Sacroiliac Joint Prolotherapy

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Please use your clinical judgement and note that this is not necessarily standard practice in NZ.
Needle Location used for injection of the sacroiiac ligaments. Trigger point of ligaments: (IL) Iliolumbar; (LS) Lumbosacral-supra and interspinus; (A,B,C,D,) Posterior sacroiliac; (SS) Sacroapinus; (ST) Sacrotuberus;(SC) Sacrococcygeal;(H) Hip-Articular; (SN) Sciatic nerve (from G.S. Hackett, Ligament and Tendon Relaxation. Charles C. Thomas Co., 1958)

Sacroiliac joint prolotherapy is sometimes used to treat sacroiliac joint pain. Protocols vary for this procedure.

Study Protocols

Cusi et al (RCT): Dorsal interosseous injection, done under CT guidance, for clinically diagnosed source of pain. 22-g spinal needle. 5mL syringe, 1.8mL of 50% dextrose, 2.3mL bupivicaine 1%, 0.8mL iopamidol contrast. 0.8mL injected into the ligament as it moves up and down the ligament. [1]

Kim et al (RCT): Intraarticular injections. 25% dextrose solution, done by diluting 50% dextrose in bupivicaine.[2]

Hoffman et al (Retrospective cohort): 15% dextrose in lidocaine monthly three times.[3]

References

  1. โ†‘ Cusi et al.. The use of prolotherapy in the sacroiliac joint. British journal of sports medicine 2010. 44:100-4. PMID: 18400878. DOI.
  2. โ†‘ Kim et al.. A randomized controlled trial of intra-articular prolotherapy versus steroid injection for sacroiliac joint pain. Journal of alternative and complementary medicine (New York, N.Y.) 2010. 16:1285-90. PMID: 21138388. DOI.
  3. โ†‘ Hoffman & Agnish. Functional outcome from sacroiliac joint prolotherapy in patients with sacroiliac joint instability. Complementary therapies in medicine 2018. 37:64-68. PMID: 29609940. DOI.

Literature Review