TESTS AND PROCEDURES

Sacroiliac Joint Injection

By MMI board-certified, academically affiliated clinician 
 | 
January 16, 2018
A sacroiliac joint injection is used to diagnose or treat lower back pain that comes from your sacroiliac joint. This joint is the place where your spine connects to your pelvis. For the procedure, your healthcare provider injects medicine directly into the joint to ease pain.

Your healthcare provider might do a sacroiliac joint injection to diagnose or treat pain that may be coming from your sacroiliac joint. This joint connects the bone at the base of your spine (sacrum) to the large pelvis bones (ilium). You have two sacroiliac joints, one on each side of the body. They connect the sacrum to each side of the pelvis. These joints act as shock absorbers. They transmit weight and forces between the upper body and the legs.

Some pain in the lower back, buttock, or hip may come from these sacroiliac joints. A sacroiliac joint injection is a good way to find out whether your pain is from a problem in the sacroiliac joint. The procedure can also help to treat pain from that area.

For this procedure, your healthcare provider injects numbing medicine (local anesthetic) into the joint. He or she may use X-rays (fluoroscopy) to show where to place the needle. He or she may also use a small amount of X-ray contrast dye. It can help make sure the needle is in the right place so that the medicine goes directly into the joint.

There are two types of sacroiliac joint injections. During a diagnostic injection, the healthcare provider injects only numbing medicine into the joint. If your pain eases, then your sacroiliac joint is likely the cause of your pain. A therapeutic injection uses numbing medicine and steroid medicine to treat pain that comes from the sacroiliac joint. It decreases inflammation in the joint.

Sacroiliac joint injections are generally safe. Some possible risks of the procedure are:

  • Infection at the injection site
  • Bleeding at the injection site
  • Nerve damage
  • Leg weakness
  • Increased pain
  • Allergic reaction to the medicines

If you get steroid medicine in your shot, you may have some side effects. These include temporary increases in blood sugar levels for 1 to 2 days, an allergic reaction, and flushing of your face.

You may have other risks based on your specific situation and other health problems. Be sure to discuss any concerns with your healthcare provider beforehand.

You will need to go over your past health with your healthcare provider. Let him or her know if you have an infection, fever, or any other recent health problems. If you have diabetes or use any blood-thinning medicines, check whether you need to take any special precautions.

You should also discuss all your medicines with your healthcare provider. You may need to stop taking certain medicines a few days before the shot. Also be sure to tell your healthcare provider if you:

  • Have any allergies
  • Have had any problems with contrast dyes, past injection procedures, or other medicines

Your healthcare provider may tell you not to eat or drink after midnight the night before the procedure. You may get medicine to help you relax during the injection. You should arrange to have someone drive you home afterward. Your provider may give you other instructions about how to prepare.

Your exact procedure may differ. But general steps for a sacroiliac joint injection are the following:

  • You will lie face down on an X-ray table.
  • You may get medicine to help you relax (sedation).
  • The skin on your lower back and buttocks will be cleaned.
  • The healthcare provider will use medicine to numb the skin around the injection area.
  • The provider puts the needle tip into the sacroiliac joint. He or she will use X-rays to guide the needle. You may have pain in this area as the needle enters the joint.
  • The provider injects the X-ray contrast dye. It will confirm that the needle tip is in the joint.
  • The provider injects the medicine into the joint. This medicine may include local anesthetic to block the pain. It may also include a steroid to reduce inflammation. You may feel a stinging or burning during the shot. This sensation usually lasts just a few seconds.
  • The needle will be removed and a bandage applied.

You will be watched for about half an hour after the procedure. Then someone can drive you home. Ask your healthcare provider about any activity restrictions after the procedure. You should also ask if it is OK to use heat or ice in the area of the shot and if it is safe to bathe that day. Make sure to follow all your healthcare provider’s instructions for care, including any directions about your medicines.

You may be sore from the injection. You may also have some slight weakness in your leg for a few hours after the shot. If your pain comes from the sacroiliac joint, you may feel pain relief in the hours after the procedure because of the numbing medicine. As it wears off, the pain may start to feel worse.

If your healthcare provider gives you a steroid medicine, it may take up to 7 days for the medicine to start reducing pain and inflammation in the joint. As a result, you may feel better for the first few hours after the shot. But you then have more pain for a few days before the steroid starts working.

Your healthcare provider might ask you to keep a diary of your pain after the injection. A diary can help find out if your pain comes from the sacroiliac joint. It can also be used to decide how helpful an injection may be in the future.

You should call your healthcare provider if you have any of these symptoms:

  • Severe pain
  • Weakness or numbness in the leg that lasts more than a few hours
  • Fever
  • Signs of infection at the injection site. These include redness, swelling, and oozing.

Your healthcare provider can tell you more about what you should do and what you can expect after the sacroiliac joint injection. You will need to see your healthcare provider to talk about the effects of the procedure and make a plan for future treatment of your pain.

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • What the possible side effects or complications are
  • When and where you are to have the test or procedure
  • Who will do the test or procedure and what that person’s qualifications are
  • What would happen if you did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and how will you get the results
    Who to call after the test or procedure if you have questions or problems
  • How much will you have to pay for the test or procedure

Updated:  

January 16, 2018

Sources:  

Cancer Pain Management, Up To Date

Reviewed By:  

Moe, Jimmy, MD,Fraser, Marianne, MSN, RN