Management of Sacroiliac Joint Pain: A Comparative Study

Abstract

This study aims to compare the efficacy, safety, and patient satisfaction associated with three different treatment modalities—medical management, sacroiliac joint (SIJ) injections, and radiofrequency ablation (RFT)—in managing chronic SIJ pain. The findings aim to guide clinicians in optimizing treatment approaches for this challenging condition. A retrospective analysis was conducted on 150 patients diagnosed with chronic SIJ pain between 2023 and 2024. Patients were treated with medical management (NSAIDs and physical therapy), fluoroscopy-guided corticosteroid injections, or RFT targeting the lateral branches of sacral nerves. Pain intensity was assessed using the Visual Analog Scale (VAS), functional improvement with the Oswestry Disability Index (ODI), and patient satisfaction via a Likert scale. Safety was evaluated by monitoring adverse events across all modalities. RFT demonstrated superior outcomes, achieving significant pain reduction (VAS score reduction from 7.3 to 3.5), improved functionality (45% improvement in ODI scores), and the highest patient satisfaction (85%). Pain relief lasted up to 12 months with RFT, compared to six months with SIJ injections and three months with medical management. Adverse events were minimal, with transient soreness being the most common. Radiofrequency ablation provides the most effective and durable relief for SIJ pain among the studied modalities, with minimal complications. These results highlight RFT as a valuable option for managing refractory SIJ pain, warranting further investigation into its integration with multimodal treatment approaches. © 2025 Elsevier B.V., All rights reserved.