Sacroiliac Joint Injection
What is a sacroiliac joint (SI) injection?
A SI joint injection is the placement of a small amount of steroid and local anesthetics using a needle under x-ray into the joint. The SI connects your low back (sacrum) to your pelvis (ileum).
Why is a sacroiliac joint injection performed?
A SI joint injection may be performed if you are experiencing pain in the low back and buttocks areas that may or may not radiate into the legs. After the injection, an improvement in pain confirms a diagnosis of SI joint pain.
Why would a sacroiliac injection NOT be performed?
A SI joint injection will NOT be performed if you have an infection at the site to be injected, fever, bleeding problems, allergy to the local anesthetic and steroid, recent injection of steroid into the same joint area, and/or pregnancy.
What are the preparations for the procedure?
Before the procedure, you are asked NOT to eat four (4) hours prior and NOT to drink liquids two (2) hours prior to your procedure time. You must have someone of age to drive you home following your procedure, as you will not be permitted to drive a vehicle on the day of your procedure. Anyone who is taking a blood thinning medication such as coumadin will be required to stop that medication for a specified period of time before the procedure. Otherwise, you may take your regularly prescribed medications the morning of your procedure with a sip of water. If you are a diabetic patient, you may eat a limited amount before your procedure to avoid hypoglycemia.
IF YOU ARE A PATIENT WITH AN IMPLANTED PACEMAKER OR A SPINAL CORD STIMULATOR, IT IS IMPERATIVE THAT YOU NOTIFY THE PHYSICIAN BEFORE THE START OF THE PROCEDURE. THIS PROCEDURE CAN INTERFERE WITH THE FUNCTION OF BOTH DEVICES AND MAY CAUSE SERIOUS SIDE EFFECTS.
What happens during the procedure?
After learning about the procedure from physician or physician assistant an informed consent paper, (giving permission for the procedure), must be signed by the patient. Then, the patient will be sedated with oral medications or with IV medications. Once in the procedure room, the patient will be placed face down on the x-ray table. The area to be injected will be cleaned with an antiseptic solution, which is usually betadine unless you are allergic to this. Numbing medicine will be injected under the skin to numb the area to be injected. The physician will use x-ray to guide a needle into the SI joint. Once the needle is in the joint a small amount of dye will be injected to confirm needle placement within the joint and to rule out vascular injection. After confirmation a small amount of steroid and local anesthetics will be injected.
How long does the procedure take?
The SI injection can take between 10-15 minutes.
What are possible complications from the procedure?
This procedure does come with risks. Complications that can occur include but are not limited to bleeding, hematoma, infection, trauma to the nerves (particularly the sciatic nerve), and reaction to the steroid and traumeel medications.
What are possible side effects of steroid medication?
Administration of steroid medication can cause side effects. Side effects can include but not limited to hyperglycemia, altered menstrual cycle, fluid retention, bruising, insomnia, sweats, hot/cold flashes, flushing of the face, weight gain, epidural lipomatosis, steroid myopathy, avascular necrosis of bone, osteoporosis, and Cushing’s syndrome.
What happens after the procedure?
After the procedure is completed, the patient is taken to the recovery area. There, you will be monitored closely by checking the blood pressure, heart rate, and pain score level. You may be given something to drink during this time. When ready, you will be given discharge instructions and any follow-up information that is needed. Remember, you may experience numbness in the affected area that may or may not go into the legs until the local anesthetic wears off completely. Do not attempt to walk until numbness completely wears off.
- If you suspect you might be pregnant or know you are pregnant, please notify the physician or any staff member prior to any injection.
- If you are a diabetic patient taking insulin or pills to manage your diabetes, the steroid used in the joint injection can raise your blood sugar level temporarily. You should monitor your blood sugar level closely after your injection. If your blood sugar level continues to be elevated then contact your primary care physician for suggestions on how to best manage this issue.
- After the injection, you should resume your regular medications as you are prescribed if those medications were stopped before the injection.
* If you do not understand any part of the above material, please discuss it with your physician or physician assistant. *