Focus of Report: The focus of this Health Technology Assessment is to evaluate the effectiveness and safety of sacroiliac joint (SIJ) corticosteroid injection compared with alternative therapies to treat SIJ pain and low back pain (LBP) in adults.

Technology Description: Corticosteroid injection into the SIJ is a procedure that typically involves image-guided injection of a mixture of local anesthetic and a corticosteroid into the SIJs Treatment with SIJ corticosteroid injection is thought to relieve SIJ pain and LBP, inflammation, and swelling by causing immunosuppression.

Controversy: Although SIJ corticosteroid injection is used for diagnostic and therapeutic purposes in patients with SIJ pain with LBP or radiculopathy, uncertainties remain because of lack of standardized patient selection and treatment protocols (including dosing parameters, type of corticosteroid, and treatment intervals), assessment intervals, and effectiveness assessment methodology and a paucity of guidelines that recommend its use. Furthermore, the duration of the effects of SIJ corticosteroid injection is unclear.

Key Questions:

  • Is SIJ corticosteroid injection effective for improving pain, function, and other symptoms in adults with SIJ and associated LBP?

  • How does SIJ corticosteroid injection compare with alternative therapies for LBP associated with the SIJ?

  • Is SIJ corticosteroid injection in adults with chronic SIJ pain and LBP safe?

  • Have definitive patient selection criteria been identified for SIJ corticosteroid injection for chronic SIJ pain and associated LBP?

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