Periarticular Corticosteroid Treatment of the Sacroiliac Joint
The efficacy of periarticular corticosteroid treatment of the sacroiliac (SI) joint was investigated in patients with chronic low back pain in the region of the SI joint in two double-blind, controlled studies. Twenty consecutive patients with spondylarthropathy (SpA) entered one study and correspondingly the other involved 24 consecutive nonspondylarthropathic patients with chronic pain in the SI joint region. The patients in both studies were randomised to receive a periarticular injection of methylprednisolone and lidocaine or isotonic sodium chloride and lidocaine to one affected SI joint. Clinical assessment at the onset and after the follow-up included the patients estimation of pain in the SI joint region on a visual analogue scale (VAS) and by a pain index calculated from tenderness and stressing tests on the SI joint. For SpA patients the follow-up was 2 months and for non-spondylarthropatic patients 1 month. At the follow-up examination in both studies the VAS and pain index had improved significantly in patients treated with methylprednisolone compared to those receiving isotonic sodium chloride. These results suggest that periarticular injection of methylprednisolone may be effective in the treatment of pain in the region of the SI joint in this kind of patients.
Keywords: Periarticular corticosteroids, sacroiliac joint, spondylarthropathy, low back pain
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