Current Diagnostic Practices for Sacroiliac Joint Pain Among Interventional Pain Physicians: Results of an Exploratory Practice Survey

Background: Sacroiliac (SI) joint pain contributes to chronic axial low back pain, but diagnosis remains challenging because no single historical feature, physical examination maneuver, imaging finding, or injection response is universally accepted as definitive. Although guidelines recommend multimodal assessment, less is known about how interventional pain physicians diagnose SI joint pain in real-world practice. Objective: We aim to describe self-reported diagnostic practices for suspected SI joint-mediated pain among interventional pain physicians. Study Design: Exploratory cross-sectional survey. Methods: An anonymous, voluntary SurveyMonkey questionnaire was distributed between 1 January 2026, and 20 June 2026, to physicians practicing interventional pain medicine through academic institutional email distribution, professional contacts, and social media platforms. The present analysis focused on survey items related to physician specialty, practice setting, diagnostic approach, discordance between history and physical examination, use of diagnostic injections, estimated prevalence of SI joint pain, and management when SI joint and lumbar facet pain coexist. Results: Forty-eight physicians initiated the survey, although some respondents skipped individual items; therefore, item-level response totals ranged from 47 to 48. Respondents were predominantly anesthesiologists (72.3%) and most commonly practiced in academic medical centers (58.3%). All incorporated history and physical examination into their primary diagnostic approach, and 62.5% also included diagnostic injection. A single diagnostic injection was reported by 59.6%, whereas 27.7% routinely used two or more. Conclusion: Respondents reported multimodal clinical assessment with variation in diagnostic injection strategies. This small, self-selected sample describes practice patterns and does not establish national consensus, diagnostic standards, or population prevalence.