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Paediatr Neonatal Pain 2022 Jun 11;4(2):87-91. Epub 2022 May 11.

Department of Anesthesiology and Critical Care Medicine Johns Hopkins All Children's Hospital St Petersburg Florida USA.

The aim of this review was to assess diagnostic and treatment challenges of adolescents with SI joint pain. We diagnosed 13 of the patients who were referred to our chronic pain clinic because of low back pain (30%) with SI joint pain based on provocative tests response. We performed SI joint steroid infiltration. Read More

Rheumatol Adv Pract 2022 23;6(2):rkac036. Epub 2022 May 23.

Pathology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.

Objective: The aim was to assess clinical improvement after US-guided injection of CSs into the SI joint of patients with SpA.

Methods: This was an observational, descriptive, retrospective study of patients with SpA and sacroiliitis who received an US-guided injection into the SI joint between 1 June 2020 and 31 May 2021. Means were compared using Student's paired -test for the variables visual analog scale (VAS), BASDAI, ASDAS, CRP and ESR before and after the procedure. Read More

Pain Physician 2022 05;25(3):239-250

Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Background: Among the multiple causes of low back and lower extremity pain, sacroiliac joint pain has shown to be prevalent in 10% to 25% of patients with persistent axial low back pain without disc herniation, discogenic pain, or radiculitis. Over the years, multiple Current Procedural Terminology (CPT) codes have evolved with the inclusion of intraarticular injections, nerve blocks, and radiofrequency neurotomy, in addition to percutaneous sacroiliac joint fusions. Previous assessments of utilization patterns of sacroiliac joint interventions only included sacroiliac joint intraarticular injections, since the data was not available prior to the introduction of new codes. Read More

Pain Physician 2022 05;25(3):223-238

Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Background: Multiple publications have shown the significant impact of the COVID-19 pandemic on US healthcare and increasing costs over the recent years in managing low back and neck pain as well as other musculoskeletal disorders. The COVID-19 pandemic has affected many modalities of treatments, including those related to chronic pain management, including both interventional techniques and opioids. While there have not been assessments of utilization of interventional techniques specific to the ongoing COVID-19 pandemic, previous analysis published with data from 2000 to 2018 demonstrated a decline in utilization of interventional techniques from 2009 to 2018 of 6. Read More

Clin Spine Surg 2022 May 10. Epub 2022 May 10.

IRCCS Istituto Ortopedico Rizzoli (IOR), Bologna, Italy.

Study Design: This was a systematic review.

Objective: The present study aims to review the available literature concerning sacroiliac joint (SIJ) pain and degeneration after lumbosacral fixation to identify the prevalence and potential risk factors.

Summary Of Background Data: Although numerous factors can predispose patients to SIJ degeneration and pain various clinical studies indicate lumbosacral arthrodesis as a major cause. Read More

Cureus 2022 Apr 11;14(4):e24039. Epub 2022 Apr 11.

Orthopedics, Hospital Raja Perempuan Zainab II, Kota Bharu, MYS.

Sacroiliac joint injection aims to provide pain relief, improve work status, and early return to work. We aimed to investigate the role of corticosteroid and anesthetic mixture to provide short- and long-term pain relief in patients with sacroiliac joint pain. This prospective observational study included 27 patients with sacroiliac joint dysfunction who received a combination of triamcinolone and ropivacaine for sacroiliac joint injection followed by three scheduled visits at four weeks, eight weeks, and six months. Read More

Phys Med Rehabil Clin N Am 2022 05;33(2):251-265

Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, 2201 Children's Way Suite 1318, Nashville, TN 37212, USA; Vanderbilt Stallworth Rehabilitation Hospital, 2201 Children's Way Suite 1318, Nashville, TN 37212, USA. Electronic address:

The sacroiliac joint complex (SIJC) is composed of complex anatomy of numerous potential pain generators that demonstrate varying pathophysiology and differing innervations. This heterogeneity has been a challenge to advancing research and clinical care. Moving forward, individualized approaches taking these factors into account may be a path forward to improved outcomes. Read More

J Pain Res 2022 19;15:1149-1162. Epub 2022 Apr 19.

Department of Pain Medicine, The Spine and Nerve Center of the Virginias, Charleston, WV, USA.

Sacroiliac joint (SIJ) pain is a common cause of low back pain. Traditionally, treatment for SIJ joint pain and dysfunction has consisted of physical therapy, medication management, SIJ injections, and SIJ ablations. Improved recognition of the SIJ as an etiology for back pain has led to advances in treatment options. Read More

J Back Musculoskelet Rehabil 2022 Apr 8. Epub 2022 Apr 8.

Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy.

Background: Sacro-iliac joint (SIJ) pain is an often-misdiagnosed cause (up to 30% cases) of atypical low back pain (LBP) that might be treated with a wide range of conservative interventions. However, Platelet-Rich-Plasma (PRP) ultrasound-guided injections at SIJ level in subjects with mitochondrial disorders have not yet been investigated.

Case Presentation: A 52-year-old Caucasian male with fluoroquinolone-related mitochondrial dysfunction referred to a Physical Medicine and Rehabilitation Outpatient, complaining of severe SIJ pain (Numeric Pain Related Scale, NPRS=8). Read More

Pain Ther 2022 Jun 17;11(2):655-665. Epub 2022 Apr 17.

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

Objectives/introduction: Superior cluneal neuralgia (SCN) is a distinct cause of lower back and/or leg pain related to pathology of the superior cluneal nerve (SCn). SCN has been termed pseudo-sciatica and is an overlooked differential diagnosis when patients are otherwise presenting with low back and/or radicular pain. Radiofrequency ablation (RFA) is commonly used for denervation of the medial branches of the dorsal root for facet joint syndrome for sacroiliac joint; however, RFA has not been described to ablate the SCn for SCN. Read More

J Phys Ther Sci 2022 Apr 8;34(4):327-334. Epub 2022 Apr 8.

Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital: 319 Longwood Ave, Ste 6, Boston, MA 02115, USA.

[Purpose] To identify running gait biomechanics associated with sacroiliac (SI) joint pain in female runners compared to healthy controls. [Participants and Methods] In this case-control study, treadmill running gait biomechanics of female runners diagnosed SI joint pain, (by ultrasound-guided diagnostic SI joint injection and/or ≥2 positive SI physical exam maneuvers) were compared with age, height, mass, and BMI matched healthy female runners. Sagittal and coronal plane treadmill running video angles were measured and compared. Read More

Arch Gynecol Obstet 2022 Apr 8. Epub 2022 Apr 8.

National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.

Purpose: We performed this research to report the clinical characteristics and clinical therapeutic strategies of acute postpartum inflammatory sacroiliitis.

Methods: We retrospectively analyzed the data of patients diagnosed with acute postpartum inflammatory sacroiliitis from 2014 to 2020. All their clinical details including clinical symptoms and signs, laboratory tests, radiologic examination, diagnosis and treatment process and clinical outcomes were obtained and analyzed in this retrospective analysis. Read More

Adv Biomed Res 2022 28;11:13. Epub 2022 Feb 28.

Department of Orthopedics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Sacroiliac pain is one of the causes of low back pain, representing with discomfort and tenderness in the sacroiliac joint. Interventional procedures might be beneficial in cases unresponsive to medical treatments. Here, we aimed to investigate the effects of intra-articular corticosteroid injections in patients with sacroiliac pain. Read More

Pain Med 2022 May;23(6):1197

Technol Health Care 2022 Mar 18. Epub 2022 Mar 18.

Department of Spine Surgery, Sana Hospital Rummelsberg, Schwarzenbruck, Germany.

Background: Sacroiliac joint (SIJ) painful dysfunction is a common source of low back pain (LBP). Several surgical treatment options for SIJ fusion were described. A promising treatment option with demonstrated clinical improvement is the minimally-invasive SIJ fusion. Read More

Diagnostics (Basel) 2022 Feb 26;12(3). Epub 2022 Feb 26.

Department of Rehabilitation Sciences, Humanitas Gradenigo Hospital, 10153 Turin, Italy.

Radiofrequency (RF) is a minimally invasive procedure used to interrupt or alter nociceptive pathways for treating musculoskeletal pain. It seems a useful tool to relieve chronic pain syndromes, even if, to date, solid evidence is still needed about the effectiveness of this therapy. By this systematic review and meta-analysis, we aimed to evaluate the efficacy of RF in treating musculoskeletal pain. Read More

Pain Physician 2022 03;25(2):E341-E347

Department of Anesthesia, Massachusetts General Hospital, Boston, MA.

Background: Sacroiliac joint (SIJ) pain is a common etiology of chronic lower back pain. Treatment of persistent sacroiliac joint pain may entail intraarticular steroid injections and lateral branch radiofrequency neurotomy.

Objectives: This study evaluates the efficacy of SIJ intervention treatments by comparing intraarticular steroid injections with lateral branch radiofrequency neurotomy. Read More

Pain Physician 2022 03;25(2):193-207

Pain Management Centers of America, Paducah, KY and Evansville, IN; LSU Health Science Center, New Orleans, LA.

Background: Regenerative medicine interventions are applied to assist in the repair, and to potentially replace or restore damaged tissue through the use of autologous/allogenic biologics and it continues to expand. The anti-inflammatory, immunomodulatory, and regenerative properties of bone marrow mesenchymal stem cells (BM-MSCs), and investigation into their therapeutic efficacy and safety in patients with severe chronic low back pain, have not been demonstrated in controlled studies. Multiple pain generators have been hypothesized to be responsible in severe spinal degeneration and it is difficult to identify a single pain generator; consequently, resulting in inadequate therapeutic results. Read More

Am Fam Physician 2022 03;105(3):239-245

Interdisciplinary Pain Management Center, Tripler Army Medical Center, Honolulu, HI, USA.

Sacroiliac (SI) joint dysfunction is a common cause of low back pain and accurate diagnosis can be challenging. A complete history and physical examination are critical in differentiating other diagnoses that may have similar signs and symptoms. Positive responses to at least three physical provocation tests suggest SI joint dysfunction, and local anesthetic SI joint blocks can also be useful for confirming the SI joint as the source of pain. Read More

Curr Pain Headache Rep 2022 May 3;26(5):385-390. Epub 2022 Mar 3.

Department of Anesthesiology, Jefferson Pain Center, Sidney Kimmel Medical College, Thomas Jefferson University, 3 Crescent Drive, Philadelphia, PA, 19112, USA.

Purpose Of Review: The purpose of the review is to evaluate the current evidence on techniques for sacroiliac joint (SIJ) injections using landmark, ultrasound, fluoroscopy, and computed tomography (CT) guidance.

Methods: A literature search was performed to find all relevant retrospective, prospective, and randomized controlled (RCT) studies where SIJ injections were performed under ultrasound, fluoroscopy, and CT guidance.

Recent Findings: A total of eight studies were identified with suitable data for inclusion. Read More

Orthopade 2022 Apr 3;51(4):307-324. Epub 2022 Mar 3.

Schmerztherapie und Rheumatologie, Orthopädie am Grünen Turm, Grüner-Turm-Str. 4-10, 88212, Ravensburg, Deutschland.

Background: Oriented towards the therapy planning and management of rheumatic patients, and based on the differentiated therapeutic principles of manual medicine (MM) with knowledge on evidence of therapeutic local infiltration techniques (TLI), the author pleads for the establishment of a structured, mechanism-based therapy concept in the sense of "treat to target" (T2T) for patients with (chronic) degenerative low-back pain (LBP) in outpatient pain therapy care.

Diagnostics: This requires a consistent (primary) diagnosis with pain analysis under the premise that LBP is always specific if it is structurally and functionally conditioned. A broad bio-psycho-social anamnesis and structure-based clinical diagnosis (imaging) with functional differentiation according to MM principles and, if necessary, interventional blocks, should result in the expression of a three-level diagnosis as a prerequisite for a mechanism-based, hierarchic step therapy in LBP. Read More

Cureus 2022 Jan 23;14(1):e21529. Epub 2022 Jan 23.

Department of Family Practice, University of British Columbia, North Vancouver, CAN.

Lifelong, pregnancy-induced low back pain forced me to search for solutions to the problem of pain. Currently, low back pain is often diagnosed as "nonspecific" and, as a result, a multitude of tests and poorly effective, at times side effect-laden or habit-forming treatments are recommended. My quest for relief took me to first diagnose my pain as coming from the sacroiliac joints, then to prolotherapy, the first treatment which brought me prolonged relief. Read More

J Med Cases 2022 Jan 17;13(1):31-35. Epub 2022 Jan 17.

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.

The sacroiliac joint (SIJ) is designed primarily for stability with minute motions. SIJ dysfunction refers to improper movement of the SIJs. Diagnosis and evaluation of SIJ dysfunction are difficult, with use of physical maneuvers and image-guided anesthetic injection. Read More

Spine J 2022 Jul 1;22(7):1100-1105. Epub 2022 Feb 1.

Department of Medicine, Division of Community Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.

Background Context: Spinal region corticosteroid injections (CSI) are intended to act locally to relieve radicular or axial back pain, however some systemic absorption occurs, potentially placing recipients at risk for immunosuppressive effects of corticosteroids. No previous studies examine whether patients undergoing spinal region CSI are at increased risk for viral infections, particularly influenza-a common viral illness with potentially serious consequences, especially for patients with multimorbidity.

Purpose: To examine odds of influenza in patients who received spinal region CSI compared to matched controls. Read More

Diagnostics (Basel) 2021 Dec 9;11(12). Epub 2021 Dec 9.

Department of Anesthesiology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.

Neck and back pain is increasingly prevalent, and has increased exponentially in recent years. As more resources are dedicated to the diagnosis of pain conditions, it is increasingly important that the diagnostic techniques used are as precise and accurate as possible. Traditional diagnostic methods rely heavily upon patient history and physical examination to determine the most appropriate treatments and/or imaging studies. Read More

Reg Anesth Pain Med 2022 02 8;47(2):89-99. Epub 2021 Dec 8.

Department of Physical Medicine & Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.

Background: There has been a worldwide surge in interventional procedures for low back pain (LBP), with studies yielding mixed results. These data support the need for identifying outcome predictors based on unique characteristics in a pragmatic setting.

Methods: We prospectively evaluated the association between over two dozen demographic, clinical and technical factors on treatment outcomes for three procedures: epidural steroid injections (ESIs) for sciatica, and sacroiliac joint (SIJ) injections and facet interventions for axial LBP. Read More

Pain Med 2021 Nov 24. Epub 2021 Nov 24.

Department of Rehabilitation Medicine, Cornell University Medical Center.

Objective: Using stringent inclusion criteria, a double-blinded study protocol, and fluoroscopic guided injections, we compare intraarticular sacroiliac joint platelet rich plasma injections to intraarticular steroids.

Design: Double-blind, randomized controlled trial.

Setting: Two large university-based interdisciplinary spine centers. Read More

Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi 2021 Nov;37(11):967-972

Department of Clinical Immunology, Xijing Hospital, Air Force Medical University, Xi'an 710032, China. *Corresponding author, E-mail:

Objective To develop a model of spondyloarthritis (SpA) in mice, and analyze their clinical manifestations, radiological and histological features, and inflammatory cytokines expression levels. Methods Fourteen-week-old female BALB/c mice were immunized by intraperitoneal injection of human cartilage proteoglycan (PG), with their peripheral joints observed and scored 3 times a week. 45 weeks after immunization, micro-computed tomography (micro-CT) was used to scan the axial and peripheral joints, and bone mineral density (BMD) and bone volume/total volume (BV/TV) of the vertebral body were analyzed. Read More

Orthop Rev (Pavia) 2021 22;13(2):24980. Epub 2021 Jun 22.

LSUHSC School of Medicine.

Bertolotti's Syndrome is defined as chronic back pain caused by transitional lumbosacral vertebra. The transitional vertebra may present with numerous clinical manifestations leading to a myriad of associated pain types. The most common is pain in the sacroiliac joint, groin, and hip region and may or may not be associated with radiculopathy. Read More

J Pain Res 2021 14;14:3251-3258. Epub 2021 Oct 14.

Department of Anesthesiology and Pain Medicine, University of Kansas Medical Center, Kansas City, KS, USA.

Background: Sacroiliac joint (SIJ) pathology is a cause of low back pain that may be difficult to diagnose and challenging to treat. Open and minimally invasive (MI) lateral approach fusions have been used to treat sacroiliitis over the past two decades. A novel MI posterior approach SIJ fusion technique utilizes a posteriorly placed transfixing device with single point S1/S2 level or mid-segment SIJ fixation (LinQ procedure). Read More