Comparison of the intra-articular injection versus quadruple injection at the joint surface in the treatment of sacroiliac joint pain

Evaluating the efficacy and safety of two methods of intra-articular injection and 4 injections at the joint level in the recovery of sacroiliac joint pain

Clinical trial with two intervention groups, with parallel groups, double-blind, phase 2 on 40 patients, randomized

The place of study is the office of the supervisors and consultants (pain fellowship and endocrinology specialist), in the first group (20 people) intra-articular injection and in the second group (20 people) peri-articular injection (4 specific points around the joint) by a specialist doctor. will be The injected drug is the same in both groups. double blind (patient and researcher). Pain level of patients according to VAS scale (before injection, one hour after injection, one month after injection). Also, side effects are determined after the intervention.

Admission requirements: patients (ASA (American Society of Anesthesiologists) in class I and II, 18 years old and above, referred to the Yazd city pain clinic, who came with complaints of back pain and during clinical examinations, they had a clinical diagnosis of SIJ joint pain. Exclusion conditions: history of any uncontrolled medical disease - history of rheumatological or infectious diseases (RA, brucellosis)

First group: intra-articular injection The second group: injection around the joint (4 specific points around the joint) The drug injected in both groups is the same, which includes a mixture of Hexal brand triamcinolone in the amount of 40 mg plus Myungmoon brand marcaine (bupivacaine) in the amount of 0-25% with a volume of 8cc, and the injection in both groups during the operation and the injection under guidance. Radiology (C-arm) will be performed by a specialist doctor.

pain intensity based on the VAS scale and side effects

The sample size of the study is 40 patients. The first patient who admitted to the office and meets the inclusion criteria will be No. 1 and the 40th patient will be No. 40. In advance, using the https://www.random.org, from the "List Randomizer" section of the website, the numbers 1 to 40 is randomly divided into two groups of 20 (the first twenty patients for the intra-articular injection group and the second 20 patients for the periarticular injection group). Example: Number 5 is in the intra-articular injection group in randomization of numbers 1 to 40, therefore, the fifth patient who meets the inclusion criteria will be in the intra-articular injection group.

The researcher and the patient are unaware of the grouping and what type of injection method (intra-joint or peri-joint) was performed. in such a way that the specialist doctor randomly selects each patient's group and Using the random numbers obtained from the List Randomizer website https://www.random.org, before referring to the operating room, he determines and performs the injection in the operating room without the presence of the researcher.Then 40 patients are given to the researcher to evaluate the severity of pain and complications after the injection.