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5. Sacroiliac joint pain.

Karolina Szadek¹, Steven P Cohen^2,3, Javier de Andrès Ares⁴

¹Department of Anesthesiology and Pain Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Pain Practice : the Official Journal of World Institute of Pain

|December 29, 2023

Summary

Sacroiliac (SI) joint pain, affecting 15-30% of low back pain patients, requires a multidisciplinary approach. Conservative treatments are first-line, with corticosteroid injections and radiofrequency ablation (RFA) options if needed.

Keywords:

cooled radiofrequency evidence‐based medicine low back pain radiofrequency ablation sacroiliac joint

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Area of Science:

Pain Management
Musculoskeletal Disorders
Interventional Pain Procedures

Background:

Sacroiliac (SI) joint pain is localized pain in the SI joint region.
Prevalence ranges from 15% to 30% in patients with mechanical low back pain.

Purpose of the Study:

To provide an updated literature review on the diagnosis and treatment of SI joint pain.
To summarize current evidence for various diagnostic and therapeutic modalities.

Main Methods:

Narrative review of existing literature.
Synthesis of information on diagnostic tests and treatment options for SI joint pain.

Main Results:

Patient history and provocative maneuvers aid diagnosis, though test value is debated.
Medical imaging is for ruling out serious conditions; diagnostic value of SI joint infiltration is controversial.
Multidisciplinary treatment is ideal, starting with conservative measures.
Corticosteroid injections and radiofrequency ablation (RFA) show efficacy for persistent pain.
Complication rates for SI joint treatments are generally low.

Conclusions:

SI joint pain management should be multidisciplinary and multimodal.
Corticosteroid injections and RFA are viable options when conservative treatments fail.