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Does Choice of Steroid Matter for Treatment of Chronic Low Back Pain with Sacroiliac Joint Injections: a Retrospective Study

  • Chronic Pain Medicine (O Viswanath, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Prevalence of chronic low back pain (cLBP) is increasing. Sacroiliac joint (SIJ) is a common source of cLBP, but data behind its diagnosis and treatment is controversial. There is moderate quality evidence for effectiveness of therapeutic SIJ injections. However, there are no studies comparing the two most common steroid preparations, methylprednisolone (MTP) and triamcinolone (TAC) in SIJ injections.

Recent Findings

After institutional IRB approval, a retrospective chart review was conducted to evaluate the effectiveness of SIJ injections in terms of pain relief at 1-month follow-up and compare MTP versus TAC. All injections were performed by a single pain physician with fluoroscopic guidance.

Results

Sixty-five percent of patients in the MTP group and 57% patients in the TAC group had >50% pain relief at 1-month follow-up, with no statistical difference between the two groups. Patients in the TAC group had significantly greater BMI and consisted of higher proportion of smokers (72% patients in TAC group versus 39% patients in the MTP group, p-value 0.004). Other sources of pain such as facet joints were unmasked post-procedurally after SIJ injections, with this unmasking being significant for the TAC group. Opiate use decreased in the MTP group from 35% pre-procedurally to 20% post-procedurally, and this difference did not reach statistical significance.

Summary

Both MTP and TAC are effective in providing pain relief for SIJ pain at 1-month follow-up, with no statistical difference between the two types of steroids. Although not statistically significant, there is a modest reduction in opiate use in the MTP group.

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Acknowledgements

Lisa Magestro APRN, Elisabeth Makubika APRN

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Authors and Affiliations

  1. Department of Anesthesia, Yale University School of Medicine, New Haven, CT, USA

    Ramya Krishnan, Viji Kurup, Nalini Vadivelu, Feng Dai, Bin Zhou & Kanishka Rajput

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  1. Ramya Krishnan
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  3. Nalini Vadivelu
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  4. Feng Dai
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Correspondence to Kanishka Rajput.

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Krishnan, R., Kurup, V., Vadivelu, N. et al. Does Choice of Steroid Matter for Treatment of Chronic Low Back Pain with Sacroiliac Joint Injections: a Retrospective Study. Curr Pain Headache Rep 25, 34 (2021). https://doi.org/10.1007/s11916-021-00942-7

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