Turkish Journal of Physical Medicine and Rehabilitation 2012 , Vol 58 , Num 1

Sacroiliac Joint as a Pain Generator in Patients With Lumbar Disc Herniatio

İltekin Duman 1 ,M. Ali Taşkaynatan 2 ,Kutay Tezel 3 ,Ahmet Özgül 4 ,Arif Kenan Tan 4
1 Gülhane Askeri Tıp Akademisi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, TSK Rehabilitasyon ve Bakım Merkezi, Ankara, Türkiye
2 Gülhane Askeri Tıp Akademisi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Ankara
3 Department of Physical Medicine and Rehabilitation, Gülhane Military Medical Academy, Turkish Armed Forces Rehabilitation Center, Ankara, Turkey
4 GATA Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Ankara
DOI : 10.4274/tftr.79804

Objective: To investigate the effect of the fluoroscopy guided sacroiliac joint (SIJ) injection in patients with lumbar disc herniation, which was determined with magnetic resonance imaging, and sacroiliac dysfunction which was identified with clinical examination.

 

Materials and Methods: Patients with low back pain (LBP) lasting more than four weeks, radiating into the tigh or lower limb were eligible for the study. In these patients, when physical examination showed that SIJ might be the pain generator, a SIJ corticosteroid and local anesthetic injection was initially performed. The patients were assessed one hour, and two weeks after the injection.

 

Results: Sacroiliac joint injection was performed on 14 patients selected from 60 patients. In 12 patients (20%), source of LBP was attributed to SIJ. In these patients, pain severity decreased more than %75 after one or two injections. A second SIJ injection was performed in two patients.

 

Conclusion: Clinicians should take into account the possibility of nonspinal pain generators even if patients presented with a specific diagnosis. In addition, a fluoroscopy guided SIJ corticosteroid and local anesthetic injection can be effective in the diagnosis and treatment of these patients.

Keywords : Sacroiliac joint, low back pain, lumbar disc herniation, intervention,epidural steroid injectio