Sacroiliac Joint Interventions for Pain Management

Covers diagnostic and therapeutic image‑guided (fluoroscopy or CT) intra‑articular sacroiliac joint (SIJ) injections, including corticosteroid administration, for evaluation and short‑term relief of SIJ pain/dysfunction. Applicable to patients with somatic/nonradicular low back or lower‑extremity pain below L5 that interferes with ADLs (typically ≥3 months), positive SIJ provocation tests and SIJ tenderness, documented failure of conservative care (e.g., 4–6 weeks of manual/physical therapy or home exercise and an NSAID trial or contraindication), and required objective baseline/function and documented response to diagnostic injection before repeat treatments. Major limits/requirements: physician‑performed, image‑guided procedures; generally no more than four therapeutic SIJ injections per rolling 12 months and only one invasive pain procedure per visit; continuation beyond 12 months requires additional justification, and SIJ nerve blocks and radiofrequency neurotomy are considered not medically necessary/insufficient evidence.