Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 11 , Pages 2048-2056 , November 2008

Sources of Sacroiliac Region Pain: Insights Gained From a Study Comparing Standard Intra-Articular Injection With a Technique Combining Intra- and Peri-Articular Injection

  • Claude D. Borowsky, MD, MPhil

      Affiliations

    • Corresponding Author InformationReprint requests to Claude D. Borowsky, MD, MPhil, Pioneer Spine and Sports Physicians, 55 St. George St, Springfield, MA 01003
    • ,
  • Glenn Fagen, PhD

References 

  1. Schwarzer AC, Aprill CN, Bogduk N. The sacroiliac joint in chronic low back pain. Spine. 1995;20:31–37
  2. Paris VP. Differential diagnosis of sacroiliac joints from lumbar spine dysfunction. In:  Vleeming A,  Mooney V,  Snidjers CJ,  Dorman T editor. Proceedings of the First Interdisciplinary World Congress on Low Back Pain and its Relation to the Sacroiliac Joint. Rotterdam: European Conference Organizer; 1992;p. 1–64
  3. Bellamy N, Park W, Rooney PJ. What do we know about the sacroiliac joint?. Semin Arthritis Rheum. 1983;12:282–313
  4. Fortin JD. Sacroiliac joint injection and arthrography with imaging correlation. In:  Lennard T editors. Physiatric procedures in clinical practice. Philadelphia: Hanley & Belfus; 1995;p. 242–253
  5. Prather H. Sacroiliac joint pain: practical management. Clin J Sports Med. 2003;13:252–255
  6. Aprill CN. The role of anatomically specific injections into the sacroiliac joint. In:  Vleeming A,  Mooney V,  Snidjers CJ,  Dorman T editor. Proceedings of the First Interdisciplinary World Congress on Low Back Pain and its Relation to the Sacroiliac Joint. Rotterdam: European Conference Organizer; 1992;p. 373–380
  7. Foley BS, Buschbacher RM. Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Am J Phys Med Rehabil. 2006;l85:997–1006
  8. Dreyfuss P, Michaelsen M, Pauza K, McLarty J, Bogduk N. The value of medical history and physical examination in diagnosing sacroiliac joint pain. Spine. 1996;21:2594–2602
  9. Dreyfuss P, Cole A, Pauza A. Sacroiliac joint injections. Phys Med Rehabil Clin North Am. 1995;6:785–813
  10. Maugars Y, Mathis C, Berthelot JM, Charlier C, Prost A. Assessment of the efficacy of sacroiliac corticosteroid injections in spondylarthropathies: a double-blind study. Br J Rheumatol. 1996;35:767–770
  11. Hanly JG, Mitchell M, MacMillan L, Mosher D, Sutton E. Efficacy of sacroiliac corticosteroid injections in patients with inflammatory spondylarthropathy: results of a 6 month controlled study. J Rheumatol. 2000;27:719–722
  12. Slipman CW, Lipetz JS, Plastaras CT, et al. Fluoroscopically guided therapeutic sacroiliac joint injections for sacroiliac joint syndrome. Am J Phys Rehabil. 2001;80:425–432
  13. Maigne JY, Planchon CA. Sacroiliac joint pain after lumbar fusion: a study with anesthetic blocks. Eur Spine J. 2005;14:654–658
  14. Kelekis AD, Somon T, Yilmaz H, et al. Interventional spine procedures. Eur J Radiol. 2005;55:362–383
  15. McKenzie-Brown AM, Shah RV, Sehgal N, Everett CR. A systematic review of sacroiliac joint interventions. Pain Physician. 2005;8:115–125
  16. Dreyfuss P, Dreyer SJ, Cole A, Mayo K. Sacroiliac joint pain. J Am Acad Orthop Surg. 2004;12:255–265
  17. Vleeming A, Pool-Goudzwaard AL, Hammudoghlu D, Stoeckart R, Snijders CJ, Mens JM. The function of the long dorsal sacroiliac ligament: its implication for understanding low back pain. Spine. 1996;21:556–562
  18. Snijders CJ, Hermans PF, Niesing R, Spoor CW, Stoeckart R. The influence of slouching and lumbar support on iliolumbar ligaments, intervertebral discs and sacroiliac joints. Clin Biomech (Bristol, Avon). 2004;19:223–229
  19. Snijders CJ, Vleeming A, Stoeckart R. Transfer of lumbosacral load to iliac bones and legs, part II: loading of the sacroiliac joints when lifting in a stooped posture. Clin Biomech (Bristol, Avon). 1993;8:295–301
  20. Vleeming A, Volkers AC, Snijders CJ, Stoeckart R. Relation between form and function in the sacroiliac joint: part 2, biomechanical aspects. Spine. 1990;15:133–136
  21. Hungerford B, Gilleard W, Hodges P. Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine. 2003;28:1593–1600
  22. Vleeming A, Pool-Goudzwaard AL, Stoeckart R, van Wingerden JP, Snijders CJ. The posterior layer of the thoraco-lumbar fascia: its function in load transfer from spine to legs. Spine. 1995;20:753–758
  23. Cohen SP, Abdi S. Lateral branch blocks as a treatment for sacroiliac joint pain: a pilot study. Reg Anesth Pain Med. 2003;28:113–119
  24. Vilensky JA, O'Connor BL, Fortin JD, et al. Histologic analysis of neural elements in the human sacroiliac joint. Spine. 2002;27:1202–1207
  25. Fortin JD, Kissling RO, O'Connor BL, Vilensky JA. Sacroiliac joint innervation and pain. Am J Orthop. 1999;28:687–690
  26. Sakamoto N, Yamashita T, Takebayashi T, Sekine M, Ishii S. An electrophysiologic study of mechanoreceptors in the sacroiliac joint and adjacent tissues. Spine. 2001;26:E468–E471
  27. Fortin JD, Dwyer AP, West S, Pier J. Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part 1: asymptomatic volunteers. Spine. 1994;19:1475–1482
  28. Slipman CW, Jackson HB, Lipetz JS, Chan KT, Lenrow D, Vresilovic EJ. Sacroiliac joint pain referral zones. Arch Phys Med Rehabil. 2000;81:334–338
  29. Hansen HC, McKenzie-Brown AM, Cohen SP, Swicegood JR, Colson JD, Manchikanti L. Sacroiliac joint interventions: a systematic review. Pain Physician. 2007;10:165–184
  30. Yin W, Willard F, Carreiro J, Dreyfuss P. Sensory stimulation-guided sacroiliac joint radiofrequency neurotomy: technique based on neuroanatomy of the dorsal sacral plexus. Spine. 2003;28:2419–2425
  31. Bogduk N. Call to arms. ISIS Sci Newsl. 2005;5:25–29
  32. Price DD, McGrath PA, Rafil A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17:45–56
  33. Gallagher EJ, Liebman M, Bijur PE. Prospective validation of clinically important changes in pain severity measured on a visual analog scales. Ann Emerg Med. 2001;38:633–638
  34. Bird SB, Dickson EW. Clinically significant changes in pain along the visual analog scale. Ann Emerg Med. 2001;38:672–674
  35. Cohen SP, Hurley RW, Christo PJ, Winkley J, Mohiuddin MM, Stoianovic MP. Clinical predictors of success and failure for lumbar facet radiofrequency denervation. Clin J Pain. 2007;23:45–52
  36. Benzon HT. Epidural steroid injections for low back pain and lumbosacral radiculopathy. Pain. 1986;24:277–295
  37. Woertgen C, Holzschuh M, Rothoerl RD, Brawanski A. Does the choice of outcome scale influence prognostic factors for lumbar disk surgery? (A prospective consecutive study of 121 patients). Eur Spine J. 1997;6:173–180
  38. Peolsson A, Peolsson M. Predictive factors for long term outcome of anterior cervical decompression and fusion: a multivariate data analysis. Eur Spine J. 2008;17:406–414
  39. Cohen SP, Bajwa ZH, Kraemer JJ, et al. Factors predicting success and failure for cervical facet radiofrequency denervation: a multi-center analysis. Reg Anesth Pain Med. 2007;32:495–503
  40. Luukanien R, Nissila M, Asikainen E, Sanila M, Lehtinen K, Alantu A. Periarticular corticosteroid treatment of the sacroiliac joint in patients with seronegative spondylarthropathy. Clin Exp Rheumatol. 1999;17:88–90
  41. Murikami E, Tanaka Y, Aizawa T, Ishizuka M, Kokubun S. Effect of periarticular and intraarticular lidocaine injections for sacroiliac joint pain: prospective comparative study. J Orthop Sci. 2007;12:274–280
  42. Maigne JY, 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;21:1889–1892
  43. Slipman CW, Sterenfeld EB, Chou LH. The predictive value of provocative sacroiliac joint stress maneuvers in the diagnosis of sacroiliac joint syndrome. Arch Phys Med Rehabil. 1998;79:288–292
  44. Laslett M, Aprill CN, McDonald B. Provocation sacroiliac joint tests have validity in the diagnosis of sacroiliac joint pain. Arch Phys Med Rehabil. 2006;87:874–875
  45. Siepe CJ, Korge A, Grochulla F, Mehren C, Mayer HM. Analysis of postoperative patterns following total lumbar disk replacement: results from fluoroscopically guided spine infiltrations. Eur Spine J. 2008;17:44–56
  46. Barnsley L, Lord S, Wallis S, Bogduk N. False positive rates of cervical zygapophysial joint blocks. Clin J Pain. 1993;9:124–130
  47. Bogduk N. Management of chronic low back pain. Med J Aust. 2004;180:79–83
  48. Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N. The false positive rate of uncontrolled diagnostic blocks of the lumbar zygoapophysial joints. Pain. 1994;58:195–200
  49. North RB, Kidd DH, Zahurak M, Piantadosi S. Specificity of diagnostic nerve blocks: a prospective, randomized study of sciatica due to lumbosacral spine disease. Pain. 1996;65:77–85
  50. Cohen Sp, Hurley RW. The ability of diagnostic spinal injections to predict surgical outcomes. Anesth Analg. 2007;105:1756–1775
  51. Sheldon EA, Bird SR, Smugar SS, Tershakovec AM. Correlation of measures of pain, function, and overall response: results pooled from two identical studies of storicoxib in chronic back pain. Spine. 2008;33:533–538
  52. Ceran F, Ozcan A. The relationship of the Functional Rating Index with disability, pain and quality of life in patients with low back pain. Med Sci Monit. 2006;12:CR435–CR439
  53. Fortin JD, Washington WJ, Falco FJ. Three pathways between the sacroiliac joint and neural structures. Am J Neuroradiol. 1999;20:1429–1434
  54. Forst SL, Wheeler MT, Fortin JD, Vilensky JA. The sacroiliac joint: anatomy, physiology and clinical significance. Pain Physician. 2006;1:61–67
  55. Wolfe F, Hawley DJ, Cathey MA. Measurement of gold treatment effect in clinical practice: evidence for effectiveness of intramuscular gold therapy. J Rheumatol. 1993;20:797–802
  56. Schwetschenau PR, Ramirez A, Johnston J, Wiggs C, Martins AN. Double-blind evaluation of intradiscal chymopapain for herniated lumbar discs: early results. J Neurosurg. 1976;45:622–627
  57. Wasan D, Kaptchuk TJ, Davar G, Jamison RN. The association between psychopathology and placebo analgesia in patients with discogenic low back pain. Pain Med. 2006;7:217–228

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(08)00530-3

doi: 10.1016/j.apmr.2008.06.006

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 11 , Pages 2048-2056 , November 2008

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