A sacroiliac joint injection, also called a sacroiliac joint block is used to diagnose or treat lower back pain. The pain is usually caused by inflammation from sacroiliac joint dysfunction.
The sacroiliac joints lie next to the spine. They connect the sacrum with the hip on both the right and left sides of the body. There are two sacroiliac joints. One is on the right side while the other one is on the left side. Inflammation or dysfunction in the sacroiliac joints can cause pain.
A sacroiliac joint injection is used primarily for two purposes. One is to diagnose the source of a patient’s pain while the other is to provide therapeutic pain relief.
At times, a patient may have sacroiliac injection specifically for diagnostic purposes or for pain relief. However, sacroiliac injections are usually provided for both diagnostic and therapeutic purposes.
What Sacroiliac Joint Pain Feels Like
SI joint pain is usually felt in the backside of your pelvis around your buttocks. A common sign is that it’s often felt only on one side. The pain usually gets worsened by weight-bearing activity, especially on one leg like when climbing the stairs, long periods of walking, doing the elliptical machine, and performing certain exercises. The pain can range from chronic and dull to sharp and shooting. The pain can sometimes radiate down your leg.
What Causes Sacroiliac Joint Pain
The human body has two sacroiliac joints at both sides of the body located in the posterior pelvic region between the sacrum and the ilium bones. The sacroiliac joints help to keep your pelvis in neutral alignment. Inflammation or dysfunction in the sacroiliac joints can cause Sacroiliac joint pain.
Sacroiliac Injection for Diagnostic Purpose
Sacroiliac joint injection is used to confirm a suspected case of sacroiliac joint dysfunction. It is used to diagnose the source of a patient’s pain. The injection is performed under X-ray guidance (fluoroscopy). When the needle is inserted into the sacroiliac joint area, contrast is injected into the area so that the doctor can see more clearly to ensure that the needle is placed properly. A local anesthetic such as lidocaine is then injected into the sacroiliac joint to numb the joint.
After the numbing medication is injected into the sacroiliac joint, you will be asked to try and reproduce the pain by performing activities that usually aggravate the pain. If you experience 75-80% pain relief, it likely means that a sacroiliac joint dysfunction is the cause of your pain.
A second diagnostic sacroiliac injection may be performed using a different numbing medication such as Bupivicaine. The second diagnostic injection is done to confirm the diagnosis.
If this second diagnostic injection provides 75-80% pain relief, there is a reasonable degree of certainty that a sacroiliac joint dysfunction is the source of your pain.
Sacroiliac Joint Injection for Pain Relief
After your doctor has confirmed that a sacroiliac joint dysfunction is the cause of your pain, a therapeutic sacroiliac joint injection will be done to provide relief of the pain associated with sacroiliac joint dysfunction.
The injection is performed the same way as the diagnostic procedure. The only difference is that an anti-inflammatory medication known as corticosteroid is included in the injection. Corticosteroids reduce inflammation in the joint and provide longer-lasting pain relief.
If you experience longer-lasting pain relief after a therapeutic sacroiliac injection, you may need to repeat the injection up to three times per year, along with physical therapy and rehabilitation program to help maintain normal function and performance.
FAQS
What can I expect after a sacroiliac joint injection?
After the injection, you may experience pain and soreness at the injection site for a day or two. While the anesthetic provides immediate pain relief, its effect usually wears out in a few hours. The corticosteroid may start to work in two to three days. The corticosteroid provides longer-lasting pain relief.
You may experience temporary numbness or weakness in your legs.
You will be asked to drink plenty of water to help flush out the dye used for fluoroscopy.
Do not perform excessive activities or exercises immediately after the injection.
How long do sacroiliac joint injections last?
Sacroiliac joint injection can last for 3-6 months. You will need to repeat the injection for up to 3 times a year to sustain the effectiveness of the injection.
How successful are SI joint injections?
If you experience pain relief from the diagnostic sacroiliac joint injection, you will most definitely experience pain relief from the therapeutic sacroiliac joint injection. Most patients have experienced significant pain relief after having sacroiliac joint injections.
What exercises are bad for SI joint?
Because you are trying to stabilize the pelvis, you should limit single-leg weight-bearing exercises.
These kinds of exercises that you should avoid include:
-
Lunges or step-ups
Single-leg lower body moves like lunges of any kind or step-ups and downs place your pelvis in a position that is less stable.
-
Impact
Avoid impact moves like running, jumping, or other ballistic moves that will likely aggravate pain due to the hyper-mobility in your pelvis.
-
Traditional cardio machines
Avoid traditional cardio machines like the elliptical, Stairmaster, and treadmill as they all promote single-leg activities.
-
Crossing your legs when seated
Avoid crossing your legs when you’re seated. Keep your weight evenly distributed by sitting tall with both feet flat on the floor.
-
Moves that triggers pain
Avoid moves or activities that trigger your pain. Pay attention to moves or activities that trigger your pain and avoid them.
-
Single-leg daily activities
Activities like walking, climbing the stairs, and getting up and down from the ground are single-leg activities that should be avoided as much as possible. When you want to get up, use the side that does not hurt.
Does sitting make SI joint pain worse?
Sitting on the painful side can make the pain worse. You should avoid sitting on the painful side.
How do I prepare for SI joint injection?
- Inform your doctor if you are on blood thinners such as warfarin or any prescription medicines. You may likely need to avoid blood thinners for 5 days before the injection.
- Avoid aspirin products for 14 days before the injection
- Avoid alcohol, cigarette smoking, or recreational drugs before the procedure.
- Avoid anti-inflammatory medications for 5 days before the injection.
- Avoid solid foods or fluids on the night prior to the procedure.
