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SACROILIAC JOINT INJECTION

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What is Sacroiliac Joint Injection?

A Sacroiliac Joint Injection is a minimally invasive procedure where a mixture of local anesthetic and/or corticosteroid medication is injected directly into the Sacroiliac (SI) joint, located in the lower back connecting the sacrum to the ilium bone. This procedure, guided by a C-arm machine, aims to diagnose or treat low back pain originating from the SI joint, the pivotal connection between the spine and pelvis. 

Sacroiliac joint pain is a common cause of lower back pain, with 10% to 27% of such cases attributed to SI joint issues. Factors like leg length discrepancy, age, arthritis, pregnancy, trauma, or prior endoscopy spine surgery elevate the risk of SI joint dysfunction. The injection targets pain relief and improved joint function, offering relief for patients with SI joint-related discomfort.

The sacroiliac joint injection is a minimally invasive procedure that can be done on an outpatient basis. It usually lasts less than 15 minutes, allowing patients to go home on the same day.

Diseases Cured by Sacroiliac Joint Injection

Sacroiliac joint injections are recommended when lower back pain, leg pain, or neck pain is suspected to originate from the sacroiliac joint. Several conditions can lead to SI joint pain, including SI joint dysfunction and sacroilitis, which results from excessive or insufficient movement of the joint. This dysfunction is commonly caused by factors like injury, pregnancy, osteoarthritis, and ankylosing spondylitis—an inflammatory arthritis affecting the spine that can cause SI joint inflammation over time.

Before opting for an SI joint injection, it’s crucial to rule out other potential causes and attempt non-interventional treatments like physical therapy or over-the-counter medications. However, patients experiencing chronic lower back pain or cervical pain without relief from conventional treatments may find relief through SI joint injections. These injections aim for pain management, improving joint function and enhancing the patient’s quality of life by targeting the specific source of discomfort arising from the sacroiliac joint.

How Does It Work?

SI joint injections are typically conducted in a hospital or outpatient surgical center, allowing patients to return home on the same day. The procedure is carried out with the help of a C-arm machine and contrast agents, enabling the doctor to accurately guide the needle into the SI joint. This ensures precise positioning of the injection. While the injection itself usually lasts around 15 minutes, patients are monitored for approximately 30 minutes to an hour post-injection, extending the overall process to about an hour. 

The steps involved in an SI joint injection procedure include positioning the patient on their stomach on the procedure table, cleansing the skin over the SI joint and applying a local anesthetic for numbing. With the aid of fluoroscopy or ultrasound, the doctor inserts a spinal injection needle into the SI joint, followed by the injection of contrast to confirm proper needle placement and avoid vascular uptake. 

Subsequently, the medication is administered into the joint, the needle is removed, and a small bandage is applied to the injection site to manage any potential bleeding. Patients are closely monitored post-procedure for any adverse reactions to the medication, with continuous assessment of vital signs during this observation period.

Post Recovery Care

After undergoing the procedure, patients are often able to return home, and unless sedation was administered during the procedure, they can typically drive themselves back. It’s common for the injection site to experience some pain a few hours after the procedure as the effects of the anesthetic wear off. However, the injected medication begins to take effect within a few days, reducing inflammation and alleviating nerve pain. In some cases, additional oral pain medications may be prescribed for a short duration to manage any discomfort.Regarding post-recovery care, there are generally no significant activity restrictions following the procedure. Patients are encouraged to engage in activities as tolerated and can gradually increase their exertion levels under the guidance of a professional like Dr. Manohar Kanwaria. Patients need to follow any specific instructions provided by their healthcare provider regarding post-procedure care and activity levels to ensure a smooth recovery and optimal outcomes.

1. How long does pain relief typically last after a sacroiliac joint injection ?

The duration of pain relief can vary from person to person. Some individuals experience immediate relief that lasts for several hours, while others may have longer-lasting relief lasting weeks to months. Repeat injections may be needed for sustained benefits.

2. Are there any risks or side effects associated with sacroiliac joint injections ?

Common risks and side effects of sacroiliac joint injections include temporary pain or discomfort at the injection site, bruising, and a slight increase in pain for a day or two after the injection. In rare cases, more serious complications such as infection or nerve damage can occur.

3. What is the difference between a diagnostic and therapeutic sacroiliac joint injection ?

A diagnostic sacroiliac joint injection is used primarily to determine if the sacroiliac joint is the source of pain. It involves injecting a local anesthetic into the joint, and if the pain is significantly reduced, it confirms the diagnosis. A therapeutic injection includes a corticosteroid along with the anesthetic to provide longer-lasting pain relief.

4. Who is a good candidate for a sacroiliac joint injection ?

Candidates for sacroiliac joint injections typically include individuals experiencing chronic lower back pain that is suspected to originate from the sacroiliac joint. This may be due to conditions like arthritis, injury, or degeneration of the joint.

5. What can I expect during and after a sacroiliac joint injection procedure ?

During the procedure, you will be positioned on your stomach, and the skin overlying the sacroiliac joint will be cleaned and numbed. Using fluoroscopic guidance, the healthcare provider will then carefully insert a needle into the joint to deliver the medication. Afterward, you may experience temporary soreness or numbness at the injection site.

6. Can sacroiliac joint injections be combined with other treatments for lower back pain ?

Yes, sacroiliac joint injections can be part of a comprehensive treatment plan that may also include physical therapy, medications, lifestyle modifications, and other interventions. A healthcare provider can help determine the most appropriate combination of treatments based on individual needs and preferences.

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