Trial Comparing Treatment With SInergy™ System to Conservative Treatment for Chronic Sacroiliac Joint Pain

• Predominantly axial pain below the L5 vertebrae
• >75% pain relief from 2 separate lateral branch blocks done on different days (followed by return to baseline pain)
• Chronic axial pain lasting for longer than six months: 3 day average VAS between 4 and 8.
• Age greater than 18 years.
• Failed to achieve adequate improvement with comprehensive non-operative treatments, including but not limited to: activity alteration, non-steroidal anti-inflammatory, physical and/or manual therapy, and fluoroscopically guided steroid injections in and around the area of pathology.
• All other possible sources of low back pain have been ruled out, including but not limited to: the intervertebral discs, bone fracture, the zygapophyseal joints, the hip joint, symptomatic spondylolisthesis, tumor and other regional soft tissue structures (this is done by physical exam, medical history, and MRI/CT/X-ray as required)

Exclusion Criteria:

• Beck Depression Score >20 or irreversible psychological barriers to recovery
• Spinal pathology that may impede recovery such as spina bifida occulta, spondylolisthesis at L5/S1, or scoliosis.
• Moderate or severe foraminal or central canal stenosis
• Systemic infection or localized infection at anticipated introducer entry site.
• Concomitant cervical or thoracic pain greater than 2/10 on a VAS
• Uncontrolled or acute illness
• Chronic severe conditions such as rheumatoid/inflammatory arthritis
• Pregnancy
• Active radicular pain
• Immunosuppression (eg. AIDS, cancer, diabetes, surgery \<3 months ago)
• Worker's compensation, injury litigation, or disability remuneration
• Allergy to injectants or medications used in procedure
• High narcotics use (>30 mg hydrocodone or equivalent)
• Patients who smoke. Termination for at least 6 months and no smoking during follow up period are acceptable with caution.
• Body Mass Index greater than 29.9 (obese).
• Subject unwilling to consent to the study