Background: Sacroiliac joint pain (SIJP) is an important cause of low back pain and seriously affects the patients' quality of life. Therefore, it is urgent to find effective treatment methods.
Objective: To observe the efficacy of intra-articular (IA) conventional radiofrequency (CRF) and pulsed radiofrequency (PRF) treatment of Sacroiliac joint syndrome (SIJS) under computed tomography (CT) guidance.
Study design: Retrospective comparative study.
Setting: Shengjing Hospital of China Medical University.
Patients and methods: Sixty-four patients with SIJS were enrolled in the Pain management. Patients were randomized into two groups: CRF (CRF group, n=32) and PRF (PRF group, n=32). At each observation time, the general condition, visual analog scale (VAS), the total efficiency rate, Oswestry disability index (ODI), and 36-item short-form health survey were followed up.
Results: Compared to the pretreatment value, the VAS and the ODI decreased in both groups after treatment (P<0.05). In the CRF group, the VAS and the ODI decreased significantly at 1 week after treatment (P<0.05); at 6 and 12 months after treatment, the VAS and the ODI were lower than that in the PRF group (P<0.05). The total efficiency rate in the CRF group and PRF group was 56.3% and 31.3%, respectively (P<0.05). After the relief of pain, both groups received different degrees of improvement in the quality of life. Compared to the pretreatment value, physical component summary (PCS) and the mental component summary (MCS) in both groups were increased after treatment (P<0.05); in the CRF group, PCS and MCS increased significantly at 1 week after treatment (P<0.05); and at 6 and 12 months after treatment, PCS and MCS were higher than those in the PRF group (P<0.05).
Conclusion: CT-guided IA PRF and CRF in the treatment of sacroiliac pain are safe and effective. CRF is superior to PRF in the early and late stage. It is recommended for the treatment of SIJP.
A good introduction to a new modality!
This treatment is not available where I live, perhaps for good reason. This small study with no control or sham group suggested a couple of kinds of heat from radiofrequency needles helped hard to diagnose sacroiliac chronic pain. I'm not convinced this is real enough to be newsworthy or relevant, but I'm more aware of the issue now.
This is a very small study done in a non-US health care setting evaluating speciality management of a problem not often managed in primary care.
I am so glad to know that someone, somewhere, is paying attention to SI joint pain. As an internist working in a US "major academic medical center," I can't get anyone to pay attention to SIJP. I diagnosis this, refer to pain management, and yet the patient ends up with a hip replacement or epidural steroid injections that don't help the pain at all. This small study may not prove if conventional versus pulsed radiofrequency is the superior treatment, but it acknowledges that with careful evaluation up to 30% of patients with low back pain may be able to find some relief.