Sacroiliac Joint Injections
What is a Sacroiliac Joint Injection (Or SI Joint Injection Or Block)
The sacroiliac joints are large joints that are at the base of the spine. These are the same type of joints as the shoulder or knee. All these joints can be helped by injecting various medications.
What is the Purpose of an SI Joint Injection?
Sacroiliac joints can become arthritic, usually as a result of trauma. One of the joints can become “stuck,” causing the pelvis to be out of alignment. Anti-inflammatory medications and medications to help restore the joints or correct alignment can be injected.
Am I a Candidate for SI Joint Injection?
Anyone with back pain from their sacroiliac joints is likely eligible, at least for screening. You can have sacroiliac joint pain with or without changes on your X-ray or other tests. There is no way to tell if the pain is coming from the sacroiliac joints without doing some type of injection. Usually, but not always, sacroiliac joint pain is made worse by sitting.
How is the Procedure Performed?
The patient lies face down on the procedure table. X-ray equipment (fluoroscopy) is always used. The site to be injected is numbed with local anesthetic (Novocain) and a needle is directed to the target area. Contrast (x-ray dye) is injected to be sure the needle is in the proper position, and the medication is slowly injected.
Will the Procedure Be Painful?
There is a certain amount of discomfort involved with this procedure. Most of the pain occurs when the skin and underlying tissues are numbed. The smallest sized needle that will accomplish the procedure is always used. A pressure sensation is common when the medication is injected. You may have sedation for this procedure, but many people do it under local anesthetic.
What are the Risks and Side Effects?
Complications for this procedure are low. Whenever a needle enters the skin, bleeding or infection can occur. If steroid medication (synthetic cortisone) is used, there may be some side effects from the medication.
Side effects from the steroid medication include flushing, insomnia, increased heart rate, some swelling, and a rise in blood sugar and occasionally blood pressure. These side effects are usually mild and temporary, but a rare patient may find the “steroid effect” quite unpleasant. If you are diabetic or have unstable blood pressure, clearance from your primary care physician should be obtained before the procedure. At a minimum, you should monitor your blood pressure and or blood sugar carefully until you are sure they are back to normal levels.
You may have an allergic reaction to any of the medications used. If you have a known allergy to any medication, especially x-ray contrast dye or local anesthetics, notify our staff before the procedure takes place.
The most serious side effects from intravenous sedation are sudden death, brain damage from low blood pressure, or allergy from the medication. These are extremely rare and have never happened in my practice. A nurse will be monitoring your blood pressure, blood oxygen level, and heart rate. If necessary, oxygen will be administered through a tube inserted in your nose.
More serious, but extremely rare, risks include nerve injury, paralysis, weakness or death. These complications have never occurred in my practice.
How Long Does it Take for the SI Joint Injection To Work?
You should feel some relief the same day as the procedure, since there is local anesthetic (Novocain) in the medication injected. It is important for you to record how much relief you get the same day as the procedure.
What Restrictions Will I Have on the Day of the Procedure?
If you have sedation, you will not be allowed to drive, operate machinery, or make legal decisions until the next day. There are no other restrictions. You are encouraged to “test” the procedure by doing activities that would otherwise be painful (and keep a record). You should not soak until the skin is healed. You may shower the same day.