What is SI joint denervation?
Pain around the sacroiliac region can arise from the joint itself or from the ligaments and tissues behind it. Selected nerve branches carry signals from this posterior SI joint complex. Denervation interrupts some of those signals without fusing the joint.
In an endoscopic procedure, the surgeon uses a small camera and instruments to reach the planned nerve targets. Percutaneous radiofrequency treatment is another way of treating selected lateral branches. The available evidence, risks and reasons for recommending one technique should be discussed for the particular case.
Why diagnosis matters
SI-region pain can resemble pain from the lumbar spine or hip. Diagnosis starts with the symptom pattern and physical examination, supported by imaging where appropriate. Image-guided diagnostic blocks may then test the suspected target. Relief from an injection into the joint does not necessarily predict the response to treatment of the posterior lateral branches, because the targets are not identical.
Benefits and limitations
The aim is to reduce pain enough to support activity and rehabilitation. It does not correct instability or fuse the joint, the effect may be temporary, and some patients do not improve. Fusion is a separate treatment for selected cases rather than the automatic next step after denervation.
Risks and recovery
Possible risks include infection, bleeding, temporary pain flare, numbness or altered sensation, nerve irritation, injury to nearby structures and incomplete or temporary relief. Activity is reintroduced according to the access used, the response after treatment and the rehabilitation plan.
How we approach your care
- 01
Find the true source
We begin with a thorough history and examination, supported by imaging where appropriate, to pinpoint the precise source of the problem.
- 02
Consider appropriate options
Where clinically appropriate, we consider established non-surgical options before surgery. The plan depends on the diagnosis, symptoms, health and priorities of the individual patient.
- 03
A plan built around you
Every step is explained clearly, so you always understand your options and what comes next.
This may help if
- Pain is centred around the sacroiliac region and the examination supports the posterior SI joint complex as a likely source
- Appropriate diagnostic blocks have produced meaningful temporary relief
- Non-surgical treatment has not provided adequate control and the treatment target has been clearly explained
Suitability can only be assessed after reviewing your symptoms, examination, relevant imaging and previous treatment.
Common questions
How is the pain source confirmed?
History, examination and imaging are considered together. Image-guided diagnostic blocks may then test the structures or nerve branches thought to be carrying the pain. An injection into the SI joint and a lateral-branch block are different tests and may answer different questions.
Is denervation the same as SI joint fusion?
No. Denervation treats selected pain-carrying nerve branches without joining the joint. Fusion places implants across the joint to reduce movement and promote bone growth. They have different indications, and one is not automatically a required step before the other.
Can the pain return?
Yes. Nerves can recover or regrow, and the original pain source may persist or change. Some people obtain temporary or incomplete benefit, and some do not improve.
What are the risks?
Possible risks include infection, bleeding, temporary pain flare, numbness or altered sensation, nerve irritation and incomplete or temporary relief. The clinician should explain the endoscopic technique being proposed and reasonable alternatives, including percutaneous radiofrequency treatment where appropriate.