Chronic lower back pain can significantly hamper one’s mobility and everyday life. The reasons can be numerous, ranging from aging and lifestyle choices to specific conditions such as sacroiliac joint dysfunction. One innovative treatment that has been gaining recognition for its effectiveness in alleviating sacroiliac joint dysfunction is the sacroiliac joint injection.

Sacroiliac joint injections, often referred to as SI joint injections, serve dual purposes: for diagnosis and treatment. When used diagnostically, SI joint injections can help confirm the source of lower back pain as the sacroiliac joint. On the other hand, treatment-wise, sacroiliac joint injections can provide relief from sacroiliac joint pain.

This article contains vital information about sacroiliac joint injections, encompassing the need, process, benefits, risks, and much more.

In This Article:

Understanding the Sacroiliac Joint

The sacroiliac joints are relatively small yet crucial in body movements. They join the pelvis with the spine in the lower back and buttocks region. This joint’s significant role includes acting as the critical articulation point between the sacrum (the base of the spine) and the ilium (the main bones of the pelvis). As such, they bear weight and transmit forces between the upper body and the legs. The sacroiliac joints effectively function as shock absorbers during movement.

The Sacroiliac Joint Injection Procedure

Sacroiliac joint injections are a minimally invasive procedure that can help diagnose the source of chronic lower back pain. In some cases, the injections may provide temporary pain relief that can last from a few days to several months, but they are not always effective and are not a cure for low back pain. The duration of pain relief varies from person to person, the severity of the condition, and factors such as lifestyle and weight management.

Generally considered safe, sacroiliac joint injections do have some potential risks and complications, such as infection, bleeding, and nerve damage.

Other treatment options available for chronic lower back pain include conservative treatments such as physical therapy and medication and interventional treatments such as surgery. The best treatment option for an individual will depend on the severity of their pain, the underlying cause of the pain, and their overall health.

Following a sacroiliac joint injection, patients may experience varying results and should adhere to specific care instructions to achieve optimal benefits. Understanding what to expect after the procedure and knowing about potential side effects can help during recovery and pain management.

Sacroiliac joint injections and surgery can both be effective treatments for chronic lower back pain; however, one is not always more effective than the other.

Given the critical role of the sacroiliac joint in overall bodily movements, patients must talk with their doctor to determine their best treatment option. The doctor will assess the severity of the pain, identify any underlying conditions, and recommend the most suitable treatment plan.

Pre-Procedure Information

Before proceeding with a sacroiliac joint injection, patients should be aware of key aspects of the procedure.

  • The Beginning: The patient’s general health history is thoroughly discussed, with emphasis on infections, fevers, or any other recent health problems.
  • Medication Details: The patient’s medications should be listed, including those for specific conditions like diabetes or blood clotting disorders. Certain medicines may need to be stopped a few days before the injection.
  • Allergy Information: All allergies, previous reactions to contrast dyes, or complications with past injection procedures should be communicated with the doctor.
  • Pregnancy Status: Women should tell their healthcare provider if they are pregnant, suspect they may be pregnant or are breastfeeding.
  • Eating and Drinking: Patients may be instructed not to eat or drink at a specific time before the procedure.
  • Transportation Arrangement: Due to the sedative effects of some medications, patients should arrange for someone to drive them home after the procedure.

Sacroiliac Joint Injection Procedure Steps

The sacroiliac joint injection procedure is a relatively straightforward, medically facilitated process.

  • Preparing the Patient: Medical staff completes the necessary paperwork and checks the patient’s vital signs. An IV line is established for the administration of medication during the process.
  • Positioning the Patient: Usually, the patient is placed face-down on the procedure table.
  • Administering Medication: A sedative is administered through the IV line to help the patient relax and manage discomfort during the procedure. However, the patient remains awake to communicate with the physician during the procedure.
  • Target Determination and Clean-Up: The area around the sacroiliac joint is cleaned and numbed. The doctor uses medical fluoroscopy (an X-ray-type device) to identify the correct placement for the injection.
  • Performing the Injection: The doctor then directs a small needle into the joint and releases a mixture of anesthetic and steroid medication.

Post-Procedure Care and Results

While the injection, conducted under fluoroscopic guidance, aims for precision and immediate pain relief, post-procedure care is crucial for optimal recovery and long-term well-being. Patients are typically observed immediately after the injection to monitor initial responses and to provide early intervention should any complications arise.

Likewise, subsequent home care demands careful adherence to healthcare provider recommendations, including activity modifications and medication management. It is important to recognize the potential for transient symptoms, such as soreness or mild leg weakness. Still, patients should also be vigilant for signs that necessitate prompt medical attention, including severe pain, persistent numbness, fever, or indications of infection. Clear communication with the healthcare provider post-injection is foundational to successfully navigating the recovery journey and charting the course for sustained pain management.

What to Expect Immediately After a Sacroiliac Joint Injection

Immediately following the injection, patients are regularly observed for 30 to 60 minutes to monitor for adverse reactions. They might experience slight leg weakness and feel sore from the injection. Due to the numbing medicine, pain relief can often start in the hours after the procedure. As it wears off, the pain might temporarily feel worse.

Pain Management and Activity Restrictions Post Injection

Post-procedure, patients will need to manage their pain effectively and adhere to certain activity restrictions. These include:

  • Heat or Ice Applications: It’s crucial to consult with the healthcare provider before using heat or ice at the injection site.
  • Bathing: Patients may have to wait for a specific time before they can bathe.
  • Medicinal Adherence: Following all the healthcare provider’s medication instructions is key to recovery.
  • Activity Restriction: Physical activities may be restricted following the procedure.
  • Pain Diary: Patients might be asked to keep a record of their pain after the injection. A diary can help determine if future injections would be beneficial.

Treatment Options: Injection Versus Surgery

Sacroiliac joint dysfunction can cause patients to consider various treatment options, including joint injections and surgery. Both approaches aim to alleviate the symptoms associated with sacroiliac joint pain, but each has distinct advantages and drawbacks.

Injections are minimally invasive and can help relieve pain. They can also be a diagnostic tool to help confirm the sacroiliac joint as the pain source. However, the efficacy of injections can be temporary, and repeat treatments may be necessary.

On the other hand, surgery to correct sacroiliac joint issues is a more permanent solution with the potential to resolve the underlying cause of pain. Yet, surgery entails a significantly longer recovery period and higher costs. Surgery also risks a reaction to the anesthesia, infection, and nerve damage. Additionally, some patients may not experience complete relief from the surgery.

The decision between these two approaches should be made in consultation with a healthcare professional, considering the latest research and individual circumstances.

Pros and Cons of Sacroiliac Joint Injections

Sacroiliac joint injections present both advantages and potential disadvantages:

Pros:

  • Effective Pain Relief: Sacroiliac joint injections can quickly alleviate pain by delivering medication directly into the affected joint.
  • Diagnostic Use: If the injection eliminates the pain, it can confirm the sacroiliac joint as the source of pain.
  • Minimally Invasive: Unlike surgery, sacroiliac joint injections are minimally invasive and do not involve cutting or removing tissue.
  • Recovery Time: Unlike surgical treatments, the recovery time after a sacroiliac joint injection is significantly shorter.

Cons:

  • Temporary Results: The benefits, while promising, are not always permanent and may require repeated injections.
  • Potential Side Effects: Though generally safe, possible side effects include infection, increased pain, bleeding, or nerve damage.

Potential Risks and Complications of Sacroiliac Joint Injections

Although generally safe, sacroiliac joint injections, like any medical procedure, carry potential risks and complications. Before undergoing the injection, patients should discuss their specific health concerns with their healthcare provider to understand the full scope of possible risks a sacroiliac joint injection might present.

As with any invasive medical procedure, the safety and success of a sacroiliac joint injection depends on several factors, including the patient’s overall health. Before electing for a sacroiliac joint injection, it is essential to have an open dialogue with your healthcare provider, ensuring a thorough understanding of potential risks in the context of your unique circumstances.

Potential Risks of Sacroiliac Joint Injections

As valuable as sacroiliac joint injections are, there are possible risks to consider. Although these complications are rare, it is crucial to be aware of them. These potential risks include:

  • Infection: Although rare, an infection can occur at the injection site.
  • Bleeding: Although extremely uncommon, bleeding can happen, especially in patients with bleeding disorders.
  • Increased Pain: Some patients may experience increased pain after the procedure.
  • Nerve Damage: While unlikely, nerves could be damaged during the procedure.

Mitigating Complications Post Sacroiliac Joint Injections

Mitigating the complications following a sacroiliac joint injection involves taking necessary precautions and following the doctor’s instructions post-procedure.

  • Preventing Infection: Ensure the injection site is kept clean and monitor for symptoms such as severe pain, swelling, redness, or discharge.
  • Managing Increased Pain: Contact your healthcare provider if you experience a significant increase in pain post-injection.
  • Allergic Reactions: Be aware of signs of rashes, itching, severe dizziness, or difficulty breathing. Seek immediate medical help if these occur.

FAQs

What conditions are treated with sacroiliac joint injections?

Sacroiliac joint injections are implemented as a course of treatment for a range of conditions that stem from the lower back and affect the sacroiliac joint. These include sacroiliitis (inflammation of the sacroiliac joint), sacroiliac joint dysfunction (an abnormal movement of the sacroiliac joints), sciatica pain radiating down the leg, and arthritis of the sacroiliac joint. Furthermore, the injections are widely used to diagnose lower back pain. These injections can confirm whether the sacroiliac joint is the origin of the pain.

Are sacroiliac joint injections painful?

While sacroiliac joint injections are generally considered a minimally invasive procedure, they may involve some discomfort, primarily during the needle insertion process. While sacroiliac joint injections may cause some discomfort, the procedure is generally considered safe and effective for managing sacroiliac joint pain.

How long does it take to recover from a sacroiliac joint injection?

Recovery time from a sacroiliac joint injection varies from person to person. Immediate post-procedure observation lasts for about 30 to 60 minutes. There may be minor injection sight soreness for a few hours. Relief from pain usually begins within a few hours to a few days after the procedure due to the numbing medicine. If a steroid was also injected, it may take up to seven days to take effect. Patients generally resume their normal activities the following day but should follow their healthcare provider’s instructions.

Are there alternative treatments for sacroiliac joint dysfunction?

Yes, several alternatives are available for treating sacroiliac joint dysfunction. They include non-surgical methods like physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and heat or ice packs. Other injection therapies, such as nerve block injections or radiofrequency ablation, may also be considered in instances where conservative treatments fail to provide adequate relief, and surgical interventions like sacroiliac joint fusion may be considered. Always consult a healthcare provider to understand the best treatment option for unique situations.

How successful are sacroiliac joint injections?

Sacroiliac joint injections can provide pain relief for many patients, with success rates ranging from 50% to 70% of patients. However, it’s crucial to acknowledge that individual responses to sacroiliac joint injections may vary considerably. Some patients may experience substantial pain relief, while others may experience only partial or temporary relief. Persistent or recurring sacroiliac joint pain may necessitate further injections or alternative treatment options.

How long do sacroiliac joint injections last?

The duration of pain relief from sacroiliac joint injections varies among patients. Typically, the numbing medicine provides immediate relief, which wears off in a few hours. The steroid injected generally starts working in about 3 to 7 days and can last for days to a few months. However, the exact duration may differ as everyone’s body responds differently.

Conclusion

Sacroiliac joint injections offer a promising, minimally invasive, and effective method for diagnosing and treating lower back pain caused by various sacroiliac joint conditions. While the procedure has benefits, such as immediate pain alleviation and shorter recovery times compared to surgery, it’s essential to consider potential risks and complications.

As with any medical procedure, individuals should have extensive discussions with their healthcare providers to ensure that the chosen treatment is the most appropriate for their unique circumstances. Sacroiliac joint injections can be integral to modern pain management, helping many patients live more comfortably.

Novus Spine & Pain Center

Novus Spine & Pain Center is in Lakeland, Florida, and treats patients with chronic pain with numerous therapies, including sacroiliac joint injections. By using a comprehensive approach and cutting-edge therapies, we work together with patients to restore function and regain an active lifestyle while minimizing the need for opiates.

For your convenience, you may schedule an appointment online, request a call back, or call our office at 863-583-4445.

Resources

Sacroiliac Joint Injection for Lower Back Pain (Spine Health)
Sacroiliac Joint Injection (University of Rochester Medical Center)
Sacroiliac Joint Injection (University of Toledo Medical Center)
Sacroiliac Joint Injection (Emory Healthcare)
A Cadaveric Study on Sacroiliac Joint Injection (Pub Med)