Treatment Of Sacroiliac Joint Pain Research Articles

Sacroiliac Joint Fusion: Approaches and Recent Outcomes.

The sacroiliac joint may be a primary source of pain in patients complaining of low back and/or buttock pain. Nonsurgical treatment of sacroiliac joint pain typically includes structured core and pelvic muscle flexibility and strengthening; pharmaceutical management through oral and injectable medication; and ablation procedures. For patients who do not improve with comprehensive, nonoperative treatment, surgical fusion of the sacroiliac joint is an option with overall good reported outcomes and high patient satisfaction. Minimally invasive surgery (MIS) approaches have been shown to have lower morbidity and earlier recovery than traditional open approaches. To date, the majority of published clinical studies on MIS sacroiliac joint fusion are industry-sponsored and predominantly using one system (ingrowth triangular titanium rods). These include two level 1 randomized controlled trials comparing MIS sacroiliac joint fusion to nonoperative management, with results favoring surgery.

A Systematic Review of the Normal Sacroiliac Joint Anatomy and Adjacent Tissues for Pain Physicians

Background: The sacroiliac joint (SIJ) forms a complex joint and has shown to be underappreciated in its involvement with lower back pain. Research efforts have intensified on SIJ anatomy and biomechanics because of its predisposing position to pain and dysfunction in individuals suffering from lower back discomfort. Previous work has focused on SIJ anatomy including bone and joint structure, innervation, as well as biomechanics and the treatment of SIJ pain. However, to date, no review exists describing the range of ‘normal’ anatomic features of the SIJ. Objectives: To describe the normal appearance of the SIJ and adjacent tissues, as opposed to ‘abnormal’ conditions involving SIJ morphology. It will also identify key areas that require further study because of lacking information or disagreement. Study Design: A systematic literature review. Setting: The research took place at the University of Otago, New Zealand. All published research on ‘normal SIJ anatomy’ available from MEDLINE, OVID, Scopus, Web of Science, PubMed, and Science Direct were included, available until December 2018, in English, French, and German. Subject areas included bony landmarks, joint type, bone morphology, ligamentous attachments, muscular and fascial relationships, blood supply, fatty infiltration, and morphologic variation. Methods: Articles met the selection criteria if they contained specific information on SIJ anatomy, including bone morphology and architecture, ligaments, muscle attachments, innervation, vasculature, and the presence of fat. Biomechanics and kinematics related keywords were used as the literature often couples these with the anatomy. Keywords of individual articles were named as ‘structures of interest.’ Results: A total of 88 primary and 101 secondary articles were identified in the time frame from 1851 to 2018. Primary articles provided quantitative data and detailed anatomic descriptions. Secondary articles did not focus specifically on the anatomy of the SIJ. Although research appeared to be in general agreement on bony landmarks, joint type, myofascial attachments, vasculature, and innervation of the SIJ, there was only part consensus on ligament attachments and cartilage structure. Information regarding bone density of the articulating surfaces of the SIJ is lacking. Despite its potential clinical significance, fatty infiltration within the joint lacks research to date. Limitations: Only the given databases were used for the initial search. Keyword combinations used for this review may not have been inclusive of all articles relevant to the SIJ. Work in languages other than the ones listed or work that is not available via the internet may be missing. Conclusions: This study provides an overview of normal SIJ structures, including all neuromusculoskeletal elements related to the joint. There is a lack of knowledge on the SIJ ligaments warranting further investigation. Furthermore, there are discrepancies in relation to the nomenclature, layers, attachment sites, and on the topographical relationships between ligamentous tissues and nerves. Subsequent studies on the quantification of fat and bone density in the SIJ have been suggested. These could be useful radiologic parameters to assess the condition of the joint clinically. This review may provide insight into the clinical signs and abnormal biomechanical features of the joint for the purposes of treating SIJ pain. Key words: Bone density, bony landmarks, fat infiltration, innervation, ligaments morphology, muscles, sacroiliac joint, vasculature

Sacroiliac joint pain: Where are we now?

Sacroiliac joint pain is often interpreted by healthcare practitioners as non-specific pain in the lower back region. This has resulted in many cases of sacroiliac joint pain being misdiagnosed as general chronic low back pain, which has led to large gaps in the knowledge regarding its exact causes and manifestation. The pain is theorized to develop because of the loss of form and/or force closure leading to destabilization and sacroiliac joint dysfunction. Current diagnostic tests include pain provocation tests and intra-articular injections. The intra-articular injections may exclude individuals with extra-articular pain, so more inclusive testing should be considered for use in clinical practice such as range of motion assessment or pubic symphysis analysis. Recent literature does not support the use of present treatments by healthcare practitioners as the therapies lack well designed studies to confirm their efficacy, are extremely invasive, or have minimal symptom management capabilities. Additional research into current and new treatment strategies needs to be done to determine their efficacy in managing this condition. Overall, the development of an animal model of the condition is recommended to better evaluate and improve the diagnosis and treatment of sacroiliac joint pain.

The effects of the Mulligan concept in ankylosing spondylitis: a report of two cases

Introduction/Aims The first complaint in ankylosing spondylitis is usually sacroiliac joint pain and morning stiffness. Aside from inflammation, sacroiliac joint pain is related to joint damage and mechanical stress. Many different methods are applied in the treatment of sacroiliac joint pain. This study aimed to investigate the effects of sacroiliac joint mobilisation on pain, function and mobility in patients with ankylosing spondylitis. Methods Two patients presented with sacroiliac joint pain: a 46-year-old male and a 34-year-old female. Both patients received eight sessions of mobilisation with movement, according to the Mulligan concept (sacroiliac joint mobilisation and mechanical correction). Sessions were held at 4-day intervals over a 28-day period. The patients were assessed for sacroiliac joint mobilisation immediately before and after the first session and their pain, function and mobility were assessed at the second and eighth sessions. Findings A decrease in pain and increases in functional performance and mobility were noted in both cases at the end of eight sessions. Conclusions Sacroiliac joint mobilisation might be effective in improving pain, function and mobility in patients with ankylosing spondylitis. Further studies should be conducted with an increased number of participants to confirm these findings.

Comparison of Quadrapolar™ radiofrequency lesions produced by standard versus modified technique: an experimental model.

Lower back pain (LBP) is a global public health issue and is associated with substantial financial costs and loss of quality of life. Over the years, different literature has provided different statistics regarding the causes of the back pain. The following statistic is the closest estimation regarding our patient population. The sacroiliac (SI) joint pain is responsible for LBP in 18%–30% of individuals with LBP. Quadrapolar™ radiofrequency ablation, which involves ablation of the nerves of the SI joint using heat, is a commonly used treatment for SI joint pain. However, the standard Quadrapolar radiofrequency procedure is not always effective at ablating all the sensory nerves that cause the pain in the SI joint. One of the major limitations of the standard Quadrapolar radiofrequency procedure is that it produces small lesions of ~4 mm in diameter. Smaller lesions increase the likelihood of failure to ablate all nociceptive input. In this study, we compare the standard Quadrapolar radiofrequency ablation technique to a modified Quadrapolar ablation technique that has produced improved patient outcomes in our clinic. The methodology of the two techniques are compared. In addition, we compare results from an experimental model comparing the lesion sizes produced by the two techniques. Taken together, the findings from this study suggest that the modified Quadrapolar technique provides longer lasting relief for the back pain that is caused by SI joint dysfunction. A randomized controlled clinical trial is the next step required to quantify the difference in symptom relief and quality of life produced by the two techniques.

Randomized Sham-controlled Double-Blind Multicenter Clinical Trial to Ascertain the Effect of Percutaneous Radiofrequency Treatment for Sacroiliac Joint Pain: Three-month Results.

Objectives:To investigate the effect of a percutaneous radiofrequency (RF) heat lesion compared with a sham procedure, applied to the lateral branches of L5, S1, S2, S3, and S4 nerve roots.Materials and Methods:Sixty patients aged 18 years and above with a medical history and physical examination suggestive for sacroiliac joint pain and a reduction of 2 or more on a numerical rating scale (NRS, 0 to 10) after a sacroiliac joint test block were included in this study. Treatment group: percutaneous RF heat lesion at the lateral branches of S1, S2, S3, and S4 nerve roots and the posterior ramus dorsalis of L5; sham group: same procedure as the treatment group except for the RF heat lesion. Primary outcome measure: pain reduction (NRS). Secondary outcome measure: Global Perceived Effect.Results:No statistically significant differences in pain level over time between the groups (Group×Period) (F1,58=0.353; P=0.56) nor within the treatment Group (F1,58=0.212; P=0.65) were found. The Period factor, however, yielded a significant difference (F1,58=61.67; P<0.001), that is, when pooled together the mean pain level of the patients was significantly reduced at T1 compared with T0. In the crossover group, 42.1% experienced a reduction in NRS of 2 or more at 1 month (P=0.65). No statistically significant difference in satisfaction over time between the groups was found (F1,50=2.1; P=0.15). The independent factors Group (F1,50=2.02; P=0.16) and Period (F1,50=0.95; P=0.33) also showed no statistically significant difference. The same applies to recovery: no statistically significant Group×Period effect (F1,51=0.09; P=0.77) was found, neither an effect of Group (F1,51=0.004; P=0.95) nor of Period (F1,51=0.27; P=0.60).Discussion:The hypothesis of no difference in pain reduction or in Global Perceived Effect between the treatment and sham group cannot be rejected.Level of Evidence:Level 1A.

Novel Single Puncture Approach for Simplicity 3 Sacral Plexus Radiofrequency Ablation: Technical Note

Radiofrequency (RF) ablation of the lateral sacral plexus has been used for the treatment of sacroiliac joint pain including as an adjunct to other palliative therapies for the treatment of painful osseous metastasis. The treatment goal is targeted ablation of the dorsal lateral branches of S1-S4. Though several techniques have been described, the Simplicity III (Neurotherm, Middleton, MA) system allows for ablation to be achieved with a single RF probe by utilizing a multi-electrode curved RF probe to create a continuous ablation line across all sacral nerves. In the standard approach, there is sequential introduction of a spinal needle along the desired ablation tract for local anesthesia followed by separate placement of the ablation probe. Though fluoroscopic guidance is utilized, multiple needle passes increase the risk of complication such as bowel perforation or probe insertion through a neural foramen. It may also extend procedure time and increase radiation dose. We illustrate a technique for Simplicity III RF ablation of the dorsal sacral plexus using a modified Seldinger approach for treatment of a patient with sacroiliac joint pain due to osseous renal cell carcinoma metastasis. The desired ablation tract is initially anesthetized via a hollow micropuncture needle. The needle is then exchanged for a peelaway sheath. The RF probe is inserted through the peelaway sheath thus ensuring the probe is placed precisely along the previously anesthetized tract allowing the procedure to be completed using a single percutaneous puncture. We believe that this approach decreases the risks of bowel perforation, patient discomfort as a result of multiple percutaneous punctures, and procedure time. Key words: Simplicity 3, sacral plexus ablation, image-guided approach, modified Seldinger, chronic sacral pain, thin wall introducer needle

Single strip lesions radiofrequency denervation for treatment of sacroiliac joint pain: two years' results.

Sacroiliac joint pain can be managed by intra-articular injections or radiofrequency of its innervation. Single strip lesions radiofrequency denervation is a new system. The objective of this study was to present one of the first utilizations of this innovative technique. 60 patients who met the diagnostic criteria for sacroiliac joint syndrome were enrolled in the study. In total, 102 single strip lesions radiofrequency denervations were performed. Pain intensity was measured with the Oswestry low back pain disability questionnaire and the Oswestry Disability Index whose scores were assessed at 1, 3, 6 and 12 months after the procedure. 91.8 % of the 102 radiofrequency treatments resulted in a reduction of more than 50% pain intensity relief at 1 month, 81.6% at 3 months and 59.16% at 6 months. In 35.7% of cases, the relief was continuative up to 1 year. No relief was observed in 12.24% of cases. The ODI scores improved significantly 1 month after the procedure, compared with the baseline scores. The ODI scores after 6 months improved very clearly compared with the baseline scores and with the 3-month scores. Single strip lesions radiofrequency denervation using the Simplicity III probe is a potential modality for intermediate term relief for patients with sacroiliac pain.

Sacroiliac joint pain: Prospective, randomised, experimental and comparative study of thermal radiofrequency with sacroiliac joint block

ObjectiveTo compare the analgesic effects between the blockade and bipolar thermal radiofrequency in the treatment of sacroiliac joint pain. MethodProspective, randomised and experimental study conducted on 60 patients selected in the two hospitals over a period of nine months, who had intense sacroiliac joint pain (Visual Analogue Scale [VAS]>6) that lasted more than 3months. Patients were randomised into three groups (n=20): Group A (two intra-articular sacroiliac injections of local anaesthetic/corticosteroid guided by ultrasound in 7days). Group B: conventional bipolar radiofrequency “palisade”. Target points were the lateral branch nerves of S1, S2, and S3, distance needles 1cm. Group C: modified bipolar radiofrequency “palisade” (needle distance >1cm). Patients were evaluated at one month, three months, and one year. Demographic data, VAS reduction, and side effects of the techniques were assessed. ResultsOne month after the treatment, pain reduction was >50% in the three groups p<.001. Three and 12months after the technique, the patients of the Group A did not have a significant reduction in pain. At 3 months, almost 50% patients of the Group B referred to improvement of the pain (p=.03), and <25% at 12months, and those results were statistically significant (p=.01) compared to the baseline. Group C showed an improvement of 50% at 3 and 12months (p<.001). All patients completed the study. ConclusionsBipolar radiofrequency “palisade”, especially when the distance between the needles was increased, was more effective and lasted longer, compared to join block and steroids, in relieving pain sacroiliac joint.

Dolor en la articulación sacroilíaca: estudio prospectivo, aleatorizado, experimental y comparativo de la radiofrecuencia térmica con el bloqueo de la articulación sacroilíaca

ObjectiveTo compare the analgesic effects between the blockade and bipolar thermal radiofrequency in the treatment of sacroiliac joint pain. MethodProspective, randomised and experimental study conducted on 60 patients selected in the two hospitals over a period of nine months, who had intense sacroiliac joint pain (Visual Analogue Scale [VAS]>6) that lasted more than 3months. Patients were randomised into three groups (n=20): GroupA (two intra-articular sacroiliac injections of local anaesthetic/corticosteroid guided by ultrasound in 7days). GroupB: conventional bipolar radiofrequency «palisade». Target points were the lateral branch nerves of S1, S2, and S3, distance needles 1cm. GroupC: modified bipolar radiofrequency «palisade» (needle distance >1cm). Patients were evaluated at one month, three months, and one year. Demographic data, VAS reduction, and side effects of the techniques were assessed. ResultsOne month after the treatment, pain reduction was >50% in the three groups P<.001. Three and 12months after the technique, the patients of the groupA did not have a significant reduction in pain. At 3 months, almost 50% patients of the groupB referred to improvement of the pain (P=.03), and <25% at 12months, and those results were statistically significant (P=.01) compared to the baseline. GroupC showed an improvement of 50% at 3 and 12months (P<.001). All patients completed the study. ConclusionsBipolar radiofrequency «palisade», especially when the distance between the needles was increased, was more effective and lasted longer, compared to join block and steroids, in relieving pain sacroiliac joint.

Effect of a physical training program based on the development sequence on postural balance in soccer players: randomized controlled trial

Database (PEDro) was conducted from inception to 3rd March 2014. Citation tracking and hand search of relevant manual therapy journals were also explored. Two independent reviewers identified studies for inclusion by screening titles, abstracts, and full text. Randomized controlled trials diagnosing sacroiliac joint pain using International association of study of pain (IASP) diagnostic criteria and manipulation performed only on sacroiliac joint, assessing pain and function were included. The studies were assessed for methodological quality using PEDro scale and the risk of bias using Cochrane risk of bias tool. The overall quality of evidence was evaluated according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) domains. Results: Only one study met the inclusion criteria out of 1414 articles. The included study scored 3 out of 10 in PEDro scale indicating poor quality and all the domains to assess the risk of bias resulted in high risk. Overall, very low quality of evidence (GRADE) was identified due to various methodological flaws. Due to paucity of literature, meta-analysis was precluded. Conclusion(s): The findings of this review draws inconclusive evidence on the effectiveness of isolatedmanipulation on sacroiliac joint symptoms.This impression justify the need of high quality randomised controlled trials to investigate the effectiveness of manipulation on sacroiliac joint pain. Implications: The results of this current review deemed to be inconclusive in recommending manipulation for the treatment of sacroiliac joint pain. However, the implication may change when new evidence emerges.

Is manipulation effective in the treatment of sacroiliac joint pain and function?—a systematic review

Is manipulation effective in the treatment of sacroiliac joint pain and function?—a systematic review

Technical Note: Treatment of Sacroiliac Joint Pain with Peripheral Nerve Stimulation

Sacroiliac joint (SIJ) pain affects older adults with a prevalence of up to 20% among patients with chronic low back pain. While pain medication, joint blocks and denervation procedures achieve pain relief in most patients, some cases fail to improve. Our goal was to determine the effectiveness of SIJ peripheral nerve stimulation in patients with severe conservative therapy-refractory SIJ pain. Here we present 12 patients with severe conservative therapy-refractory pain receiving an SIJ peripheral nerve stimulation. Patient satisfaction, pain, and quality of life were evaluated by means of the International Patient Satisfaction Index (IPSI), visual analog scale (VAS), and Oswestry Disability Index 2.0 (ODI) using standard questionnaires. For stimulation we placed an eight-pole peripheral nerve electrode parallel to the SIJ. Two weeks postoperatively, our patients reported an average ODI reduction from 57% to 32% and VAS from 9 to 2.1. IPSI was 1.1. After six months, the therapy was rated as effective in seven out of eight patients reporting at that period. The average ODI was low at 34% (p = 0.0006), while the VAS index rose to 3.8 (p < 0.0001) and IPSI to 1.9. Twelve months after stimulation, six out of seven patients considered their treatment a success with an average ODI of 21% (p < 0.0005), VAS 1.7 (p < 0.0001), and IPSI 1.3. We conclude that SIJ stimulation is a promising therapeutic strategy in the treatment of intractable SIJ pain. Further studies are required to determine the precise target group and long-term effect of this novel treatment method.

Interventional Treatments for Sacroiliac Joint Pain

Sacroiliac joint pain is a common cause of low back pain and can be a diagnostic challenge. Interventional treatment may be considered after patients fail conservative/noninterventional treatments. This article provides a review of current interventional procedures for the treatment of sacroiliac joint pain including sacroiliac joint injection, noncorticosteroid injection and radiofrequency ablation.

Cooled radiofrequency denervation for treatment of sacroiliac joint pain: two-year results from 20 cases

BackgroundSacroiliac joint pain is a common cause of chronic low back pain. Different techniques for radiofrequency denervation of the sacroiliac joint have been used to treat this condition. However, results have been inconsistent because the variable sensory supply to the sacroiliac joint is difficult to disrupt completely using conventional radiofrequency. Cooled radiofrequency is a novel technique that uses internally cooled radiofrequency probes to enlarge lesion size, thereby increasing the chance of completely denervating the sacroiliac joint. The objective of this study was to evaluate the efficacy of cooled radiofrequency denervation using the SInergy™ cooled radiofrequency system for sacroiliac joint pain.MethodsThe charts of 20 patients with chronic sacroiliac joint pain who had undergone denervation using the SInergy™ cooled radiofrequency system were reviewed at two years following the procedure. Outcome measures included the Numeric Rating Scale for pain intensity, Patient Global Impression of Change, and Global Perceived Effect for patient satisfaction.ResultsFifteen of 20 patients showed a significant reduction in pain (a decrease of at least three points on the Numeric Rating Scale). Mean Numeric Rating Scale for pain decreased from 7.4 ± 1.4 to 3.1 ± 2.5, mean Patient Global Impression of Change was “improved” (1.4 ± 1.5), and Global Perceived Effect was reported to be positive in 16 patients at two years following the procedure.ConclusionCooled radiofrequency denervation showed long-term efficacy for up to two years in the treatment of sacroiliac joint pain.

The percutaneous stabilisation of the sacroiliac joint with hollow modular anchorage screws: a prospective outcome study

The use of percutaneous iliosacral screw fixation as a treatment of sacroiliac joint pain has been reported to be successful. This study was a prospective single surgeon series to evaluate the short-term outcomes of patients who underwent percutaneous sacroiliac joint stabilisation. Between July 2004 and February 2011, 73 patients underwent percutaneous sacroiliac joint fusion in our unit. All patients completed a short form (SF)-36 questionnaire, visual analogue pain score and Majeed scoring questionnaire prior to treatment and at last follow-up. 55 patients (9 male and 46 female) completed follow-up. The average follow-up period was for 36.18 months (range 12-84). The mean preoperative SF-36 scores were 26.59 for physical health and 40.38 for mental health. The mean postoperative SF-36 scores were 42.93 for physical health and 52.77 for mental health. The mean visual analogue pain scores were 8.1 preoperative and 4.5 postoperative. The mean pelvic specific scoring were 36.9 preoperative and 64.78 postoperative. We noted that patients who had previous instrumented spinal surgery did significantly worse than those who had not. We had two nerve root-related complications. We conclude that in selected patient group who respond positively to CT-guided injection, a percutaneous SI joint stabilisation is beneficial in effecting pain relief and functional improvement.

Diagnosis and treatment of sacroiliac joint pain

Diagnosis and treatment of sacroiliac joint pain

Cooled radiofrequency application for treatment of sacroiliac joint pain

The unavailability of an effective and long-lasting treatment for sacroiliac-based pain has led researchers to study the efficacy of radiofrequency in denervation. In this study, we aimed to investigate the efficacy and safety of novel cooled radiofrequency application for sacral lateral-branch denervation. Patients experiencing chronic sacroiliac pain were selected for our observational study. Fluoroscopy guidance cooled radiofrequency denervation was applied on the L5 dorsal ramus and the S1-3 lateral branches on patients who had twice undergone consecutive joint blockages to confirm the diagnosis and obtained at least 75% pain relief. At the 1st, 3rd and 6th month postoperatively, the patients' pain was evaluated using a visual analog scale (VAS), and their physical function was evaluated with the Oswestry Disability Index (ODI). Cooled radiofrequency was applied on a total of 15 patients. Prior to the procedures, the median VAS score (interquartile range) was 8 (7-9), but at the 1st, 3rd and 6th month, this had fallen to 3 (1-4), 2 (1-3) and 3 (2-4). The baseline median ODI score (interquartile range) was 36 (32-38), while at the 1st, 3rd and 6th month, it was 16 (8-20), 12 (9-18) and 14 (10-20), respectively. At the final control, while 80% of the patients reported at least a 50% decline in pain scores, 86.7% of those reported at least a ten-point reduction in ODI scores. It was seen that the cooled radiofrequency used for sacroiliac denervation was an effective and safe method in the short to intermediate term.

13. Sacroiliac Joint Pain

The sacroiliac joint accounts for approximately 16% to 30% of cases of chronic mechanical low back pain. Pain originating in the sacroiliac joint is predominantly perceived in the gluteal region, although pain is often referred into the lower and upper lumbar region, groin, abdomen, and/ or lower limb(s). Because sacroiliac joint pain is difficult to distinguish from other forms of low back pain based on history, different provocative maneuvers have been advocated. Individually, they have weak predictive value, but combined batteries of tests can help ascertain a diagnosis. Radiological imaging is important to exclude "red flags" but contributes little in the diagnosis. Diagnostic blocks are the diagnostic gold standard but must be interpreted with caution, because false-positive as well as false-negative results occur frequently. Treatment of sacroiliac joint pain is best performed in the context of a multidisciplinary approach. Conservative treatments address the underlying causes (posture and gait disturbances) and consist of exercise therapy and manipulation. Intra-articular sacroiliac joint infiltrations with local anesthetic and corticosteroids hold the highest evidence rating (1 B+). If the latter fail or produce only short-term effects, cooled radiofrequency treatment of the lateral branches of S1 to S3 (S4) is recommended (2 B+) if available. When this procedure cannot be used, (pulsed) radiofrequency procedures targeted at L5 dorsal ramus and lateral branches of S1 to S3 may be considered (2 C+).

Clinical Effectiveness of Botulinum Toxin A Compared to a Mixture of Steroid and Local Anesthetics as a Treatment for Sacroiliac Joint Pain

The sacroiliac joint (SIJ) is one of the sources of low back pain and referred pain to the lower limb. Steroid injections have been used to treat SIJ pain, but this frequently necessitates repeated injections. Botulinum toxin (BT) type A has been shown to provide significant reduction of joint pain, and functional improvements. This study investigated the efficacy of BT for reducing SIJ pain and maintaining a clinical effect, compared with steroid injections. Prospective case control study. Spine hospital. Patients who were diagnosed with SIJ syndrome based on physical examination and diagnostic SIJ injection were selected. Either Dysport (BT group) or a mixture of triamcinolone and lidocaine (triamcinolone and local anesthetics [TA] group) was injected into the posterior sacroiliac ligaments under C-arm fluoroscopy. Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) were used for evaluation at pretreatment, 1 month, 2 months, and 3 months after treatment. At 1 month, the BT and TA group showed no significant differences in NRS or ODI. However, at 2 and 3 months, the BT group had significantly lower scores in NRS and ODI than did the TA group. BT shows clinical usefulness in pain reduction and for functional improvement in patients with SIJ pain. This effect was maintained for 3 months following the injection, by which time the effects of TA had diminished.