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Sacroiliac joint (SIJ) pain

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The sacroiliac joint (SIJ) is a synovial joint.

  • prevalence of sacroiliac joint pain in patients presenting with lower back pain ranges from 15% to 25%

  • SIJ pain can result from either intra-articular causes, for example arthritis or infection, or extraarticular causes, including enthesopathy, ligamentous injury, fractures ormyofascial pain

  • SIJ pain cannot be diagnosed from history or physical examination alone, and X-ray and MRI are necessary

Treatment

  • initial treatment should involve non-invasive measures such as anti-inflammatory medications and physiotherapy, focussing on exercises to improve lumbopelvic stability
  • invasive treatment, which involves injection of the SIJ, can also be used in the diagnosis of SIJ pain
    • blind injections are unreliable and not recommended
    • radiologically guided SIJ injections can provide pain relief for up to 1 year (1)
      • injections are performed under fluoroscopy or CT or MRI guidance or more recently, realtime, high-resolution ultrasound guidance.

Reference:

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