Consensus practice guidelines on sacroiliac joint complex pain from a multispecialty, international working group - Summary - MDSpire

Consensus practice guidelines on sacroiliac joint complex pain from a multispecialty, international working group

  • By

  • Zachary L McCormick

  • Robert W Hurley

  • Magdalena Anitescu

  • Arun Bhaskar

  • Anuj Bhatia

  • Ryan Carter Cassidy

  • Allen S Chen

  • Timothy C Dawson

  • Javier De Andrés Ares

  • José Luiz de Campos

  • Salim M Hayek

  • Berenice Carolina Hernández-Porras

  • Narayan R Kissoon

  • Lynn R Kohan

  • María Francisca Elgueta Le Beuffe

  • Jee Youn Moon

  • David A Provenzano

  • David E Reece

  • Nathaniel M Schuster

  • Clark C Smith

  • Alison Stout

  • Karolina Szadek

  • Donna-Ann Thomas

  • Nuj Tontisirin

  • Michael F Vagg

  • Jan Van Zundert

  • Anna Woodbury

  • Steven P Cohen

  • November 30, 2025

  • 0 min

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Objective:

To develop standardized guidelines for the diagnosis and treatment of sacroiliac joint (SIJ) complex pain, addressing the need for consistency in clinical practice.

Key Findings:
  • Complete consensus was achieved on all 21 questions among committee members, highlighting the collaborative effort.
  • Intra-articular injections are valid for diagnosing SIJ intra-articular pain but not for extra-articular pain, emphasizing the need for accurate diagnostic methods.
  • Evidence supports extra-articular corticosteroid injections for short-term relief, indicating a preferred treatment approach.
  • Strong evidence exists for sacral lateral branch radiofrequency ablation (RFA) providing relief for at least 6 months, suggesting its effectiveness.
  • Minimally invasive SIJ fusion shows weak evidence for benefit in selected patients after conservative therapy failure, necessitating careful patient selection.
Interpretation:

Sacroiliac joint complex pain is a significant contributor to chronic low back pain, necessitating an interdisciplinary and multimodal approach for effective management.

Limitations:
  • Many findings are based on low-quality evidence, highlighting the need for further research in specific areas.
  • Consensus was not achieved on certain recommendations, particularly regarding patient selection criteria for RFA and fusion, indicating differing opinions among societies.
Conclusion:

The guidelines aim to standardize the management of SIJ complex pain, emphasizing the need for improved research, interdisciplinary collaboration, and a comprehensive treatment strategy.

Original Source(s)

Consensus practice guidelines on sacroiliac joint complex pain from a multispecialty, international working group

  • by Zachary L McCormick, Robert W Hurley, Magdalena Anitescu, Arun Bhaskar, Anuj Bhatia, Ryan Carter Cassidy, Allen S Chen, Timothy C Dawson, Javier De Andrés Ares, José Luiz de Campos, Salim M Hayek, Berenice Carolina Hernández-Porras, Narayan R Kissoon, Lynn R Kohan, María Francisca Elgueta Le Beuffe, Jee Youn Moon, David A Provenzano, David E Reece, Nathaniel M Schuster, Clark C Smith, Alison Stout, Karolina Szadek, Donna-Ann Thomas, Nuj Tontisirin, Michael F Vagg, Jan Van Zundert, Anna Woodbury, Steven P Cohen

  • November 30, 2025

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