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Review of Opioid Sparing Interventional Pain Management Options and Techniques for Radiofrequency Ablations for Sacroiliac Joint Pain

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

Abstract

Purpose of Review

The goal of this clinical review was to provide an update about the existing treatment options and associated evidence for various radiofrequency ablation techniques for sacroiliac joint pain.

An electronic literature search on radiofrequency for the treatment of sacroiliac joint pain was conducted using PubMed, NCBI and Google Scholar. The following search keywords were used: radiofrequency ablation (cooled, pulsed, conventional, bipolar, intra-articular), sacroiliac joint and sacroiliac pain. The search was limited to human subjects, English language and articles with available full text. The bibliographic sections of all manuscripts were further searched for additional relevant citations. The full text of the relevant articles was reviewed by all the authors.

Recent Findings

Our study showed that radiofrequency ablation is a safe and effective treatment option that can be utilized to manage sacroiliac joint pain. It offers accessibility to the primary care physician, reduces office visits with “pain” as the primary complaint and provides the added benefit of acting as a non-opioid sparing means of analgesia.

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References

  1. Yang H, Haldeman S, Lu M-L, Baker D. Low back pain prevalence and related workplace psychosocial risk factors: a study using data from the 2010 National Health Interview Survey. J Manipulative Physiol Ther. 2016;39(7):459–72.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Cohen SP, Chen Y, Neufeld NJ. Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Expert Rev Neurother. 2013;13(1):99–116.

    Article  CAS  PubMed  Google Scholar 

  3. Khalil JG, Smuck M, Koreckij T, Keel J, Beall D, Goodman B, et al. A prospective, randomized, multicenter study of intraosseous basivertebral nerve ablation for the treatment of chronic low back pain. The Spine Journal. 2019;19(10):1620–32.

    Article  PubMed  Google Scholar 

  4. Maigne J-Y, Aivaliklis A, Pfefer F. Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain. Spine. 1996;21(16):1889–92.

    Article  CAS  PubMed  Google Scholar 

  5. Schwarzer AC, Aprill CN, Bogduk N. The sacroiliac joint in chronic low back pain. Spine. 1995;20(1):31–7.

    Article  CAS  PubMed  Google Scholar 

  6. Szadek KM, van der Wurff P, van Tulder MW, Zuurmond WW, Perez RS. Diagnostic validity of criteria for sacroiliac joint pain: a systematic review. J Pain. 2009;10(4):354–68.

    Article  PubMed  Google Scholar 

  7. Cohen SP. Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Anesth Analg. 2005;101(5):1440–53.

    Article  PubMed  Google Scholar 

  8. Hansen HC, Brown AM, Cohen SP, Swicegood JR, Colson JD, Manchikanti L. Sacroiliac joint interventions: a systematic review. Database of Abstracts of Reviews of Effects (DARE): quality-assessed Reviews [Internet]. 2007.

  9. Zin CS, Chen LC, Knaggs RD. Changes in trends and pattern of strong opioid prescribing in primary care. Eur J Pain. 2014;18(9):1343–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Loh E, Reid JN, Alibrahim F, Welk B. Retrospective cohort study of healthcare utilization and opioid use following radiofrequency ablation for chronic axial spine pain in Ontario. Canada Regional Anesthesia & Pain Medicine. 2019;44(3):398–405.

    Article  Google Scholar 

  11. Tinnirello A. Reduction of opioid intake after cooled radiofrequency denervation for sacroiliac joint pain: a retrospective evaluation up to 1 year. The Korean journal of pain. 2020;33(2):183.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Aydin SM, Gharibo CG, Mehnert M, Stitik TP. The role of radiofrequency ablation for sacroiliac joint pain: a meta-analysis. PM&R. 2010;2(9):842–51.

    Article  Google Scholar 

  13. Visnjevac O, Ma F, Abd-Elsayed A. A literature review of dorsal root entry zone complex (DREZC) lesions: integration of translational data for an evolution to more accurate nomenclature. J Pain Res. 2021;14:1.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kapural L, Nageeb F, Kapural M, Cata JP, Narouze S, Mekhail N. Cooled radiofrequency system for the treatment of chronic pain from sacroiliitis: the first case-series. Pain Pract. 2008;8(5):348–54.

    Article  PubMed  Google Scholar 

  15. Gilligan CJ, Shih JC, Cai VL, Hirsch JA, Rodrigues C, Irani ZD. Novel single puncture approach for simplicity 3 sacral plexus radiofrequency ablation. Pain Physician. 2016;19(4):E643–8.

    Article  PubMed  Google Scholar 

  16. Cheng J, Chen SL, Zimmerman N, Dalton JE, LaSalle G, Rosenquist R. A new radiofrequency ablation procedure to treat sacroiliac joint pain. Pain Physician. 2016;19(8):603–15.

    Article  PubMed  Google Scholar 

  17. Tekin I, Mirzai H, Ok G, Erbuyun K, Vatansever D. A comparison of conventional and pulsed radiofrequency denervation in the treatment of chronic facet joint pain. Clin J Pain. 2007;23(6):524–9.

    Article  PubMed  Google Scholar 

  18. Forst SL, Wheeler MT, Fortin JD, Vilensky JA. The sacroiliac joint: anatomy, physiology and clinical significance. Pain Physician. 2006;9(1):61–7.

    PubMed  Google Scholar 

  19. Vleeming A, Schuenke M, Masi A, Carreiro J, Danneels L, Willard F. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat. 2012;221(6):537–67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Szadek KM, Hoogland PV, Zuurmond WW, de Lange JJ, Perez RS. Nociceptive nerve fibers in the sacroiliac joint in humans. Reg Anesth Pain Med. 2008;33(1):36–43.

    Article  PubMed  Google Scholar 

  21. Fortin JD, Kissling RO, O’Connor BL, Vilensky JA. Sacroiliac joint innervation and pain. AMERICAN JOURNAL OF ORTHOPEDICS-BELLE MEAD-. 1999;28(12):687–90.

    CAS  Google Scholar 

  22. Dreyfuss P, Henning T, Malladi N, Goldstein B, Bogduk N. The ability of multi-site, multi-depth sacral lateral branch blocks to anesthetize the sacroiliac joint complex. Pain Med. 2009;10(4):679–88.

    Article  PubMed  Google Scholar 

  23. Cohen SP, Raja SN. Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. The Journal of the American Society of Anesthesiologists. 2007;106(3):591–614.

    Google Scholar 

  24. Smith HP, McWhorter JM, Challa VR. Radiofrequency neurolysis in a clinical model: neuropathological correlation. J Neurosurg. 1981;55(2):246–53.

    Article  CAS  PubMed  Google Scholar 

  25. Chua NH, Vissers KC, Sluijter ME. Pulsed radiofrequency treatment in interventional pain management: mechanisms and potential indications—a review. Acta Neurochir. 2011;153(4):763–71.

    Article  PubMed  Google Scholar 

  26. Cedeno DL, Vallejo A, Kelley CA, Tilley DM, Kumar N. Comparisons of lesion volumes and shapes produced by a radiofrequency system with a cooled, a protruding, or a monopolar probe. Pain Physician. 2017;20(6):E915–22.

    Article  PubMed  Google Scholar 

  27. Cibulka MT, Koldehoff R. Clinical usefulness of a cluster of sacroiliac joint tests in patients with and without low back pain. J Orthop Sports Phys Ther. 1999;29(2):83–92.

    Article  CAS  PubMed  Google Scholar 

  28. Kroski W, Hommer D. 77 Sacroiliac joint pain. Ramamurthy’s decision making in pain management. 2018:214.

  29. Laslett M. Evidence-based diagnosis and treatment of the painful sacroiliac joint. J Man Manip Ther. 2008;16(3):142–52.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Cosman ER Jr, Dolensky JR, Hoffman RA. Factors that affect radiofrequency heat lesion size. Pain Med. 2014;15(12):2020–36.

    Article  PubMed  Google Scholar 

  31. Finch P. A curved approach to nerve blocks and radio frequency lesioning. Pain Digest. 1997:251–7.

  32. Sluijter ME. The effect of pulsed radiofrequency fields applied to the dorsal root ganglion: a preliminary report. Pain Clin. 1998;11:109–17.

    Google Scholar 

  33. Vallejo R, Benyamin RM, Kramer J, Stanton G, Joseph NJ. Pulsed radiofrequency denervation for the treatment of sacroiliac joint syndrome. Pain Med. 2006;7(5):429–34.

    Article  PubMed  Google Scholar 

  34. Vuka I, Marciuš T, Došenović S, Ferhatović Hamzić L, Vučić K, Sapunar D, et al. Efficacy and safety of pulsed radiofrequency as a method of dorsal root ganglia stimulation in patients with neuropathic pain: a systematic review. Pain Med. 2020;21(12):3320–43.

    Article  PubMed  Google Scholar 

  35. Ding Y, Li H, Yao P, Hong T, Zhao R, Zhao G. Clinical observation of CT-guided intra-articular conventional radiofrequency and pulsed radiofrequency in the treatment of chronic sacroiliac joint pain. J Pain Res. 2018;11:2359.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Mitchell B, MacPhail T, Vivian D, Verrills P, Barnard A. Radiofrequency neurotomy for sacroiliac joint pain: a prospective study. Surg Sci. 2015;6:265–72.

    Article  Google Scholar 

  37. Schmidt PC, Pino CA, Vorenkamp KE. Sacroiliac joint radiofrequency ablation with a multilesion probe: a case series of 60 patients. Anesth Analg. 2014;119(2):460–2.

    Article  PubMed  Google Scholar 

  38. Stelzer W, Aiglesberger M, Stelzer D, Stelzer V. Use of cooled radiofrequency lateral branch neurotomy for the treatment of sacroiliac joint-mediated low back pain: a large case series. Pain Med. 2013;14(1):29–35.

    Article  PubMed  Google Scholar 

  39. Cohen SP, Hurley RW, Buckenmaier CC, Kurihara C, Morlando B, Dragovich A. Randomized placebo-controlled study evaluating lateral branch radiofrequency denervation for sacroiliac joint pain. The Journal of the American Society of Anesthesiologists. 2008;109(2):279–88.

    Google Scholar 

  40. Ho K-Y, Hadi MA, Pasutharnchat K, Tan K-H. Cooled radiofrequency denervation for treatment of sacroiliac joint pain: two-year results from 20 cases. J Pain Res. 2013;6:505.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Sun H-H, Zhuang S-Y, Hong X, Xie X-H, Zhu L, Wu X-T. The efficacy and safety of using cooled radiofrequency in treating chronic sacroiliac joint pain: A PRISMA-compliant meta-analysis. Medicine. 2018;97(6).

  42. Simopoulos TT, Manchikanti L, Gupta S, Aydin SM, Kim CH, Solanki D, et al. Systematic review of the diagnostic accuracy and therapeutic effectiveness of sacroiliac joint interventions. Pain Physician. 2015;18(5):E713–56.

    Article  PubMed  Google Scholar 

  43. Cohen SP, Strassels SA, Kurihara C, Crooks MT, Erdek MA, Forsythe A, et al. Outcome predictors for sacroiliac joint (lateral branch) radiofrequency denervation. Regional Anesthesia & Pain Medicine. 2009;34(3):206–14--14.

  44. Cheng J, Pope JE, Dalton JE, Cheng O, Bensitel A. Comparative outcomes of cooled versus traditional radiofrequency ablation of the lateral branches for sacroiliac joint pain. Clin J Pain. 2013;29(2):132–7.

    Article  PubMed  Google Scholar 

  45. Ferrante FM, King LF, Roche EA, Kim PS, Aranda M, DeLaney LR, et al. Radiofrequency sacroiliac joint denervation for sacroiliac syndrome. Reg Anesth Pain Med. 2001;26(2):137–42.

    Article  CAS  PubMed  Google Scholar 

  46. Burnham RS, Yasui Y. An alternate method of radiofrequency neurotomy of the sacroiliac joint: a pilot study of the effect on pain, function, and satisfaction. Reg Anesth Pain Med. 2007;32(1):12–9.

    PubMed  Google Scholar 

  47. Anjana Reddy VS, Sharma C, Chang K-Y, Mehta V. ‘Simplicity’radiofrequency neurotomy of sacroiliac joint: a real life 1-year follow-up UK data. Br J Pain. 2016;10(2):90–9.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Hegarty D. Clinical outcome following radiofrequency denervation for refractory sacroiliac joint dysfunction using the simplicity III probe: a 12-month retrospective evaluation. Pain Physician. 2016;19(1):E129–35.

    Article  PubMed  Google Scholar 

  49. Bellini M, Barbieri M. Single strip lesions radiofrequency denervation for treatment of sacroiliac joint pain: two years’ results. Anaesthesiology intensive therapy. 2016;48(1):19–22.

    Article  PubMed  Google Scholar 

  50. Tinnirello A, Barbieri S, Todeschini M, Marchesini M. Conventional (Simplicity III) and cooled (SInergy) radiofrequency for sacroiliac joint denervation: one-year retrospective study comparing two devices. Pain Med. 2017;18(9):1731–44.

    Article  PubMed  Google Scholar 

  51. Dutta K, Dey S, Bhattacharyya P, Agarwal S, Dev P. Comparison of efficacy of lateral branch pulsed radiofrequency denervation and intraarticular depot methylprednisolone injection for sacroiliac joint pain. Pain Physician. 2018;21(5):489–96.

    PubMed  Google Scholar 

  52. Chang MC, Ahn SH. The effect of intra-articular stimulation by pulsed radiofrequency on chronic sacroiliac joint pain refractory to intra-articular corticosteroid injection: a retrospective study. Medicine. 2017;96(26).

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Authors and Affiliations

  1. McMaster University, Hamilton, ON, Canada

    Mila Pastrak & Ognjen Visnjevac

  2. St. George’s University School of Medicine, St. George’s, Grenada

    Nikola Vladicic

  3. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada

    Jordan Sam

  4. Dartmouth Hitchcock Medical Centre, Lebanon, NH, USA

    Bruce Vrooman

  5. Bloor Pain Specialists, Toronto, ON, Canada

    Frederick Ma, Farhan Khandwalla & Ognjen Visnjevac

  6. Northern Light Health, Bangor, ME, USA

    Ammar Mahmoud

  7. Mount Sinai Hospital, Toronto, ON, Canada

    James S. Khan

  8. School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA

    Alaa Abd-Elsayed

  9. Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Scott McGilvray

  10. Cleveland Clinic Canada, Toronto, ON, Canada

    Ognjen Visnjevac

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  1. Mila Pastrak
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Correspondence to Alaa Abd-Elsayed.

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The authors have no conflict of interest related to this work. Dr. Abd-Elsayed is a consultant of Avanos and Medtronic.

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Pastrak, M., Vladicic, N., Sam, J. et al. Review of Opioid Sparing Interventional Pain Management Options and Techniques for Radiofrequency Ablations for Sacroiliac Joint Pain. Curr Pain Headache Rep 26, 855–862 (2022). https://doi.org/10.1007/s11916-022-01088-w

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