Ever since my third child was born, I've had constant sacroiliac joint pain. My doctor wants to inject the joint but I'm a little afraid to do this. Is this the right thing to do?

The sacroiliac joint (SI) remains a mystery in many ways. It can be very difficult to tell if pain is coming from the SI or if it is referred from someplace else. For example, problems in either the low back or the hip can cause SI pain.

There can even be SI pain from systemic diseases. Ulcerative colitis, Crohn's disease, and irritable bowel syndrome can cause SI pain. For women, gynecologic conditions such as endometriosis, uterine fibroids, and ovarian cysts can cause SI pain.

The one sure way to find out if pain is coming from the SI joint is by injecting it. The physician injects a combination of steroid (antiinflammatory) and a numbing agent like Novocaine into the joint.

If the problem is coming from someplace else, the injection will have no benefit. But if the cause of your symptoms is truly from the joint, this treatment will give you pain relief. It may be only temporary pain relief. Some people get lasting relief.

Review of the latest research on pain management reports nothing more up-to-date on the evaluation and management of SI pain. This review is conducted every two years by a committee of pain specialists. It is sponsored by the American Society of Interventional Pain Physicians (ASIPP). The 2007 updates are available on-line at www.guidelines.gov. Just type the letters: ASIPP in the search window.

Rose Fox. ASIPP Updates Guidelines on International Techniques for Spinal Pain. In Pain Medicine News. May/June 2007. Vol. 5. No. 3. Pp. 1, 22.



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