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SACRO-ILIAC JOINT DYSFUNCTION, BACK PAIN AND RTA: HAVE WE MET BEFORE?



Abstract

Multiple treatments of Sacro-iliac joint (SIJ) dysfunction have been adopted by various disciplines that treat low back pain. The aim of this audit is to evaluate the effect of steroids and Local anaesthetic injection (LA) in the management of SIJ dysfunction and to determine the relation between road traffic accident and low back pain (LBP).

We retrospectively reviewed 31 patients who were diagnosed as having SIJ dysfunction. All patients had steroids and LA injection under x-ray control. Based on previous history of road traffic accident patients were divided into RTA and non-RTA group. Through a postal questionnaire the severity of LBP and leg pain (pre and post injection) were assessed using visual analogue scale (VAS). Functional level was evaluated through the Oswestery disability Index (ODI).

All patients showed improvements in LBP and leg pain post injection with mean improvement in VAS of 2.95 (SD 3.0, p-value < .0001) for LBP and mean improvement of 3.3 (SD 3.3, p-value < 0.001) for leg pain. Similarly the ODI showed mean improvement of 15.0 (SD 17.0, p-value < 0.0001). Patients in the RTA group showed greater improvement than the non RTA group, however this did not reach statistical significance.

We conclude that steroids and LA injection is an effective method in management of SIJ dysfunction. Also our study suggests that RTA can be a potential cause of back pain by causing SIJ dysfunction. We accept that our sample size is small and needed to be confirmed through a prospective randomised controlled trial which is currently taking place in our institution.

Correspondence should be addressed to Mr J. O’Dowd, Honorary Secretary at SBPR c/o BOA, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE.