Make Pain a Thing of the Past – sacroiliac joint injection – Physician Partners of America

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The controversial DSUVIA painkiller is poised to upend the opiate market. Reportedly, 500 times more potent than morphine, DSUVIA is formulated to dissolve instantly, allowing it to act more quickly than other opioids. It was recently approved by the FDA despite reservations.

Acelrx, the company behind DSUVIA, believes that this drug represents an “important non-invasive acute pain management option.” Others are somewhat skeptical of the new drug.

“I find it truly surprising that in the midst of this nation-wide opioid problem, a new product is being considered for release that appears to be the ideal formulation for abuse of a very high potency narcotic with very little obvious clinical indication,” said Christopher Creighton, M.D., Physician Partners of America pain specialist in Richardson, Texas. He weighed in a few days before the FDA’s decision on DSUVIA.

Last year, the FDA rejected the drug’s approval. There were concerns that the drug could be administered improperly if it wound up in the wrong hands. This year guidelines have been included that require the drug to be administered only by trained healthcare professionals.

In the midst of the current opioid epidemic, lawmakers have serious concerns about the potential for misuse. Sen. Edward Markey (D-Mass.) believes that the FDA’s consideration of this new drug “makes no sense.” In a statement, Markey noted, “Even in the midst of the worst drug crisis our nation has ever seen, the FDA once again is going out of its way to approve a new super-charged painkiller that would only worsen the opioid epidemic.”

Pain management expert  and Chief Medical Officer with Physician Partners of America Abraham Rivera, M.D. echoes these concerns. He points out that DSUVIA is not a new drug. “It’s actually an oral formulation of Sufentanil. This drug was invented in the late 1950’s… It’s a ‘cousin’ drug to Fentanyl, Alfentanyl, Remifentanil, Carfentanyl, and a few others.”

When asked about the effectiveness of the drug as a pain management treatment, Rivera readily admits that it is extremely potent. However, he goes on to say, “In my opinion, it brings very little to the armamentarium of a pain management practitioner. It has a serious potential for abuse and misuse.”

Physician Partners of America has long focused on interventional pain management techniques that do not rely on opioids as a primary course of treatment.

Like Senator Edward Markey and others in the healthcare and political arenas who have seen firsthand the devastating effects opioid addiction has had on the community, Drs. Creighton and Rivera worry that people who want to abuse DSUVIA painkiller will find creative ways to accomplish their goals — regardless of the safety precautions the medical community or pharmaceutical companies put in place.

This is especially worrisome considering the potency of the drug. Dr. Rivera states: “This particular drug packs such a punch that I am afraid the recreational street chemists will get their numbers wrong and write their mistakes on gravestones.”

Non-oral forms of the DSUVIA painkiller are already being used in the operating room as an adjuvant anesthetic. In this setting, it has excellent cardiovascular stability at high doses, Rivera says.

He summed up his feelings about introducing DSUVIA to the market like this: “Taking this drug out of the operating room and putting it in an oral formulation reminds me of the making of small nuclear weapons. In times of conflict, some people thought that it would be a good idea. Drop a small nuke here and there and save money on bullets. Good thing somebody disagreed.”


Sacroiliac joint injections are used to treat dysfunction of the sacroiliac, or SI, joint, located at the bottom of the spine, just above the tailbone. This joint has a large of responsibility. Not only does it absorb shock for the lower back, but it also connects the sacrum with the pelvis and helps to transmit movement to the pelvis and legs. Due to this constant stress, it is not uncommon for SI joint pain to develop as a result of osteoarthritis, overexertion, or long periods of immobility, as may occur if someone sits for long periods of time at a desk for work.

SI joint dysfunction symptoms can often mimic other symptoms that affect the lower back, such as sciatica or a herniated disc:

  • Dull or throbbing pain in the lower back
  • Radiating pain that moves down the buttocks and legs
  • Weakness in the lower back or legs

Before considering sacroiliac joint injections as a treatment option, it is extremely important for a doctor to accurately diagnosis the condition and make sure another degenerative spine condition or injury isn’t causing your back pain. An SI joint injection may initially be used for diagnostic purposes so that your doctor can pinpoint the source of your discomfort.

How Sacroiliac Joint Injections Work

A sacroiliac joint injection also called a sacroiliac joint block, involves a special type of X-ray called a fluoroscope to help the doctor guide the needle into the correct location in the joint. A numbing anesthetic such as lidocaine is usually injected into the joint. If this stops the pain, the doctor can confirm that the SI joint is the culprit. A steroid solution is also injected into the joint to reduce inflammation and pain.

The local anesthetic can help to relieve pain immediately but will wear off within a few hours. It is the slow-release steroid that can provide longer-lasting pain relief. The steroid begins to work within a few days of receiving the injections. Depending on the severity of your condition, your doctor may recommend sacroiliac joint injections every few months.

Sacroiliac Joint Injections in Florida and Texas

If you’re looking for pain relief specialists with extensive experience administering sacroiliac joint injections, turn to the experts at Physician Partners of America. Our pain clinics offer a compassionate, supportive environment where we will take the time to ask questions about your pain and learn what treatments you’ve already tried. Using this information, we can then formulate a targeted pain relief plan.

We know that SI joint pain can affect everything you do. You may feel like this chronic discomfort has put your life on hold. At Physician Partners of America, our goal is to become your partner for long-term pain management and healing. Contact us today to schedule an appointment.