Sacroiliac Joint Injection

A sacroiliac joint injection is performed to reduce inflammation causing low back, hip, groin, and buttock pain.  Sometimes you feel pain in your thighs.  The sacroiliac (SI) joints are located in the lower spine above your tailbone.  There is one SI joint on the left and right sides of the sacrum.

Sacroiliac joint injection…

  • May relieve pain
  • Helps to diagnose a SI joint as the pain source

Causes of SI joint pain…

  • Spondylosis (spinal osteoarthritis)
  • Strain from trauma
  • Infection
  • Ankylosing spondylitis (less common)

Preparation for a sacroiliac joint injection

Your doctor reviews all the medications, vitamins and herbal supplements you take.  Certain drugs (e.g., blood thinners), such as NSAIDs (non-steroidal anti-inflammatory drugs) and supplements should be stopped several days before your procedure.  If you are taking an anti-inflammatory medication, your doctor may ask you to stop taking the NSAID, so he can accurately assess the effectiveness of the sacroiliac joint injection and reduce the risk of bleeding.

Possible risks of SI joint injections

All medical procedures are inherent for risk.  Rare but serious complications include bleeding, infection, nerve injury, headache, and allergic reaction to medication.  Other risks include increased pain or injection site tenderness.  Your doctor thoroughly discusses your personal risks with you before the procedure.

Sacroiliac Joint Injection Video

The SI joint injection procedure

A sacroiliac joint injection is performed in a sterile setting, such as an operating room or ambulatory surgery center suite.  You change into a gown.  An intravenous line is started, and medication is administered through the IV to keep you comfortable.  You are either awake or given twilight medication.

In the surgical suite, your body is positioned face down on the treatment table.  The skin area over the low back and sacrum is cleansed using a sterile soap.  A local anesthetic is injected to numb the area.  A special imaging machine called a C-arm (fluoroscopy) is positioned to enable your doctor to view your spine during the procedure.  The needle is advanced at an angle into the sacroiliac joint.  A small amount of contrast (dye) is injected to confirm needle placement and material flow.  Next, a local anesthetic and corticosteroid is injected into the area.  A corticosteroid is a slow-releasing and long-lasting anti-inflammatory medication that effectively reduces inflammation.  As the medication is injected, it flows inside the joint.

A small bandage covers the entry point of the needle.  An ice pack is applied.

After the SI joint injection procedure

The procedure takes about 15-minutes but may take longer if more than one injection is performed.  You are moved into a recovery area and closely monitored before being discharged home with written aftercare instructions.  We call you the day after your procedure to follow up.

You may experience some bruising and discomfort for a few days after a SI joint injection.  This is normal.  Apply an ice pack periodically during the first 24- to 48-hours.  Thereafter, heat can be applied.  Your doctor will give you instructions about activity modification and when to begin range of motion exercise.  Simple analgesics or non-steroidal anti-inflammatory drugs (NSAIDs) may be recommended.

Keep a pain diary

We ask you to record your pain levels and other symptoms after the procedure.  Your pain diary helps your doctor fine-tune your treatment plan.

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