Sacroiliac Joint Radiofrequency Ablation

What is sacroiliac joint radiofrequency ablation?

 

Sacroiliac joint radiofrequency ablation is a minimally invasive procedure that uses carefully controlled heat to interrupt pain signals carried by the small sensory nerves supplying the sacroiliac joint.

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Unlike a steroid injection, which aims to reduce inflammation inside the joint, radiofrequency ablation treats the nerves transmitting pain. This may provide longer-lasting pain relief for suitable patients.

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The procedure is performed using X-ray guidance to ensure accurate placement of the treatment needles.

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Understanding sacroiliac joint pain

 

The sacroiliac joints are located where the sacrum meets the pelvis.

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Pain arising from these joints is commonly felt:

• Across the lower back

• Over one buttock

• Around the pelvis

• Occasionally into the groin or upper thigh

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Symptoms are often worse with:

• Standing for prolonged periods

• Walking

• Climbing stairs

• Turning in bed

• Getting out of a car

• Sitting for long periods

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Because these symptoms can overlap with problems arising from the lumbar spine or hip, careful diagnosis is essential.

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Who may benefit?

 

Sacroiliac joint radiofrequency ablation may be appropriate if you have:

• Persistent sacroiliac joint pain lasting longer than three months

• Pain confirmed to arise from the SI joint

• Significant but temporary relief following diagnostic or therapeutic SI joint injections

• Persistent pain despite physiotherapy and medication

• Pain limiting work, exercise or daily activities

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Not everyone with lower back pain is suitable for this procedure.

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How do we determine whether I'm suitable?

 

Before recommending radiofrequency ablation, I carry out a comprehensive assessment including:

• A detailed discussion of your symptoms

• Physical examination

• Sacroiliac joint provocation tests

• Review of previous imaging

• Consideration of alternative causes of pain

• Review of your response to previous sacroiliac joint injections

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Patients who have experienced clear but temporary improvement following image-guided sacroiliac joint injections are often the best candidates for radiofrequency treatment.

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What happens during the procedure?

 

The procedure is performed as a day case under local anaesthetic and usually takes 30 to 45 minutes.

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It involves:

1. Lying comfortably on the X-ray table.

2. Cleaning the skin and administering local anaesthetic.

3. Using X-ray guidance to identify the target nerves.

4. Positioning specialised radiofrequency needles accurately.

5. Performing stimulation testing where appropriate.

6. Applying controlled radiofrequency energy.

7. Applying a small dressing before discharge home.

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Most patients return home shortly afterwards.

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Recovery

 

It is common to experience mild soreness around the treatment sites for several days.

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Most patients can:

• Walk immediately after the procedure

• Resume light activities within one or two days

• Gradually return to normal exercise over the following weeks

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Pain relief is usually gradual and often develops over two to six weeks.

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Continuing your physiotherapy and strengthening exercises is recommended to help achieve the best long-term outcome.

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What are the benefits?

 

For carefully selected patients, sacroiliac joint radiofrequency ablation may:

• Reduce lower back and buttock pain

• Improve walking tolerance

• Improve sitting comfort

• Improve sleep

• Improve participation in physiotherapy

• Reduce reliance on pain medication

• Improve quality of life

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The degree and duration of pain relief varies between individuals, and no procedure can guarantee complete relief.

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What are the risks?

 

Sacroiliac joint radiofrequency ablation is generally considered a safe procedure when performed using image guidance.

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Possible risks include:

• Temporary soreness

• Bruising

• Bleeding

• Infection

• Temporary increase in pain

• Temporary numbness around the treatment area

• Failure to improve symptoms

• Very rarely, injury to nearby nerves or blood vessels

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These risks will be discussed fully during your consultation before treatment.

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Frequently Asked Questions

 

How is radiofrequency ablation different from a sacroiliac joint injection?

 

A sacroiliac joint injection places local anaesthetic and corticosteroid into the joint to reduce inflammation and relieve pain.

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Radiofrequency ablation treats the nerves carrying pain signals from the joint and may provide longer-lasting relief in suitable patients.

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Will the procedure cure my arthritis?

 

No.

Radiofrequency ablation does not repair the joint or reverse arthritis. Its aim is to reduce pain and improve function.

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How long does pain relief last?

 

Many patients experience pain relief for up to 18 months. As the treated nerves gradually regenerate, symptoms may return and repeat treatment may be considered if appropriate.

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Can I have the treatment on both sides?

 

Yes.

If both sacroiliac joints are contributing to your pain, treatment can be performed on both sides when clinically appropriate.

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Will I still need physiotherapy?

 

Yes.

Radiofrequency ablation is most effective when combined with an active rehabilitation programme to improve strength, movement and long-term function.

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What happens if the treatment doesn't help?

 

If there is little or no improvement, we will review your diagnosis and consider whether another structure may be responsible for your pain. Alternative treatments may then be recommended.

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Why choose Dr David Crabtree?

 

As a Consultant in Pain Medicine, I specialise in diagnosing and treating persistent spinal and pelvic pain using evidence-based, image-guided techniques.

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Sacroiliac joint pain can be difficult to diagnose because it often overlaps with conditions affecting the lumbar spine, hips and pelvis. My approach is to identify the true source of your pain before recommending any intervention.

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Where sacroiliac joint radiofrequency ablation is appropriate, procedures are performed under X-ray guidance using meticulous technique to maximise precision, safety and the likelihood of achieving meaningful pain relief.

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Ready to explore your treatment options?

 

If persistent pain around your lower back, buttock or pelvis is affecting your quality of life despite physiotherapy, medication or previous injections, a consultation can help determine whether sacroiliac joint radiofrequency ablation is the right treatment for you.

 

Together, we'll identify the source of your pain and develop a personalised treatment plan aimed at helping you move more comfortably and return to the activities that matter most.