Background & Aims
Low back pain (LBP) is an extremely common health problem; it is the leading cause of activity limitation and absenteeism from work. Amongst LBP, the Sacroiliac joint has been found as a pain generator in 10% to 27% of suspected patients with chronic low back pain and/or buttock pain with or without lower extremity pain. Purpose of this study is to assess the pain relief and functional outcome after fluoroscopic guided intraarticular sacroiliac joint injection of 1cc 1% lignocaine with 1cc 40 mg triamcinolone acetonide in diagnosed cases of sacroiliitis.
Methods
Total 139 adult patients were taken for study. Severity of pain and functional disability due to pain were assessed by Numeric rating score (NRS), and Oswestry Disability Index (ODI) respectively. Severity of pain and functional disability due to pain were assessed before pain intervention procedure, immediately after procedure, at 2 weeks, 4 weeks and 3 months after the procedure.
Results
As observed from this study, Fluoroscopic guided intraarticular sacroiliac joint injection of 1cc 1% lignocaine with 1cc 40 mg triamcinolone acetonide is associated with improvements in pain scores. The pain scores evaluated using Numeric rating score and functional outcome using Oswestry Disability Index immediately post-procedure, at 2 weeks, 4 weeks, and at 3 months showed significant improvement when compared to pre-procedural scores.
Conclusions
The fluoroscopic guided intra articular sacroiliac joint injection can be an effective treatment option for patients diagnosed with sacroiliitis, those receiving medical treatment for low backache, and those who have undergone surgery for Low backache without relief.
References
1. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):769-81.
2. . Schuit D, McPoil TG, Mules P. Incidence of sacroiliac joint malalignment in leg length discrepancies. J Am Podiatr Med Assoc 1989;79:380 –3.
3. Cohen SP. Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Anesth Analg. 2005 Nov;101(5):1440-1453.
4. Calvillo O, Skaribas I, Turnipseed J. Anatomy and pathophysiology of the sacroiliac joint. Curr Rev Pain. 2000;4(5):356-61.
5. Herzog W, Conway PJ. Gait analysis of sacroiliac joint patients. J Manipulative Physiol Ther 1994;17:124 –7
6. Marymont JV, Lynch MA, Henning CE. Exercise-related stress reaction of the sacroiliac joint: an unusual cause of low back pain in athletes. Am J Sports Med 1986;14:320 –3.
7. Telli H, Telli S, Topal M. The Validity and Reliability of Provocation Tests in the Diagnosis of Sacroiliac Joint Dysfunction. Pain Physician. 2018 Jul;21(4):E367-E376.
8. Gartenberg A, Nessim A, Cho W. Sacroiliac joint dysfunction: pathophysiology, diagnosis, and treatment. Eur Spine J. 2021 Oct;30(10):2936-2943.
9. Rashbaum RF, Ohnmeiss DD, Lindley EM, Kitchel SH, Patel VV. Sacroiliac Joint Pain and Its Treatment. Clin Spine Surg. 2016 Mar;29(2):42-8.
10. Breivik H, Borchgrevink PC, Allen SM, et al. Assessment of pain. Br J Anaesth 2008;101 (1):17–24.
11. Johnsen LG, Hellum C, Nygaard OP, et al. Comparison of the SF6D, the EQ5D, and the Oswestry Disability Index in patients with chronic low back pain and degenerative disc disease. BMC Musculoskelet Disord 2013;14:148.
12. 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 Sep;21(5):489-496.
13. Chakraverty R, Dias R. Audit of conservative management of chronic low back pain in a secondary care setting–part I: facet joint and sacroiliac joint interventions. Acupunct Med. 2004 Dec;22(4):207-13.
14. Kennedy DJ, Engel A, Kreiner DS, et al. Fluoroscopically guided diagnostic and therapeutic intra-articular sacroiliac joint injections: A systematic review. Pain Med 2015;16(8):1500–18.
15. Patel A, Kumar D, Singh S, Mohan R, Mishra S, Gupta AK, Yadav G. Effect of Fluoroscopic-Guided Corticosteroid Injection in Patients With Sacroiliac Joint Dysfunction. Cureus. 2023 Mar 20;15(3):e36406.
16. Grob KR, Neuhuber WL, Kissling RO: [Innervation of the sacroiliac joint of the human]. Z Rheumatol. 1995, 54:117-22.
17. Borowsky CD, Fagen G. Sources of sacroiliac region pain: Insights gained from a study comparing standard intra-articular injection with a technique combining intra- and peri-articular injection. Arch Phys Med Rehabil 2008;89(11):2048–56.
Presenting Author
Bhuvna Ahuja
Poster Authors
DR ROOPESH JAIN
MD, Anaesthesiology
L. N. Medical College, Bhopal
Lead Author
Topics
- Access to Care