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Sacroiliac joint treatments
New research is out in the medical journal Pain Physician about sacroiliac joint interventions. Here is what they say: “The contribution of the sacroiliac joint to low back and lower extremity pain has been a subject of debate with extensive research. It is generally accepted that approximately 10% to 25% of patients with persistent low back pain may have pain arising from the sacroiliac joints. In spite of this, there are currently no definite conservative, interventional, or surgical management options for managing sacroiliac joint pain.”1
So their review of the medical literature regarding sacroiliac pain treatment is as follows:
- The evidence for cooled radiofrequency neurotomy in managing sacroiliac joint pain is fair.
- The evidence for effectiveness of intraarticular steroid injections is poor.
- The evidence for periarticular injections of local anesthetic and steroid or botulinum toxin is poor.
- The evidence for effectiveness of conventional radiofrequency neurotomy is poor.
- The evidence for pulsed radiofrequency is poor.
A lot of poor results. There is, however, one conservative treatment that shows excellent results in resolving low back pain: Prolotherapy.
Evidence for Prolotherapy Use with Sacroiliac Pain
Here is what we reported on our findings if 145 patients with unresolved lower back pain in the Journal of Prolotherapy:
“One hundred forty-five patients, who had been in pain an average of four years and ten months, were treated quarterly with Hackett-Hemwall dextrose Prolotherapy. This included a subset of 55 patients who were told by their medical doctor(s) that there were no other treatment options for their pain and a subset of 26 patients who were told by their doctor(s) that surgery was their only option. Patients were contacted an average of 12 months following their last Prolotherapy session and asked questions regarding their levels of pain, physical and psychological symptoms and activities of daily living, before and after their last Prolotherapy treatment.”
Here are some of the results from these 145 low back Prolotherapy patients:
- Pain levels decreased from 5.6 to 2.7 after Prolotherapy
- 89% experienced more than 50% pain relief with Prolotherapy
- More than 80% showed improvements in walking and exercise ability, anxiety, depression and overall disability
- 75% percent were able to completely stop taking pain medications.
The decrease in pain reached statistical significance for the 145 low backs, including the subset of patients who were told there was no other treatment options for their pain and those who were told surgery was their only treatment option.
Conclusion: “In this retrospective study on the use of Hackett-Hemwall dextrose Prolotherapy, patients who presented with over four years of unresolved low back pain were shown to improve their pain, stiffness, range of motion, and quality of life measures even 12 months subsequent to their last Prolotherapy session. This pilot study shows that Prolotherapy is a treatment that should be considered and further studied for people suffering with unresolved low back pain.”2
Other research appearing in the Journal of Alternative and Complementary Medicine stated that “Intra-articular prolotherapy provided significant relief of sacroiliac joint pain, and its effects lasted longer than those of steroid injections”3
Clinical Use of Prolotherapy for Sacroiliac Pain
Prolotherapy is effective in sacroiliac pain because it treats the genesis of the pain. We find it fairly rare for a pinched nerve or a slipped or herniated disc to cause sacroiliac pain. Much more common is a ligament injury which caused ligament laxity or ‘looseness.” Research published in the medial journal Spine, states “ligament laxity in the sacroiliac joint is the number one reason for ‘sciatica’, or pain radiating down the side of the leg, and is one of the most common reasons for chronic low back pain.”4 Our clinical experience has been that if we treat back pain with Prolotherapy, administering injections into the lumbar and sacroiliac ligament attachments that exhibit tenderness, the pain and referred pain diminishes, even when MRI’s showed disc abnormalities. The injections are not given near the discs yet the back pain is completely healed. Why? Because Prolotherapy, through injections that stimulate an inflammatory reaction, works to strengthen the ligaments of the low back, healing the underlying weakness and injury and curing sacroiliac pain.
For more information: stem cell injection therapy.
1. Hansen H, Manchikanti L, Simopoulos TT, et al. A systematic evaluation of the therapeutic effectiveness of sacroiliac joint interventions. Pain Physician. 2012 May;15(3):E247-78.
2. Hauser R, Hauser M, Dextrose Prolotherapy for Unresolved Low Back Pain: A Retrospective Case Series Study. Journal of Prolotherapy. 2009;3:145-155.
3. Kim WM, Lee HG, Jeong CW, Kim CM, Yoon MH. A randomized controlled trial of intra-articular prolotherapy versus steroid injection for sacroiliac joint pain.J Altern Complement Med. 2010 Dec;16(12):1285-90.
4. Schwarzer AC, April CN, Bogduk N. The sacroiliac joint in chronic low back pain. Spine. 1995;20:31-37