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Enhanced Pain Relief With Ultrasound Guided Combined Submaltifidus and Sacroiliac Joint Injection

T

Tanta University

Status

Not yet enrolling

Conditions

Pain Management

Treatments

Procedure: combined sacroiliac joint injection and sub maltifidous plane block
Procedure: sacroiliac joint injection

Study type

Interventional

Funder types

Other

Identifiers

NCT07137806
Faculty of Medicine, Tanta Uni

Details and patient eligibility

About

Sacroiliitis is not the same as SI joint dysfunction. Sacroiliitis is specific to an inflammatory processes present in the SI joint and the pain sensed is a direct result of those inflammatory processes, whereas sacroiliac joint dysfunction is a condition caused by abnormal motion or slight mispositioning of the SI joint.

Sacroiliac joint syndrome is a condition that is difficult to diagnose and is often overlooked by physicians and physiotherapist

Full description

Treatment of SI joint pain usually involves a multi-pronged approach, utilizing both, multi-modal medical pain control and interventional pain/surgical techniques such as local anesthetic and steroid injections, radiofrequency nerve ablation, and minimally invasive sacroiliac arthrodesis.[7] Sacroiliac (SI) joint injection is a minimally invasive procedure that involves injecting a mixture of local anesthetic and/or corticosteroid medication directly into the SI joint[8] Depending on the mixture of medications used, the duration of pain relief varies but can last anywhere from several days to months[9] Local anesthetic and corticosteroid medications are used to reduce inflammation and provide symptom relief to patients with arthritis, inflammatory conditions, and/or acute injuries[10]

The goal of SI joint injections is to provide enough pain relief to allow the patient to improve their functional status. Participation in physical therapy or exercise is encouraged, which can lead to longer-term improvements in pain and function. The number of SI joint injections required for effective pain relief can vary depending on the patient. [11, 12] Some patients may only require one injection, while others may require several injections. As a general guideline, injections may be administered once every 2 weeks, and no more than 3 injections may be given per year[11, 12] In general, if the first injection provides significant relief, additional injections may be recommended. However, the exact timing can vary based on the doctor's guidance, the patient's response to the treatment, and the type of injection[13] The long-term outcomes of SI joint injections can vary depending on a number of factors, including the underlying cause of the pain, the patient's overall health, the patient's response to the injection, and the type of injection used. Steroid injections may work well for some patients, while others may respond more positively to prolotherapy or PRP therapy[14]

Sacral Multifidus Plane Block(SMPB), a variant of paraspinal plane blocks, has been used for various surgeries in the perineal and buttock region[15]

Enrollment

62 estimated patients

Sex

All

Ages

21+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • patients aged above 21 years, both genders diagnosed with chronic sacroiliac joint pain with a rating on the numeric pain rating scale (NPRS) of at least 5, without radiculopathy lasting 3 months or longer, and lack of medical treatment satisfactory response

Exclusion criteria

Patient refusal. Patients who have any allergies to local anesthetics or have had a reaction to contrast dyes in the past.

Patients who are unable to describe their pain (e.g., language barrier or neuropsychiatric disorder).

Patients with history of bleeding diathesis

Trial design

Primary purpose

Supportive Care

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Double Blind

62 participants in 2 patient groups

ultrasound guided sacroiliac joint injection group
Active Comparator group
Description:
patients included in this group will receive SIJ injection alone.The injectate includes 40 mg of methylprednisolone acetate diluted in 2 mL of bupivacaine 0.25% with epinephrine 1:200,000 (total 3 mL injectate).
Treatment:
Procedure: sacroiliac joint injection
combined ultrasound guide sacroiliac joint injection and submaltifidous plan (combined block group):
Experimental group
Description:
patients included in this group will receive combined SMPB and SIJ injection twenty millilitres of local anaesthetic solution (1:1 mixture of lidocaine 2% and bupivacaine 0.25%) will be injected in the plane between the multifidus muscle (MFM) and the hyperechoic bony area (between the median and intermediate sacral crests)
Treatment:
Procedure: combined sacroiliac joint injection and sub maltifidous plane block

Trial contacts and locations

1

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Central trial contact

Aliaa M Belal, Assistant Professor

Data sourced from clinicaltrials.gov

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