FAQs on Sacroiliac (SI) Joint Injection in Nashville TN

A sacroiliac (SI) joint injection is the instillation of a corticosteroid agent and/or other medication directly into one or more of the SI joints. The SI joints are located on either side of the sacrum area (tailbone). These joints connect the tailbone to the pelvis.

Why is the SI joint injection done?

When a steroid is injected into the SI joint, it will reduce the inflammation and swelling of the tissue in and around the joint space. This eliminates pain or reduces discomfort, as well as alleviating other symptoms associated with SI joint inflammation.

What medications are used for the SI join injection procedure?

The SI joint injection only takes around 10 minutes. The medications used include a local anesthetic and a corticosteroid agent. Occasionally, the doctor will use phenol during the procedure to destroy a portion of the nerve. The procedure does not require general anesthesia, but you can choose to receive a mild sedative, which is given through an IV catheter in the arm.

What conditions are treated with the SI joint injection?

The injection is used to decrease pain and inflammation of the SI joint. Diseases that are treated with the SI joint injection include:

  • Sacralilitis
  • Arthropathy
  • Arthritis
  • Ankylosing spondylitis

What can I expect before the SI joint injection?

Before the procedure, a nurse will explain the risks and benefits with you and have you sign a consent form. If you are on any blood-thinning agents, be sure to discuss this with your doctor, as these must be held before the procedure. An IV catheter will be placed in your arm to administer medications as needed. In addition, you will need to bring someone with you to drive you home.

How is the sacroiliac joint injection performed?

A nurse will position you on your stomach and cleanse your back with an antiseptic solution. Your blood pressure, oxygen level, and heart rate will be continuously monitored during the procedure. The skin and soft tissues are numbed with a local anesthetic, and needles are placed into the SI joint(s). Once medications are injected, the needle will be removed and a bandage is applied.

What should I expect after the SI joint injection procedure?

Immediately following the injection, you will notice that your pain is decreased or eliminated, which is due to the anesthetic. Once the medication wears off, you will feel some tenderness at the injection site, which lasts for 24-48 hours. We advise that you take it easy for the remainder of the day, and use ice to the injection site to alleviate discomfort. You are permitted to return to usual activities on the next day.

What are the risks, complications, and side effects associated with the SI joint injection?

As with any injection procedure, there are some risks and complications associated with the SI joint injection. These include prolonged pain at the injection site, bleeding, inflection, and nerve damage. In addition, you could experience an allergic reaction to the medications, but this is rare. Side effects to corticosteroids include water retention, slight weight gain, trouble sleeping, and elevated blood glucose.

How many sacroiliac joint injections are necessary?

Depending on your condition and pain intensity, the first injection may not relieve your symptoms. If you have not improved in 2 weeks, the doctor may recommend a repeat SI joint injection. The doctor will only perform 3 injections in a 6-month period, due to use of corticosteroids.

What is the success rate of SI joint injections?

According to the American Society of Interventional Pain Physicians, SI joint injections have a success rate of 75-100%. In 2009, researchers reported that SI joint injections significantly reduced pain in 67% of patients. According to this study, the pain relief lasted for longer than 6 weeks.

Resources

Hawkins J & Schofferman J (20090. Serial therapeutic sacroiliac joint injections: a practice audit. Pain Medicine, 10(5):850-3.

Hansen H, Manchikanti L, Simopoulos TT, et al. (2012). A systematic evaluation of the therapeutic effectiveness of sacroiliac joint interventions. Pain Physician, 15(3):E247-78.

Liliang PC, Lu K, Weng HC, Liang CL, et al. (2009). The therapeutic efficacy of sacroiliac joint blocks with triamcinolone acetonide in the treatment of sacroiliac joint dysfunction without spondyloarthropathy. Spine, 34(9):896-900.