Sacroiliac joint Injection

Sacroiliac joint can be a very painful condition. Pain management procedure involves an injection in the joint directly under x-ray guidance. The medicines injected are local anesthetic and steroid directly into the sacroiliac (SI) joint. The inflammation is reduced and if pain is relieved it confirms SI joint as a source of pain.It allows a physical therapist to treat the joint in much better way.

The injection can be repeated every few months till patient is completely pain free.

If the steroid injection is not helping and pain relief is lasting for short duration, RF ablation is an another good option for lasting pain relief.A radiofrequency neurotomy is a type of injection that allows radiofrequency current to be passed on the nerves supplying sensations to SI joint. They are heated and blocked for long time. The goal is to relieve your pain coming from sacroiliac joint.The terms radiofrequency ablation is also used for the same procedure. 

For pain coming from SI joint there are two primary types of radiofrequency ablation:A medial branch neurotomy (ablation) affects the nerves carrying pain from the facet joints. In addition to Facet joints L4 and L5 medial branches supply the SI joint.A lateral branch neurotomy (ablation) affects nerves that carry pain from the sacroiliac joints. S1 S2 and S3 lateral branches supply SI joint.

These medial or lateral branch nerves do not control any muscles or sensation in the arms or legs, so a heat lesion poses little danger of negatively affecting those areas. The medial branch nerves do control small muscles in the neck and mid or low back, but loss of these nerves has not proved harmful.

Medial Branch/Lateral Branch Nerve Block

Before the radiofrequency ablation procedure, a lateral branch or medial branch nerve block will have already been performed to prove that the patient's pain is being transmitted by those nerves. The medial branch or lateral branch block acts as a test run before the neurotomy procedure.

Additionally, a sacroiliac joint injection, facet joint injection, or other treatment methods will usually already have been attempted.

Radiofrequency Ablation Success Rates -

Success rates vary, but typically about 50% of patients undergoing this procedure for low back pain will experience significant pain relief for as much as two years. Of the remaining low back pain patients, about 50% will get some pain relief for a shorter period.  Some patients do not experience any relief from pain as a result of this procedure. As a general rule, if effective, the ablation will often provide pain relief lasting at least 9 to 14 months and sometimes for longer. After this period of time, however, the nerve will regenerate and the pain may return.