Sacroiliac Joint Pain
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 reported that 10–25% of chronic low back pain is attributable to the sacroiliac joint. Provocative physical examination maneuvers and confirmatory intra-articular injections can help diagnose SI joint pain. 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 modalities include medications, physical therapy, manual therapy, injections, radiofrequency denervation, and arthrodesis. SI joint fusion may be performed using a variety of approaches and techniques, both open and minimally invasive. Several implant devices are available that promote fusion by simply crossing the joint space, but according to several authors, SI joint fusion should be considered unproven. To help guide selection of the appropriate treatment, further studies need to be conducted to establish which approach or technique is best.
KeywordsSacroiliac joint Low back pain Diagnostic injection Physical therapy Sacroiliac joint fusion
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