Information

Sacroiliac (SI) joint injection is a minimally invasive procedure designed to alleviate pain and inflammation associated with conditions like sacroiliitis or sacroiliac joint dysfunction. This therapeutic intervention involves injecting a combination of local anesthetic and/or corticosteroid medication directly into the SI joint, located in the lower back, connecting the sacrum to the ilium bone of the pelvis.

Beyond providing immediate pain relief through the local anesthetic, corticosteroids contribute to long-term inflammation reduction, offering sustained benefits. This procedure not only serves as a therapeutic measure but also as a valuable diagnostic tool. By closely monitoring the patient's response to the injected medications, healthcare professionals can pinpoint the specific source of pain, facilitating a more targeted and effective treatment plan.

Administered under the precision of x-ray or ultrasound guidance, this ensures accurate delivery of the injection, optimizing its impact. Patients typically experience improved symptoms, enhanced mobility, and an overall better quality of life. This approach underscores our commitment to providing comprehensive and effective care for those seeking relief from SI joint-related issues.

Types

Administering a steroid mixture into the joint is a common approach for SI joint injections; however, various other injection treatments target SI joint pain with distinct modes of action for pain relief.

Local Anesthetic and Steroid Injections:
Local anesthetic and corticosteroid medications are utilized to reduce inflammation and alleviate symptoms in patients with arthritis, inflammatory conditions, and acute injuries.

Prolotherapy Injections:
Prolotherapy, a form of regenerative therapy, involves injecting a medicated solution into the affected area. This process induces tissue regeneration, promoting healing and diminishing pain.

Platelet-Rich Plasma Injections (PRP):
PRP harnesses the healing properties of the patient's own blood to repair damaged cartilage, tendons, ligaments, muscles, or bone, aiding in natural healing.

Radiofrequency Ablation (RFA):
Also known as radiofrequency neurotomy, RFA entails heating a pain-transmitting nerve with a radiofrequency needle. This creates a heat lesion, preventing the nerve from sending signals to the brain.

A physician with specialized training in musculoskeletal disorders can identify the most suitable injection treatment based on the specific underlying condition and symptoms. This personalized approach ensures targeted and effective pain relief for individuals dealing with SI joint-related issues.

Side Effects

SI joint injections serve dual purposes:

Diagnostic Purposes:

  • Objective: To confirm whether the SI joint is the origin of lower back pain.
  • Method: Typically performed with a local anesthetic only.
  • Indicator: If the patient experiences significant pain relief immediately after the injection, it strongly suggests that the SI joint is likely the source of their pain.

Treatment:

  • Objective: To offer prolonged relief from SI joint pain.
  • Duration: Varies based on the medication mixture, providing relief ranging from several days to months.
  • Goal: To alleviate lower back pain caused by SI joint dysfunction, supporting the objectives of physical therapy and enhancing the patient's quality of life by enhancing joint function.

Whether used for diagnosis or treatment, SI joint injections are a valuable tool in addressing lower back pain, providing both confirmation and relief for individuals dealing with SI joint-related issues.

Procedure

SI joint injections are commonly administered in a hospital or outpatient surgical center, allowing patients to return home on the same day. The procedure unfolds in a specialized x-ray procedure room, utilizing fluoroscopy (live x-ray) and contrast to guide the needle accurately into the SI joint.

Key steps in the SI joint injection procedure include:

Patient Positioning:

  • The patient lies on their stomach on the procedure table.

Preparation:

  • The skin over the SI joint is cleaned, and a local anesthetic is applied to numb the area.

Needle Placement:

  • Utilizing fluoroscopy or ultrasound guidance, the doctor inserts a thin needle into the SI joint.

Contrast Injection:

  • Contrast is injected to verify the needle's accurate position within the joint and to ensure no vascular uptake occurs.

Medication Injection:

  • The doctor administers the prescribed medication into the joint.

Post-Injection Steps:

  • The needle is removed, and a small bandage is applied to the injection site.
  • Patients are observed for a short period to monitor any adverse reactions, with continuous vital sign monitoring.

Doctors specializing in pain management, including anesthesiologists, physiatrists, or radiologists, typically perform SI joint injections. In some instances, orthopedic surgeons or neurologists may also conduct the procedure. This multidisciplinary approach ensures expertise and precision in delivering SI joint injections effectively.

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