Sacroiliac joint pain treatment

Marc Darrow, MDMarc Darrow, MD

In this article, Marc Darrow, MD explains Prolotherapy, Platelet rich Plasma Therapy, and Stem Cell Therapy uses for Sacroiliac joint pain treatment

One of the most common causes of low back pain that we see in patients in our office is the pain caused by the sacroiliac joint (SI).

A typical patient will come in after visiting a physician who prescribed NSAIDS, pain medications, or provided a cortisone injection. They may have also visited a chiropractor, a physical therapist,and a massage therapist. All obviously with limited results.

Herniation between the L5 and S1 vertebrae

Those who come with an MRI will usually provide a film showing a herniation between the L5 and S1 vertebrae and a prognosis of impending surgery.But is it the joint itself causing the pain? In one medical study, the sacroiliac joint was shown to be a source of pain in 10% to 27% in patients with chronic low back pain. –1–

Sacroiliac joint pain treatment

If it is not the disc causing pain, what is? Many times it is the ligaments and tendons. The sacrum, is a triangular shaped bone at the bottom of your spine. It fuses between the iliac bones, your “right and left hips,” to complete the pelvis. Holding this boney structure together is a network of ligaments and tendons. When these ligaments and tendons become weakened or lax, one of the most common causes of low back pain occurs.

Subluxation or a slipping of the sacroiliac joint.

Ligaments and tendons are weakened by age, overuse syndrome, or injury. In the sacroiliac joint, because it supports the torso and has large nerves running through it all the way to the feet, these injuries to the sacroiliac ligaments can mimic other injuries such as disc herniation and lead to an incorrect diagnosis which could lead to an unnecessary lower back surgery.

In many Prolotherapy practices, Stem Cell Therapy, Prolotherapy and Platelet Rich Plasma (PRP) therapy are used. (See the video above) They work by strengthening the connective tissue that holds the pelvic, groin, hip region together. Research into PRP and stem cell therapy is ongoing as these treatments are a newer method of treating SI pain. Prolotherapy however has already been documented in the literature as providing positive effects in 76% of patients. –2– Further, Intra-articular prolotherapy provided significant relief of sacroiliac joint pain, and its effects lasted longer than those of steroid injections.–3–

Prolotherapy research for Sacroiliac joint pain treatment

1. Rupert MP, Lee M, Manchikanti L, Datta S, Cohen SP. Evaluation of sacroiliac joint interventions: a systematic appraisal of the literature. Pain Physician. 2009 Mar-Apr;12(2):399-418.

2.Cusi M; Saunders J; Hungerford B; Wisbey-Roth T; Lucas P; Wilson S. The use of prolotherapy in the sacroiliac joint. Br J Sports Med 2010;44: 100-104.

3.Kim WM, Lee HG, Jeong CW, Kim CM, Yoon MH. J Altern Complement Med. 2010 Dec;16(12):1285-90.A randomized controlled trial of intra-articular prolotherapy versus steroid injection for sacroiliac joint pain.