FAQ’s on Sacroiliac Joint Injection
What is a Sacroiliac Joint Injection?
The sacroiliac joints are located at the juncture where the pelvis of the body meets the sacrum (the ending point of the spine). These joints, called SI joints, are located on each side of the body and are comprised of– cartilage.
The overall range of movement the SI joints provide, however, is much smaller. Like the other joints of the body, these areas are susceptible to cartilage damage from arthritic inflammation resulting in pain and loss of function for the patient.
What will a Sacroiliac Joint Injection treat?
Complications with the SI joint are the sole cause of pain in 12-25% of lumbar back pain scenarios, making it one of the primary conditions physicians examine for during a diagnosis when a patient reports pain symptoms. When there is arthritic damage present, pain relief may be obtained by an SI joint injection, which is a combination of pain relievers, anti-inflammatories, and corticosteroids.
How is a Sacroiliac Joint Injection performed?
There are two separate purposes of a SI joint injection: diagnostic and therapeutic. A diagnostic injection involves using a small amount of the medication within the injection needle, and is performed to see what effect the injection will have on the patient. If pain relief is obtained reasonably well, then the physician may conclude that the SI joint is the source of pain and that a therapeutic injection may be able to provide adequate relief for an extended duration of time.
The injection can be a very complex process depending on the patient’s SI joint. Since the joint can be a combination of very jagged bones – changing based on the arthritic damage – many physicians will use both a bilateral approach (a needle on each side of the joint) and use visual guidance (fluoroscopy) to assist in the placement of the needles.
What is Fluoroscopy?
The most common guidance technique used is fluoroscopic imaging, which is a series of X-rays taken to create a real-time image of the needles position in the patient. This helps to ensure that the needles are placed correctly within the joint prior to injection.
Patients will not need to be placed under IV sedation for this procedure, and many require only a local anesthetic applied to the injection site. Once the needles have been placed correctly, medication will be injected to numb the joint and help combat any inflammation present.
How well do Sacroiliac Joint Injections work?
Most patients respond very well to a SI joint injection and steroid supplement, with the average injection able to provide 2 to 3 months of relief. Patients who have a re-appearance of symptoms will be able to have this procedure repeated as needed to regain and maintain relief. About three quarters of patients are able to achieve relief with this type of injection.
Patients who are not able to get relief with an SI joint injection do have some alternatives available with the primary one being a lateral branch block. The lateral branch nerves are the nerves that provide feeling to the SI joint, meaning that the blocking of these may provide long-lasting relief for a patient.
What are the risks of a Sacroiliac Joint Injection?
There are the standard risks of a needle-based treatment which include infection, bleeding, and possibly short-lived pain at the injection site. There is a small occurrence of water retention among patients having a steroid-assisted injection, and there may be an increase in the body’s blood sugar.
What is the bottom line with Sacroiliac Joint Injections?
SI joint injections are a very low-risk type of injection that can serve to provide relief reliably for patients. There are also alternative options available to patients who respond well to the treatment, but their symptoms remain.