Leave Your Pain At The Door: What is a contributor to lower back pain in up to 20-25% of the time?

Share 0 More

Next Blog

Create Blog

Sign In

Leave Your Pain At The Door

A Pain Management Doctor located in NY, focusing on how to live a healthy pain free life in a world that's constantly on the go!

TWITTER UPDATES

TUESDAY, OCTOBER 2, 2012

SHARE IT

Finally signed up for Twitter! about

an hour ago
Follow me on Twitter

Share this on Facebook

What is a contributor to lower back pain in up to 20-25% of the time?

The sacroiliac joints (SIJ) are two large joints between the tail bone (sacrum) and the pelvic bone (ilium). The purpose of the joints is to transmit force from the spine to the pelvis, hips and lower extremities. The SIJ can be a cause or contributor to lower back pain in up to 20-25% of the time. Typically the pain is in the lower back area and can radiate or refer to the buttocks, thighs, hips and groin. Occasionally the pain can reach to below the knee although this is not as common. Many times the pain is indistinguishable from hip pain or pain coming from facet joints (small joints of the spine). The best test for SIJ mediated pain is a good response to SIJ injections since physical exam, imaging and history taking is highly non definitive. The pain tends be worst with sitting, can be caused by trauma (falling on your bottom) and is more common in women. During pregnancy and labor the widening of the pelvis causes stress and even laxity of the SIJs. Not long ago, many experts thought that the looseness of the Sacro-iliac joints contributed to mechanical dysfunction and pain so many providers performed prolotherapy to these joints in which a solution (consisting of sugar and other substances) is injected into the joints in an attempt to scar them down and provide more

Tweet this
View stats
(NEW) Appointment gadget >>

ABOUT ME BLOG ARCHIVE

2012 (7) October (2) What is a contributor to lower back pain in up to ... Leg Pain and Numbness What might these symptoms ... September (1) August (2) May (1) April (1)

Dr. Robert Zhang Dr. Robert Yu-Fan Zhang is an Interventional Pain Management Specialist with extended expertise in treating back pain, head and neck pain, and cancer pain. He is board certified in anesthesiology and fellowship trained in interventional pain management. After graduating from Albert Einstein College of Medicine, he completed his residency at Yale New Haven Hospital and pain management fellowship at University of California of San Francisco Mount Zion Hospital. After practicing as an attending for Kaiser Permanente in California,

http://drrobertzhang.blogspot.com/2012/10/what-is-contributor-to-lower-back-pain.html[10/2/2012 3:46:46 PM]

Leave Your Pain At The Door: What is a contributor to lower back pain in up to 20-25% of the time?

he now serves as the Director of Pain Management at Queens Medical Associates. Dr. Zhang has extensive experience in a variety of interventions including epidurals, facet therapies, nerve blocks, neurolytic procedures, and radiofrequency ablation. View my complete profile

stability. This practice, despite some favorable outcomes, lacked data from clinical studies so insurance companies stopped reimbursing them in many cases. Consequently phototherapy has fallen out of favor in clinical practice. Steroid (cortisone) injections are the most common form of interventional treatments for SIJ pain but as the article suggests the pain relief is often very temporary. Radiofrequency ablation (rfa) is a procedure in which needles that heat up are placed near the nerves that sense the joint. The heat damages or stuns the nerve thus providing pain relief. In the case of facet joint rfa the effect last for 6months to a year (benefits of rfa tends to last slightly less in SIJ area) before the nerves regain their function at which point the rfa procedure can be repeated. The SIJ also has sensory nerves but unlike the facet joint nerves (medial branch nerves) they are numerous and placed diffusely along the edge of the joint. This causes a problem for traditional radiofrequency ablation because the needles produce small discrete lesions making it nearly impossible to cover all the nerves that supply the sij. With newer rfa technology namely being cooled radiofrequency ablation and bipolar rfa (you can ask your pain doctor more about these techniques), which allows for a much larger lesion area, the results of SIJ rfa has been much better than in the past. Of course the data on the on these newer techniques is still sparse and most insurances companies are hard pressed to allow for these newer procedures but none the less these techniques seems promising and as more studies are done on their efficacy and safety, I suspect rfa for sij pain will be used much more often. Dr. Robert Zhang 176-60 Union Turnpike Fresh Meadows, NY 11366 718-460-2300
Posted by Dr. Robert Zhang at 12:46 PM

Recommend this on Google

Reactions:

Informative (0) N d i f (0)

Interesting (0)

http://drrobertzhang.blogspot.com/2012/10/what-is-contributor-to-lower-back-pain.html[10/2/2012 3:46:46 PM]

Leave Your Pain At The Door: What is a contributor to lower back pain in up to 20-25% of the time?

No comments:

Post a Comment

Comment as:
Publish Preview

Select profile... Select profile...

Links to this post

Create a Link Home Subscribe to: Post Comments (Atom) Older Post

Simple template. Powered by Blogger.

http://drrobertzhang.blogspot.com/2012/10/what-is-contributor-to-lower-back-pain.html[10/2/2012 3:46:46 PM]