Introduction
The sacroiliac (SI) joints, located where the sacrum (the triangular bone at the base of the spine) meets the iliac bones of the pelvis, play a crucial role in supporting and stabilizing the upper body. Dysfunction or inflammation in these joints can lead to significant pain in the lower back, buttocks, and even legs. When conservative treatments such as physical therapy, medications, or lifestyle modifications fail to provide adequate relief, sacroiliac joint injections may be recommended as a diagnostic and therapeutic tool.
At Endoscopic & Minimally Invasive Spine Specialists, we have extensive experience and expertise in sacroiliac joint injections and provide the highest-quality care in surgical and non-surgical spine care.
To learn more about sacroiliac joint injections and treatments, call the office today or request an appointment online.
This guide provides an in-depth overview of sacroiliac joint injections, including what they are, why they are used, how they work, and what to expect during and after the procedure.
What Are Sacroiliac Joint Injections?
Sacroiliac joint injections are minimally invasive procedures that involve injecting a combination of local anesthetic and corticosteroid medication into or around the sacroiliac joint. These injections serve two main purposes:
1. Diagnostic: To confirm whether the SI joint is the source of the pain by observing if the injection temporarily alleviates symptoms.
2. Therapeutic: To provide pain relief by reducing inflammation in the joint, allowing patients to participate in physical therapy or other rehabilitation programs.
Why Are Sacroiliac Joint Injections Performed?
Sacroiliac joint injections are recommended for patients experiencing chronic lower back or pelvic pain that has not improved with non-invasive treatments. Common conditions and symptoms that may benefit from these injections include:
1. Sacroiliac Joint Dysfunction: Abnormal movement or alignment of the SI joint, leading to pain and inflammation.
2. Sacroiliitis: Inflammation of the SI joint due to arthritis, injury, or infection.
3. Pregnancy-Related SI Pain: Hormonal changes and increased stress on the pelvis during pregnancy can cause SI joint pain.
4. Trauma: Injuries from falls, car accidents, or other impacts can damage the SI joint.
5. Post-Surgical Pain: Pain following lumbar spinal fusion or other spinal surgeries may originate from the SI joint.
How Do Sacroiliac Joint Injections Work?
The therapeutic effects of sacroiliac joint injections come from two components:
1. Local Anesthetic: Provides immediate but temporary pain relief by numbing the joint and surrounding tissues.
2. Corticosteroid: Reduces inflammation within the joint, offering longer-lasting pain relief over days or weeks.
The diagnostic aspect of the injection helps determine if the SI joint is the source of pain. If the patient experiences significant pain relief immediately following the injection, it confirms that the SI joint is involved.
Preparing for the Procedure
Before the Procedure
1. Medical Evaluation: Your doctor will review your medical history, symptoms, and imaging studies (e.g., X-rays, CT scans, or MRIs) to confirm the need for the injection.
2. Medication Review: Inform your doctor of any medications you’re taking, especially blood thinners, as these may need to be paused before the procedure.
3. Fasting: You may be asked to avoid eating or drinking for a few hours before the procedure.
4. Clothing: Wear loose, comfortable clothing and avoid applying lotions or creams near the injection site.
5. Transportation: Arrange for someone to drive you home after the procedure, as you may experience temporary numbness or discomfort.
What Happens During the Procedure?
Sacroiliac joint injections are typically performed in an outpatient setting and take 5-10 minutes. The steps include:
1. Positioning: You will lie on your stomach on an X-ray or fluoroscopy table, with pillows or cushions used for comfort.
2. Sterilization: The skin over the injection site is cleaned with an antiseptic solution to reduce the risk of infection.
3. Local Anesthesia: A small amount of local anesthetic is injected to numb the skin and surrounding tissues.
4. Imaging Guidance: The doctor uses fluoroscopy (real-time X-ray) or ultrasound to guide the needle into the precise location of the sacroiliac joint.
5. Contrast Dye: A contrast dye may be injected to ensure accurate needle placement within or near the joint.
6. Medication Injection: A mixture of local anesthetic and corticosteroid is injected into the joint.
7. Completion: The needle is removed, and a small bandage is placed over the injection site.
After the Procedure
Immediate Effects
- Pain Relief: You may experience immediate pain relief due to the local anesthetic, but this is temporary and may wear off within a few hours.
- Soreness: Mild soreness or bruising at the injection site is common and usually resolves within a day or two.
- Observation: You will be monitored for 15-30 minutes before being discharged.
Activity and Recovery
- Rest: Avoid strenuous activities for the first 24-48 hours after the procedure.
- Ice Packs: Apply ice to the injection site as needed to reduce soreness or swelling.
- Physical Therapy: Begin or resume physical therapy as directed by your doctor to improve strength, flexibility, and joint stability.
- Driving: Do not drive or operate heavy machinery on the day of the procedure.
Follow-Up
- Your doctor will schedule a follow-up appointment to evaluate the effectiveness of the injection and discuss next steps. If the injection provided significant relief, additional treatments or repeat injections may be recommended.
Risks and Complications
Sacroiliac joint injections are generally safe, but as with any medical procedure, there are potential risks, including:
1. Infection: Rare, but possible at the injection site.
2. Bleeding: A small risk, especially for patients on blood-thinning medications.
3. Nerve Damage: Extremely rare, as the procedure is performed under imaging guidance.
4. Allergic Reactions: Rare, but may occur due to the anesthetic or contrast dye.
5. Temporary Flare-Up: Some patients may experience increased pain for 1-2 days following the injection.
6. Lack of Effectiveness: Not all patients experience significant relief.
Effectiveness of Sacroiliac Joint Injections
Diagnostic Value
The primary purpose of an SI joint injection is to determine if the SI joint is the source of pain. Significant pain relief immediately following the injection strongly suggests that the joint is involved.
Therapeutic Value
While the corticosteroid can reduce inflammation and provide longer-lasting relief, the duration of relief varies among patients. Some may experience weeks or months of relief, while others may need additional treatments.
Who is a Good Candidate for Sacroiliac Joint Injections?
Ideal candidates for SI joint injections include:
1. Patients with chronic lower back or pelvic pain suspected to originate from the SI joint.
2. Individuals who have not found relief from conservative treatments.
3. Patients without contraindications, such as active infection or severe bleeding disorders.
4. Those willing to follow through with physical therapy or other rehabilitative measures.
Frequently Asked Questions
1. How long does the procedure take?
- The procedure usually takes 15-30 minutes.
2. Is the procedure painful?
- You may feel slight pressure or discomfort during the injection, but the local anesthetic minimizes pain.
3. How soon will I feel relief?
- Relief from the local anesthetic is immediate but temporary. The corticosteroid may take a few days to reduce inflammation and provide longer-lasting relief.
4. How often can I have these injections?
- Most doctors recommend limiting corticosteroid injections to 3-4 times per year to avoid potential side effects.
5. Are SI joint injections covered by insurance?
- Most insurance plans cover the procedure when medically necessary. Check with your provider for details.
Conclusion
Sacroiliac joint injections are a safe and effective option for diagnosing and managing chronic lower back or pelvic pain. By reducing inflammation and providing targeted pain relief, these injections can improve quality of life and support participation in physical therapy and other treatments. If you are experiencing persistent pain that may originate from the SI joint, consult with your doctor to determine if this procedure is right for you. Understanding the process and following your doctor’s recommendations can help you take the first step toward lasting relief and improved mobility.
To learn how you can benefit from sacroiliac joint injections and patient-centered care your spinal problems, call Endoscopic & Minimally Invasive Spine Specialists today, or book an appointment online.
