Sacroiliac Joint Pain and Its Treatment

Abstract

The sacroiliac joint (SIJ) as a source of symptoms has been controversial; however, as knowledge about the joint increased, its role as a pain generator in patients complaining of symptoms that are often attributed to spinal pathology has become better appreciated. The literature reports that the SIJ is the pain origin in as many as 30% of patients presenting with low back pain. Clinically, the SIJ can be challenging to evaluate; however, assessing pain location, patient posture/movement, and provocative manual testing are useful in making the presumptive diagnosis of SIJ disruption. The most definitive evaluation is image-guided injection of anesthetic solutions into the joint which is diagnostic if there is at least 75% symptom relief acutely. Treatment begins with nonoperative intervention including physical therapy and/or chiropractic care. If these fail, the next option is generally radiofrequency denervation (rhizotomy) of the joint. If this does not provide adequate relief, surgical intervention, in the form of minimally invasive SIJ fusion may be considered. The literature increasingly supports favorable results of SIJ fusion in appropriately selected patients. The purpose of this review is to provide an overview of the current literature on the SIJ, with focus on its surgical treatment.

Validation study of a diagnostic scoring system for sacroiliac joint-related pain

“…As a result of the strict definition, the SIJ group defined here consisted of ~20% of all patients in the current study. Some reports indicated that the proportion was 10%–30% 4,5,7. Therefore, our results were consistent with those of previous reports.…”

“…LBP originating from SIJ dysfunction has been regarded as one non-specific cause of LBP 2. Some reports showed that the proportion of SIJ pain was 10%–30% of all LBP 4,5,7. There are no specific radiological findings, even on MRI, for the diagnosis of SIJ dysfunction.…”

Development of a Clinical Decision Aid for Chiropractic Management of Common Conditions Causing Low Back Pain in Veterans: Results of a Consensus Process

“…Visit frequency and duration should be determined by synthesizing clinical information such as the diagnosis, physical condition, care goals, intervention options, and expected response. Interventions: Education about the condition 13,[25][26][27][28][29]33,34 Spinal manipulation (thrust or non-thrust as tolerated) 10,13,[37][38][39] Heat, massage, low-level laser 37,38 Motor control exercise 37,38 General self-care and self-management advice 37,38 Consider recommending mindfulness-based stress reduction, tai chi, yoga, and progressive relaxation 37,38 Sacroiliac joint pain: Pain stemming from a sacroiliac joint 36 Interventions: Education about the condition 13,[25][26][27][28][29]33,34 Spinal manipulation 40 Regional muscle strengthening 41 Motor control exercise 37,38 Heat, massage, low-level laser 37,38 General self-care and self-management advice 37,38 Consider recommending mindfulness-based stress reduction, tai chi, yoga, and progressive relaxation 37,38 Discogenic pain: lumbar spinal pain, with or without referred pain, stemming from a lumbar intervertebral disk 36 Interventions: Education about the ...…”

Sacroiliac Joint Pathology in Elderly Patients With Low Back Pain (Observation Program “Iolanta”)

“…Из-за особенностей иннервации боль, связанная с неспецифическим патологическим процессом в илеосакральном сочленении, имеет многофакторный и комплексный характер [10][11][12]. по представленным в ряде исследований данным, боль неспецифического характера в крестцовоподвздошном суставе имеет место почти у 20% населения, она чаще встречается у лиц пожилого возраста без существенных гендерных различий [13][14][15][16].…”