Sacroiliac Joint Dysfunction

2018 ◽  
Author(s):  
Victor Foorsov ◽  
Omar Dyara ◽  
Robert Bolash ◽  
Bruce Vrooman
Keyword(s):  
Low Back Pain ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Treatment Options ◽  
Evidence Based ◽  
Low Back ◽  
Common Cause ◽  
Evidence Based Treatment ◽  
Sacroiliac Joint Dysfunction ◽  
Radiologic Imaging

Sacroiliac joint dysfunction is a common cause of chronic low back pain. Certain populations are particularly susceptible to disorders of this unique joint. Anatomically, the joint is complex, and the clinician must understand both intrinsic and extrinsic structures in its vicinity. Unfortunately, there are no particular pathognomonic findings on radiologic imaging. A cluster of physical examination findings has been recognized as demonstrating sacroiliac joint pain. Various treatment options exist in the evidence-based treatment of this condition.

The role of sacroiliac joint dysfunction in the genesis of low back pain: the obvious is not always right

2007 ◽  
Vol 127 (10) ◽  
pp. 885-888 ◽  
Author(s):  
Natan Weksler ◽  
Gad J. Velan ◽  
Michael Semionov ◽  
Boris Gurevitch ◽  
Moti Klein ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sacroiliac Joint ◽  
Low Back ◽  
Sacroiliac Joint Dysfunction

scholarly journals Low back pain: Sacroiliac joint pain may be myth

BMJ ◽  
2004 ◽  
Vol 329 (7459) ◽  
pp. 232.1 ◽  
Author(s):  
Andrew N Bamji
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Low Back ◽  
Sacroiliac Joint Pain

scholarly journals Is the History of a Surgical Discectomy Related to the Source of Chronic Low Back Pain?

2012 ◽  
Vol 1;15 (1;1) ◽  
pp. E53-E58
Author(s):  
Michael J. DePalma
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Facet Joint ◽  
Small Sample ◽  
Medial Branch ◽  
Low Back ◽  
Discogenic Pain ◽  
History Of

Background: Recurrent or persistent low back pain (LBP) after surgical discectomy (SD) for intervertebral disc herniation has been well documented. The source of low back pain in these patients has not been examined. Objective: To compare the distribution of the source of chronic LBP between patients with and without a history of SD. Study Design: Retrospective chart review. Setting: Academic spine center. Patients: Charts from 358 consecutive patients were reviewed. Charts noting the absence/ presence of SD in patients who subsequently underwent diagnostic injections to determine the source of chronic LBP were included resulting in 158 unique cases for analysis. Methods: Patients underwent either dual diagnostic facet joint blocks, intra-articular diagnostic sacroiliac joint injections, provocation lumbar discography, or anesthetic injection into putatively painful interspinous ligaments/opposing spinous processes/posterior fusion hardware. If the initial diagnostic procedure was negative, the next most likely structure in the diagnostic algorithm was interrogated. Subsequent diagnostic procedures were not performed after the source of chronic LBP was identified. Outcome: The source of chronic LBP was diagnosed as discogenic pain (DP), facet joint pain (FJP), sacroiliac joint pain (SIJP), or other sources of chronic LBP. Results: Based on a Fisher’s exact test, there was marginal evidence the distribution of the source of chronic LBP differed for those with and without a history of SD (P = 0.080). Posthoc comparisons suggested that patients with a history of SD have a higher probability of DP compared to those without a history of SD (82% versus 41%; P = 0.011). Differences in the probability of FJP, SIJP, or other sources between the SD history groups were not significant. Limitations: Small sample size, restrospective design, and possible false-positive results. Conclusions: This is the first published investigation of the tissue source of chronic LBP after SD. It appears that DP is the most common reason for chronic LBP after SD. If more rigorous study confirms our findings, future biologic treatments may hold value in repairing symptomatic annular fissures after SD. Key words: surgical discectomy, chornic low back pain, discogenic pain, facet joint, sacroiliac joint, low back pain, diagnostic injections, medial branch block, lumbar provcation discography

scholarly journals Sacroiliac Joint Interventions: A Systematic Review

2007 ◽  
Vol 1;10 (1;1) ◽  
pp. 165-184
Author(s):  
Hans C. Hansen
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Local Anesthetic ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Low Back ◽  
Sacroiliac Joint Pain ◽  
Radiofrequency Neurotomy ◽  
Joint Injections

Background: The sacroiliac joint is a diarthrodial synovial joint with abundant innervation and capability of being a source of low back pain and referred pain in the lower extremity. There are no definite historical, physical, or radiological features to provide definite diagnosis of sacroiliac joint pain, although many authors have advocated provocational maneuvers to suggest sacroiliac joint as a pain generator. An accurate diagnosis is made by controlled sacroiliac joint diagnostic blocks. The sacroiliac joint has been shown to be a source of pain in 10% to 27% of suspected cases with chronic low back pain utilizing controlled comparative local anesthetic blocks. Intraarticular injections, and radiofrequency neurotomy have been described as therapeutic measures. This systematic review was performed to assess diagnostic testing (non-invasive versus interventional diagnostic techniques) and to evaluate the clinical usefulness of interventional techniques in the management of chronic sacroiliac joint pain. Objective: To evaluate and update the available evidence regarding diagnostic and therapeutic sacroiliac joint interventions in the management of sacroiliac joint pain. Study Design: A systematic review using the criteria as outlined by the Agency for Healthcare Research and Quality (AHRQ), Cochrane Review Group Criteria for therapeutic interventions and AHRQ, and Quality Assessment for Diagnostic Accuracy Studies (QUADAS) for diagnostic studies. Methods: The databases of EMBASE and MEDLINE (1966 to December 2006), and Cochrane Reviews were searched. The searches included systematic reviews, narrative reviews, prospective and retrospective studies, and cross-references from articles reviewed. The search strategy included sacroiliac joint pain and dysfunction, sacroiliac joint injections, interventions, and radiofrequency. Results: The results of this systematic evaluation revealed that for diagnostic purposes, there is moderate evidence showing the accuracy of comparative, controlled local anesthetic blocks. Prevalence of sacroiliac joint pain is estimated to range between 10% and 27% using a double block paradigm. The false-positive rate of single, uncontrolled, sacroiliac joint injections is around 20%. The evidence for provocative testing to diagnose sacroiliac joint pain is limited. For therapeutic purposes, intraarticular sacroiliac joint injections with steroid and radiofrequency neurotomy were evaluated. Based on this review, there is limited evidence for short-term and longterm relief with intraarticular sacroiliac joint injections and radiofrequency thermoneurolysis. Conclusions: The evidence for the specificity and validity of diagnostic sacroiliac joint injections is moderate. The evidence for accuracy of provocative maneuvers in diagnosis of sacroiliac joint pain is limited. The evidence for therapeutic intraarticular sacroiliac joint injections is limited. The evidence for radiofrequency neurotomy in managing chronic sacroiliac joint pain is limited. Keywords: Low back pain, sacroiliac joint pain, axial pain, spinal pain, diagnostic block, sacroiliac joint injection, thermal radiofrequency, and pulsed radiofrequency

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