SI joint area pain may or may not be actually coming from the SI joint. It may be strictly situated in this area (the buttock) or it may radiate down the leg somewhat. It may be confused with myofascial type pain in the paraspinal muscles, piriformis, or gluteal muscles. Other patient problems that can mimic SI joint pain include intervertebral discs that have tears in the outer portion (annulus), or potentially arthritic and painful facet joints that have pain that radiates into the buttock region.
All of these issues may lead to pain in the same region, therefore, delineating the exact pain cause may take some significant mental consideration. A thorough history and exam of the patient is critical to ruling in or out some of the potential diagnostic sources.
The challenge for SI pain is finding the patients whose history and physical match true symptoms for SI joint pain, and then a diagnosis of SI joint pain can be confirmed by a positive response to an anesthetic intra-articular block.
A significant amount of time more than one anesthetic block will be necessary into the SI joint to definitely rule int the joint as the pain generator. Once this diagnosis occurs, the additional treatment options may begin. At times patients will obtain relief for a while from the anesthetic blocks themselves, or it could just be short term. Should the pain block not work after a while, a radiofrequency neurotomy has been shown to work well. Arizona pain doctors typically debate the exact techniques that are best for the joint.
The sacroiliac joint can be very difficult to enter for an interventional procedure. Fluoroscopic assistance is critical, as the SI joint is irregular and jagged. It may necessitate an unusual angle for entry. Understanding the exact entrance point with this real time x-ray may make the difference between a successful outcome with a satisfied patient versus missing the joint and the individual remaining in pain.
Along with the interventional pain efforts, additional treatment options include NSAIDS, physical therapy, Phoenix chiropractors treatment, spinal traction, and potentially massage and/or acupuncture. It may take several different options including both alternative and traditional medicine to help the patient get better.
No great surgery option for SI pain exists. There is a new fusion procedure for the SI joint, but no long term data exists as to its success. Currently, it seems prudent to avoid fusion and treat the issue with outpatient treatments such as radiofrequency neurotomy.
Preferred Pain Center is a Comprehensive Pain Center including Medical and Interventional Arizona Pain Doctors, Phoenix Chiropractors Treatment, Phoenix Physical Therapy, Spinal Decompression Therapy, and Manipulation Under Anesthesia.
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