Bilateral Sacroiliitis – Causes, Symptoms, Diagnosis & Ayurvedic Cure | Raseshwar Herbal
Bilateral Sacroiliitis – Introduction
Bilateral Sacroiliitis refers to inflammation involving both sacroiliac joints, which connect the lower spine (sacrum) to the pelvic bones (iliac bones). These joints support the entire weight of the upper body and play a vital role in walking, standing, sitting, bending, and lifting. When inflammation develops in these joints, severe pain, stiffness, and mobility impairment occur, often progressing into chronic disability if untreated.
This condition is commonly linked to autoimmune disorders such as ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, inflammatory bowel disease, infections, injuries, pregnancy-related biomechanical changes, and prolonged improper posture or heavy physical work. With increasing lifestyle-related and inflammatory disorders, Bilateral Sacroiliitis is becoming a widespread musculoskeletal problem across all age groups.
Causes of Bilateral Sacroiliitis
Bilateral Sacroiliitis has multifactorial origins and often develops due to a combination of structural, inflammatory, autoimmune, infectious, and occupational risk factors. The underlying causes vary among individuals and may progress gradually or appear suddenly after injury or infection. The primary causes include:
-
Autoimmune and inflammatory arthritic conditions such as ankylosing spondylitis which causes chronic inflammation of sacroiliac joints, leading to structural degeneration.
-
Psoriatic arthritis and rheumatoid arthritis trigger immune-mediated joint destruction affecting both SI joints simultaneously.
-
Traumatic physical injuries, falls, accidents, and repeated strain from lifting heavy weights lead to joint instability and inflammation.
-
Infection-induced sacroiliitis caused by bacterial, viral, or tuberculosis infection spreading from the bloodstream or pelvic region.
-
Pregnancy-induced hormonal changes loosen pelvic ligaments, causing excessive joint mobility and inflammation, which may continue postpartum.
-
Poor posture, chronic sitting, long-distance driving, standing for long durations, or abnormal gait mechanics increase stress on SI joints.
-
Leg length discrepancy, scoliosis, flat feet, and spinal deformities alter pelvic biomechanics causing joint overload.
-
Obesity increases mechanical pressure on SI joints, accelerating cartilage degeneration.
-
Degenerative disc disease or lumbar spinal arthritis causes compensatory strain on sacroiliac joints.
-
Athletic sports such as running, jumping, or sudden twisting movements lead to wear and tear.
-
Inflammatory bowel diseases such as Crohn’s or ulcerative colitis contribute to systemic joint inflammation.
-
Post-surgical complications related to spine or hip surgery may alter gait and pelvic alignment.
Signs & Symptoms of Bilateral Sacroiliitis
Symptoms largely depend on the severity of inflammation, autoimmune involvement, lifestyle strain, and duration of disease progression. Common symptomatic patterns include:
Severe lower back pain located near the buttocks region, typically worsened by standing, walking, or climbing stairs. Continuous hip stiffness especially in the morning or after prolonged sitting, requiring slow stretching before movement begins. Pain radiating to groin, thighs, and legs, creating difficulty in bending, lifting, or twisting. Swelling and inflammation around the pelvic region. Limited mobility causing difficulty turning in bed or sitting cross-legged. Pain worsening after coughing, sneezing, or physical exertion. Difficulty walking long distances, relying on support or limping. Warmth around pelvic joints with tenderness upon pressing the sacroiliac region. Numbness or tingling sensations in lower limbs due to nerve compression. Fatigue, imbalance, and compromised posture. Sleep disturbance due to pain.
In autoimmune cases, gradual stiffness develops, eventually leading to spinal fusion in advanced ankylosing spondylitis patients, severely restricting motion.
Diagnostic Methods for Bilateral Sacroiliitis
Diagnosis requires clinical evaluation, physical examination, imaging, and laboratory testing to identify inflammation, structural damage, and autoimmune involvement. Diagnostic approaches include:
Physical tests such as FABER test, Gaenslen’s test, compression and distraction tests to reproduce SI joint pain. X-ray imaging to observe joint irregularities, narrowing, sclerosis, or fusion. MRI scans detect early-stage inflammation, bone marrow edema, and soft tissue damage. CT scans reveal structural damage, fractures, and degenerative changes. Blood tests to detect inflammatory markers ESR, CRP, HLA-B27 gene and autoimmune pathology. Ultrasound for evaluating joint fluid accumulation. Differential diagnosis to rule out lumbar disc herniation, hip arthritis, piriformis syndrome, and sciatica.
Early diagnosis prevents structural deformity and chronic disability.
Bilateral Sacroiliitis – Ayurvedic View
In Ayurveda, Bilateral Sacroiliitis is associated with aggravated Vata Dosha localized in the pelvic region affecting the Asthi Dhatu and Sandhi (joints), traditionally correlated with conditions like Gridhrasi and Kati Shoola. Chronic Vata imbalance leads to dryness of joint tissues, cartilage degeneration, obstruction of srotas, stiffness, pain, and nerve irritation.
Ayurveda attributes causation to improper diet, excessive dry food, irregular eating habits, constipation, heavy physical exertion, ageing, trauma, and emotional stress leading to Vata prakopa. When Vata combines with Ama (toxins) it results in inflammation and swelling known as Ama-Vata mechanism.
Ayurvedic management includes pacifying Vata, strengthening bones and joints, improving lubrication, enhancing circulation, removing ama, reducing inflammation, and restoring joint mobility. Panchakarma therapies like Vasti (medicated enema), Abhyanga (herbal oil massage), Kati Basti, Pinda Sweda, and Agni Karma are highly effective.
Herbal Remedies for Bilateral Sacroiliitis
Ayurvedic herbal medicines provide natural anti-inflammatory, analgesic, nervine strengthening, and Vata balancing effects. Generally recommended herbs include:
Shallaki for reducing joint inflammation and restoring flexibility. Guggul especially Yograj Guggul and Kaishore Guggul for chronic joint disorders. Ashwagandha for reducing muscle stiffness and strengthening nerves. Rasna for anti-arthritic action. Nirgundi for relieving pain and swelling. Hadjod for strengthening bones and repairing degeneration. Shunthi, Eranda, and Dashmool helping to reduce inflammation and improve structural stability. Turmeric and Curcumin with strong anti-inflammatory response. Bala for neuromuscular nourishment. Punarnava for reducing edema and swelling. Bone strengthening formulations like Lakshadi Guggul. Medicated oils such as Mahanarayan oil, Dhanwantaram oil, and Sahacharadi oil for external application.
Diet recommendations include warm cooked foods, ghee, oils, nuts, milk, turmeric, ginger, and avoiding cold, dry, junk and sour foods. Gentle yoga, stretching and physiotherapy support recovery.
Conclusion
Bilateral Sacroiliitis is a painful, mobility-restricting inflammatory disease involving both sacroiliac joints that demands early diagnosis and holistic treatment to avoid permanent disability. Ayurveda offers a highly effective therapeutic approach by balancing Vata, reducing inflammation, improving joint integrity, eliminating ama, and strengthening musculoskeletal structure. With disciplined herbal treatment, corrective lifestyle practices, Panchakarma therapies, and consistent physiotherapy, sufferers can significantly reduce pain, regain mobility, prevent progression and restore quality of life naturally without lifelong medication dependence.