What is a Sacroiliac Joint Injection?
The sacroiliac (SI) joints connect the lower part of the spine to your hip. The SI joints distribute your weight across the pelvis. This absorbs shock and reduces the pressure on your spine.
A therapeutic sacroiliac joint injection provides relief of the pain associated with sacroiliac joint dysfunction. Using x-ray guidance, the injections supply a small amount of cortisone and numbing medicine into the SI joint to reduce inflammation.
How is the procedure performed?
A sacroiliac joint injection is no different than other joint injections such as a knee or shoulder. Most often, these injections can be done right in the office in the comfort of a recliner. Less often, these larger joints may be done with the assistance of fluoroscopic guidance (x-ray mapping) in our office procedure suite. Commonly, the joint is injected with a mixture of a long-acting corticosteroid with the addition of a local anesthetic. Dr. Irwin will inject the lower portion of the joint where most of the nerve supply is located.
What conditions are treated with a sacroiliac joint injection?
The conditions most commonly treated with a sacroiliac joint injection include sacroilitis (inflammation of the sacroiliac joints), rheumatoid arthritis, ankylosing spondylitis, degenerative bone disease, and osteoarthritis.
How Should I prepare for the injection?
If you need something to help with anxiety related to the procedure, you should discuss this with Dr. Irwin. Receiving a pre-procedure medication can help reduce the anxiety. If you are taking any blood pressure medication, you should not skip any regular dose of this medication. However, if you are taking any medications that might thin your blood, you should discuss this with Dr. Irwin to make sure we have approval from your Cardiologist to hold this medication for the appropriate number of days prior to the injection.
On the day of your injection, you should have nothing to eat or drink for two hours prior to the injection. You should have someone who can drive you home from the procedure. You should not return to work the day of your procedure. You can safely resume your normal activity the day after your injection.
What should I expect after my injection?
The local anesthetic may start helping the day of the injection. The corticosteroid might take up to 5 days to start to take effect. If you have some injection site pain, you can use ice to help reduce pain. Do not use heat until 24 hours after the injection.
How often should I have the injection repeated?
Our hope is that the sacroiliac joint injection will give months of pain relief. If this is the case, we can repeat the injection every few months as needed for pain relief.
Patients will often receive profound relief from just their first injection. If this is the case for you, and you are happy with your pain relief, then you can cancel any remaining injections. If you have a less than satisfactory level of pain relief from your first injection, we might repeat the injection. If you have not received any relief after two injections we will likely need to change course and pursue other treatments for your pain.
Are there things I should look for after having this procedure?
Of course, you can call our office with any questions you might have. There are certain “red flag” warnings that you should call us about, or if it is after clinic hours you should go to your nearest ER. These would include severe or worsening pain, fever over 101, new or worsening weakness, injection site redness or drainage.