Therapy
The therapy of sacroiliitis is mainly based on two components: Consistent physiotherapy and pain relief. The physiotherapy should be carried out under professional supervision, whereby it is important that a patient also receives instructions to be able to carry out gymnastics independently and regularly at home. For the treatment of pain, drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs) are primarily used.
These include ibuprofen or diclofenac. First of all, affected persons should only take these painkillers when necessary and only if really necessary continuously, and then only for a limited period of time. Corticosteroids are another option.These should also be used only temporarily and if possible only when other painkillers have shown no effect.
These corticosteroids can also be injected directly into the affected sacroiliac joints. There are other anti-inflammatory drugs, such as sulfasalazine or the so-called biologicals, which can be used in the treatment of sacroiliitis. Whether the administration of these drugs is useful or not, however, depends above all on the disease underlying sacroiliitis. In the case of very advanced diseases, surgical therapy can be considered as a last resort, whereby the advantages and disadvantages must be discussed in detail between the patient and the doctor. If the decision for a surgical intervention has been made, either a joint replacement or an erection surgery is possible.
Duration
When sacroiliitis has manifested itself and has been clearly diagnosed as such, it usually accompanies the affected person for a lifetime. In the course of the disease, it typically worsens as the disease progresses. While at the beginning there is only pain in the lower back or buttocks, in the course of the disease movement and postural deformities may occur. With early, regular and consistent physiotherapy, deterioration can usually be postponed. This can often prevent a significant impairment of activity and quality of life for many years.
Course and prognosis
Sacroiliitis is one of the chronic progressive inflammations, which means that once it has occurred, it cannot be completely cured and tends to increase in severity over time. Nowadays, however, a severe disability can usually be prevented by consistent physiotherapy. Sacroiliitis is medically classified as a steadily progressing disease and is therefore usually not completely curable.
In most cases, the complaints increase more and more. However, the course of the disease can be slowed down and in the best case even temporarily stopped by regular and individually adapted therapy. Since a cure cannot usually be the goal of treatment, the aim is instead to alleviate symptoms and improve the quality of life.
The degree of disability (GdB) in sacroiliitis is mainly dependent on functional impairments such as impaired movement and reduced ability to work under pressure, as well as possible involvement of other organ systems and any complaints that may arise as a result. The following values can give an orientation for inflammatory rheumatic diseases in general, in which sacroiliitis usually occurs: In the case of only slight complaints without significant functional impairment, a degree of disability of at most ten percent is assigned. In cases of slight functional impairment and low disease activity, the maximum degree of disability to be expected is 20 to 40 percent. For a degree of disability of more than 50% and thus a severe disability, there must be at least permanent and significant functional impairment. In the case of irreversible damage such as stiffening of the back, even 80 to 100 percent are possible.
