COMPARISON OF ANALGESIC EFFICACY OF INTRA-ARTICULAR & PERI-ARTICULAR SACRO-ILIAC JOINT INJECTION IN PATIENTS WITH SACRO-ILIAC JOINT PAIN SYNDROME
Sacro-Iliac Joint Pain Syndrome
Keywords:Analgesic efficacy,, Intra-articular,, Peri-articular, Sacroiliac joint
Objective: To compare the analgesic efficacy of intra-articular vs peri-articular sacroiliac joint (SIJ) injection in patients with sacroiliac joint pain syndrome.
Study Design: Prospective, randomized control trial.
Place and Duration of study: The study was conducted at the department of Pain Medicine, Combined Military Hospital (CMH) Rawalpindi, from Jul 2015 to Jun 2016.
Material and Methods: Forty eight patients of sacroiliac joint (SIJ) pain syndrome were randomly assigned into two equal groups. Group A (n=24) received intra articular SIJ injection of local anesthetic with steroid (Triamcinol one 40mg) under fluoroscopic guidance (drug volume 2.5) and group B (n=24) received Periarticular SIJ injection of local anesthetic with steroid (Triamcinolone 40mg) using land mark technique (drug volume 10ml). Pain score was assessed at 0 (Preprocedural baseline), 4, 8, and 12 week intervals after intervention by using numerical rating scale (NRS).
Results: Mean NRS pain score of group A was 7.5 ± 0.99 and 3.1 ± 1.6 at 0 and 12 week respectively. Mean NRS pain score of group B was 7 ± 1.10 and 5.55 ± 1.0 at 0 and 12 week respectively. A p-value <0.05 at 12 week between group A vs group B. There was a reduction in mean pain score from baseline to 12 week in both the groups but this reduction in mean pain score was statistically significant in group A as compared to group B.
Conclusion: Pain relief score was found to be statistically significant in fluoroscopic guided intra-articular technique as compared to peri-articular landmark technique for sacroiliac joint pain syndrome at 12 weeks post procedure.