Histologic Analysis of Neural Elements in the Human Sacroiliac Joint

Abstract

The presence of nerve fibers and mechanoreceptors in the sacroiliac ligament demonstrates that the central nervous system receives information, certainly proprioceptive, and possibly pain from the sacroiliac joint. Although it is not known how the central nervous system uses such information, it seems reasonable to speculate that the proprioceptive information is used to optimize upper body balance at this joint. In addition, because the staining techniques used generally to show nerves and nerve elements in periarticular connective tissue are nonspecific, the distinction between neural and nonneural should be made on the basis of both morphologic and staining characteristics.

A Randomized Clinical Trial of Manual Versus Mechanical Force Manipulation in the Treatment of Sacroiliac Joint Syndrome

“…Histologic examination of human SIJs has revealed nerve fibers compatible with a broad repertoire of sensory receptors including nociceptive afferents. 42,43 This innervation pattern may provide explanations for various patterns of local, pseudoradicular, and referred pain in afflictions of the SIJ that have been confirmed with direct SIJ capsular stimulation. [44][45][46] A reduction in pain in patients treated for presumptive SIJ pain by injection of an anesthetic into the SIJ has also been shown, validating its status as a pain generator.…”

A pilot study to determine the effects of a supine sacroiliac orthopedic blocking procedure on cervical spine extensor isometric strength

“…6 Histologic analysis of SIJ ligaments demonstrates the presence of paciniform-type mechanoreceptors. 15 Generally, all 4 types of joint receptors are found in all diarthrodial joints and associated ligaments. 16 Mechanoreceptor afferents have reflexive connections to motoneurons.…”

Intensity mapping of pain referral areas in sacroiliac joint pain patients

“…This would also fit more with the described innervation pattern of the SI joint. [21][22][23] The Fortin area depicts referral to dermatomes S 1-3 , the tuber area only to S 1 and S 2 . Therefore, referral to dermatome S 3 seems to be discriminative and would parallel the findings of Grob et al 21 for the dorsal SI joint nerve supply.…”