drug therapy

Pain and inflammation are of paramount importance in osteococcygeal arthrosis. The doctor prescribes non-steroidal anti-inflammatory drugs that relieve pain and inflammatory process (diclofenac, ibuprofen, phenylbutazone). In addition, corticosteroid injections into the capsule cavity may be used.

To support and restore the cartilage tissue of the joints, chondroprotectors containing chondroitin and hyaluronic acid are prescribed. They start the process of cartilage regeneration, make them smooth, restore elasticity and firmness.

Ointments, gels help to relieve pain, warm up the muscles in the area of \u200b\u200bthe joint. Pharmacy ointments are divided into 2 groups:

• Warming (snake-based ointments, bee venom, red pepper);
• Pain relievers (based on anti-inflammatory drugs).

The doctor may prescribe the intake of vitamins, mineral food additives to maintain the body's immunity and cartilage tissue.

Physiotherapy and exercise therapy

In addition to drugs, for the treatment and return of mobility in arthrosis of the sacro
the iliac joints are prescribed physiotherapy:

• Mud massages;
• Wraps;
• Electrophoresis;
• Magnetic, laser therapy;
• Physiotherapy;
• Reflexology (acupuncture).

When carrying out procedures, do not forget - you cannot endure pain! In case of the slightest discomfort or painful sensations, immediately inform your physiotherapist. He will interrupt the procedure and choose another physiotherapy method.

Physiotherapy exercises for arthrosis are carried out in a medical institution, under the control of the correctness of the doctor's execution, for the correct load on the sacrococcygeal joint.

Surgical treatment

In the absence of results of conservative therapy, the doctor prescribes an operation. With the help of thermal action, the surgeon "disconnects" the nerve endings in the sacroiliac region. This relieves pain, but does not heal the joint itself.

If the deformation of the articular surfaces is strong, irreversible, then the surgeon performs an operation to replace the joint - endoprosthetics. The old, deformed joint is replaced with an artificial one.

Home treatment with folk recipes

At home, you can use compresses, ointments, homemade rubbing.

With pain in lumbar the cabbage compress with honey helps. Grease a fresh cabbage leaf with honey and attach to the joint area, insulate. Leave such a compress overnight, wash off the honey in the morning with warm water.

Horseradish compress perfectly warms and relaxes the muscles around the joint, increases blood circulation and metabolism in the coccygeal region. Chop horseradish, heat in a water bath and wrap in cotton cloth. Apply this compress to the ilium at night.

Herbal ointment relieves pain and reduces inflammation. For its preparation, it is necessary to mix equal amounts of chamomile, calendula and burdock root with a petroleum jelly base and let it brew during the day. Massage the sacral and iliac region with light movements.

Honey with mummy is good for relieving pain in arthrosis. Mix 3 g of mummy with honey and apply to the area of \u200b\u200bthe sacroiliac joint.

Mumiyo is a gift from nature that has a powerful anti-inflammatory, anti-toxic and tonic effect.

Rubbing potato sprouts helps relieve puffiness. Pour the potato sprouts with alcohol and leave for 4-5 hours in a dark place. Rub sore joints before going to bed, then warm them.

Prevention of arthrosis of the sacroiliac joint

Prevention measures for arthrosis of the spine, including the sacrococcygeal joint, are simple:

1. Proper nutrition. Adequate intake of vitamins and minerals in the body helps to maintain the cartilage tissue in good condition.
2. Motor mode. Warming up during the work day, playing sports, stretching or yoga can help your joints develop flexibility and mobility.
3. Fighting excess weight. The body weight strongly loads the spine and its joints, which accelerates the development of arthrosis.

Conclusion

With timely treatment of the sacrococcygeal joint, it is possible to achieve lasting results and completely cure arthrosis. Maintaining cartilage tissue and following the doctor's recommendations will help you forget about the disease for a long time. A healthy back and lower back are the basis for a long and happy life!

Osteoarthritis of the sacroiliac joint is a rather rare pathology of the musculoskeletal system, which belongs to the group of osteoarthritis. This degenerative-dystrophic process affects the sacroiliac joints - one or both, depending on the spread of the disease. Exacerbations occur most often against the background of hypothermia or excessive load on the sacrum area.

If you deal with anatomical structure sacroiliac joints (and a person has two: left and right), then it can be understood that five sacral vertebral segments, which are fused into a single sacral bone, form a solid framework for attaching the iliac bones of the pelvis to it. Moreover, this process of fusion occurs closer to the age of 25.

In men, the sacrum is longer and more curved than in women. This feature is associated with the function of childbearing in the weaker sex. It is worth paying attention to the fact that on each side on the lateral surfaces the sacrum has ear-shaped joints. These sites serve to connect the sacral and iliac bones. The caudal sacral bone passes into the vertebrae of the coccygeal spine. The sacroiliac joint is paired and belongs to the tight joints. These joints bear a fairly large load during human motor activity.

Symptoms of arthrosis of the sacroiliac joints and diagnosis of the disease

As with arthrosis of any other joints, the disease has a number of characteristic symptoms, based on which you can establish a preliminary diagnosis. These symptoms include:

1. Severe pain syndrome.
2. Limitation of joint mobility.
3. A visible change in the normal configuration of the pelvis when viewed from behind.
4. Visible swelling in the lumbosacral region.
5. Signs of osteopenia of the articular bones.

With the defeat of the sacroiliac joints, the pain when walking becomes unbearable. sharp pain appears after any physical activity or with other movements. In addition, the appearance of a crunch in the affected joint can be noted. These symptoms provide a basis for the diagnosis of arthrosis of the sacroiliac joints. But for an accurate diagnosis, it is necessary to perform a number of procedures. The doctor will most likely refer the patient to such studies:

• R-gram;
• MRI tomography;
• examination and questioning of the patient;
• general laboratory blood test;
• examination by a gynecologist (for women).

When interviewing a patient, the doctor finds out and studies the history of the disease, as well as the reasons that could be a provocation of the onset and exacerbation of the disease.

Treatment of the described disease

The therapeutic regimen is very similar to general therapy arthrosis of large joints. But nevertheless, there are some distinctive points that should not be forgotten. In general terms, it can be stated that treatment includes drugs, massage, physiotherapy, exercise therapy and orthopedic compliance.

All of these methods must be prescribed by a doctor.TO medicines include non-steroidal anti-inflammatory drugs, such as:

• Diclofenac-Retard;
• Indomethacin;
• Ketonal;
• Ketorolac.

Of course, these drugs quickly relieve pain, but they have a very large amount side effects... For example, ulcerogenic action, that is, a direct destructive effect on the gastric mucosa, which can lead to an ulcer. For osteoarthritis of the sacroiliac joints, analgesics and corticosteroids are used. In the most severe cases, blockages with Lidocaine, Diprospan, Hydrocortisone, or Kenalog can be used.

After the acute process subsides, very good effect is provided by physiotherapy exercises. Thanks to the implementation of specially selected exercises, it is possible to reduce the load on the inflamed joints and transfer it to other musculoskeletal blocks. You can also advise to include massage in the treatment. This procedure improves the metabolic processes in the damaged joints and thus speeds up the healing process. Regarding manual therapy, it should be noted that although this method of treatment is recognized as very effective, manual therapy can only be used not in the acute period of the disease. In addition, it is recommended to use orthopedic braces in order to restrict the movement of the sacroiliac joints.

Basic preventive measures

In order to prevent an exacerbation of the chronic process, it is recommended to follow simple preventive measures. These include: maintaining a normal body weight and an active lifestyle.

Complete rejection of alcohol and smoking is required.

You should also follow a normal diet and follow certain dietary recommendations. Food must contain all the necessary nutrients and trace elements. It is recommended to limit or completely eliminate physical overload, for example, lifting heavy weights. The implementation of these simple recommendations allows you to achieve long-term remission of the disease.