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Most of us in the UK will have lower back pain at some point in our lives. 

While clinicians are very good at treating lower back pain caused by the spine or muscles, there is a lack of understanding of how pain can be caused by the sacroiliac (SI) joint.

Now spinal surgeons at The Royal Orthopaedic Hospital are helping to highlight the importance of the SI joint in lower back pain and the treatment options available to patients.

The iFuse treatement

A treatment called iFuse (which has been approved by NICE), has been found to be 90% effective for patients with chronic, severe SI joint pain. It is minimally invasive and can replace steroid injections

This is the first time that a minimally invasive surgical implant to treat the debilitating pain caused by chronic SI joint problems has been approved for routine use in the NHS.

NICE estimates that 33% of the adult population of England has lower back pain; of whom 22% (646,000 people) have pain due specifically to SI Joint problems, yet according to NICE’s own estimates, only a tiny proportion of patients receive treatment for their condition, due to lack of awareness among the public and poor rates of diagnosis by clinicians.

NICE acknowledged the iFuse Implant System has unique benefits, including the improvement of quality of life for over 90% of patients presenting with prolonged, severe pain due to problems specifically with their SI joint, which lies at the bottom of the spine where it joins to the pelvis. The iFuse Implant is a triangular, titanium peg, which has a rough surface allowing new bone to grow on to it; to fuse the joint so it stops joint motion and associated pain.

Getting treatment

The iFuse treatment is available at The Royal Orthopaedic Hospital. You can find out more about whether this treatment could help you by reading this SI joint information leaflet. You can also view symptoms here.

Because the pain caused by the SI joint is not well understood, you can support your GP or clinician in their diagnosis by reading about questions to ask your GP or clinician

Patient story - Leigh

Leigh underwent the iFuse procedure in September of 2008. Soon after her surgery she felt the deep SI joint pain slowly dissipate, and within three months, Leigh had returned to her work at the hospital resuming her normal duties.

Patient story - Larry

In the years that followed his back injury, Larry underwent several lumbar surgeries and many conservative therapy treatments. Outside of the SI joint injections, nothing else relieved his SI joint pain for more than a couple of days.

Patient story - Ananda


Ananda was born with spondylolisthesis, a condition that allowed one of her lumbar vertebra to slip forward on top of the vertebra below. The SI joint pain came on so suddenly, she had to withdraw from college classes because she could no longer climb stairs.