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Buchanan P, Lee DW, Comer A, Hussaini Z, Grillo C, Vodapally S, Strand NH, Sayed D, Deer TR. Best Practices for Postoperative Management of Posterior Sacroiliac Joint Fusion. J Pain Res 2022; 15:1149-1162. [PMID: 35469250 PMCID: PMC9034860 DOI: 10.2147/jpr.s357123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
Sacroiliac joint (SIJ) pain is a common cause of low back pain. Traditionally, treatment for SIJ joint pain and dysfunction has consisted of physical therapy, medication management, SIJ injections, and SIJ ablations. Improved recognition of the SIJ as an etiology for back pain has led to advances in treatment options. Radiofrequency of the lateral sacral branches has been shown to be effective, though evidence is fraught with inconsistent patient selection, study design and procedural technique. It also does not directly address the mechanical dysfunction of the SIJ. In order to create a more enduring approach SIJ fusion has become an attractive option to reduce pain and to improve function. This method of SI joint treatment requires guidance in the perioperative phase of care from both the physicians and advanced practice providers (APP). In order to improve care and outcomes of those undergoing posterior SI joint fusion the American Society of Pain and Neuroscience appointed an expert panel of physicians and advanced practice providers to create a best practice for the post operative care of this approach. As with any best practice, the panel considered current peer reviewed literature and clinical expertise to create guidance today. This is intended to be a living document with modifications as additional evidence comes to light in data publication. The goals of this paper are to focus on (1) wound care, (2) medication use, (3) physical activity and (4) therapeutic exercises.
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Affiliation(s)
- Patrick Buchanan
- Department of Pain Medicine, Spanish Hills Interventional Pain Specialists, Camarillo, CA, USA
| | - David W Lee
- Department of Pain Medicine, Fullerton Orthopedic Surgery Medical Group, Fullerton, CA, USA
| | - Ashley Comer
- Department of Pain Medicine, The Spine and Nerve Center of the Virginias, Charleston, WV, USA
| | - Zohra Hussaini
- Department of Anesthesiology, Division of Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Casey Grillo
- Department of Pain Medicine, The Spine & Pain Institute of New York, New York, NY, USA
| | - Shashank Vodapally
- Department of Physical Medicine and Rehabilitation, Michigan State University, East Lansing, MI, USA
| | - Natalie H Strand
- Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Dawood Sayed
- Department of Anesthesiology, Division of Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Timothy R Deer
- Department of Pain Medicine, The Spine and Nerve Center of the Virginias, Charleston, WV, USA
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Prather H, Bonnette M, Hunt D. Nonoperative Treatment Options for Patients With Sacroiliac Joint Pain. Int J Spine Surg 2020; 14:35-40. [PMID: 32123656 DOI: 10.14444/6082] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Sacroiliac joint (SIJ) pain is thought to be a component of low back pain in 20% of people who suffer with it chronically. There is no consistent objective diagnostic testing that includes SIJ pain as the diagnosis and thereby it can become a diagnosis of exclusion. Treatment of SIJ pain is variable, and no set method or protocol of treatment has been found to be efficacious or reliable. Thus, the healthcare provider is often left to create an individual treatment plan based on their own experiences and expertise. The purpose of this narrative review is to describe and discuss nonoperative treatment options for patients with SIJ pain. Further, coordination of treatment options and progression of treatment will be offered.
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Affiliation(s)
- Heidi Prather
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Michael Bonnette
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Devyani Hunt
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri
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