Sacroiliac (SI) joint injections are a diagnostic tool and treatment option for SI joint dysfunction. This minimally invasive outpatient procedure provides pain relief for chronic SI joint pain and is also known as a sacroiliac (SI) joint block. Using these injections as a diagnostic tool provides patients with quick-acting pain relief, while it provides patients with slower-acting but longer-term pain relief when used as a treatment option.
When used as a diagnostic tool, your healthcare professional will use a local anesthetic to numb your SI joint. They will then ask you to engage in ordinarily painful activities. If the SI joint injection lessens the pain during these activities, your healthcare professional will perform a second diagnostic injection with a different numbing medication. If both injections provide a statistically significant reduction in the patient’s pain, the SI joint is confirmed as the source of pain. If not, your medical professional will order other diagnostic tests to find the cause of your lower back pain.
When used as a treatment option, your healthcare provider will inject a corticosteroid into your SI joint to provide pain relief by reducing inflammation in the joint. Your doctor may suggest this treatment option if you have not found pain relief after six months of conservative treatment. SI joint injections may be used in conjunction with other conservative treatment options or as a one-time procedure. Pain relief provided by nerve blocks varies between patients. Some patients report complete pain relief for several months, while others report partial pain relief for several weeks.
SI joint dysfunction
Low back pain
Able to help diagnose lower back pain
Provides pain relief
Short procedure and recovery time
Before your procedure, your doctor may ask you to stop taking non-steroidal anti-inflammatory drugs (NSAIDs), immunosuppressant medication, and blood thinners to reduce your risk of serious complications or infections. If you are pregnant or suspect you are pregnant, talk to your doctor about alternative treatment options. Your healthcare professional may ask you not to eat or drink several hours before the procedure. This procedure cannot be performed if the patient has an active infection or symptoms of a cold, flu, or similar malady. If you experience these symptoms on the day of the procedure, you will need to reschedule your injections.
During the procedure, you will lie face down on the table. The healthcare professional performing your procedure may administer general anesthesia through an IV, depending on your comfort levels and pain tolerance. They will then sanitize the skin surrounding your SI joint and inject local anesthesia into the area. Using x-ray guidance and contrast dye, they will inject the numbing medication. They will inject lidocaine or bupivacaine for diagnostic tests, while they will inject a corticosteroid or other anti-inflammatory medicine for therapeutic nerve blocks.
This procedure lasts between twenty and thirty minutes, and you will remain in an observation room afterward to ensure no immediate complications or adverse reactions occur.
You will need someone to drive you home following your injection, and you should rest the remainder of the day. You may notice an increase in pain at the injection site, but it will dissipate within two to three days. If the pain becomes too bothersome, you can take over-the-counter pain relievers or use an ice pack. Drink plenty of water while resting to flush the contrast dye from your system.
The diagnostic injections should provide some pain relief instantaneously. Your healthcare professional will ask you to engage in previously painful activities over the next several days to weeks. Document what activities you do and any pain or soreness you feel during or after those activities.
The corticosteroid injections may take several days to weeks to feel any pain relief. If you experience no pain relief three weeks after your injection, contact your healthcare professional to discuss further treatment options.
Steroid injections are generally safe, but there remains a small chance of complications, such as:
Allergic reaction to anesthesia or medication
Bleeding or infection at injection site
Bruising or soreness at or around the injection site
Leg weakness or numbness
Short-term elevated blood sugar for those living with diabetes
Your medical professional has weighed the benefits of this treatment against its risks to determine this is the best treatment option for you. If you have further concerns, discuss them with your doctor.