Sacroiliac Joint Injections are safe and effective treatments indicated for chronic low back pain that is unresponsive to conservative medical management. The sacroiliac joint lies next to the spine and connects the sacrum to the hip on both sides. It has been shown to be a source of pain in up to 30% of cases of chronic low back pain. Patients with medical conditions such as rheumatoid arthritis, gout, psoriasis, ankylosing spondylitis, fracture, congenital deformity, cancer, or infection can also develop pain in the sacroiliac joint. Pregnant women, people with a leg length discrepancy and patients who have undergone spinal surgery are also at risk for this type of lower back pain.
How Sacroiliac Joint Injections Work
Sacroiliac joint injections involve depositing of medicine, consisting of a mixture of a local anesthetic and a steroid, directly into the joint. These injections can help diagnose the source of pain, because by placing the medicine into the joint, the amount of pain relief experienced will help confirm whether the joint is the source of pain. Complete pain relief in the sacroiliac joint confirms that this area is likely to be the source of pain.
Along with the local anesthetic, time-release steroid is also injected into the sacroiliac joint to reduce inflammation, which often provides long-term pain relief. Since the treatment uses locally administered medications, it does not have a widespread effect on the body; rather, only painful areas are targeted, and no systemic side effects are expected.
Patients benefit from this procedure because after the injection, inflammation and pain are reduced for several months, allowing the patient to resume normal activities and undergo rehabilitation or physical therapy while healing takes place.
A sacroiliac joint injection is an outpatient procedure performed by a qualified Chronic Pain Specialist who is an expert with the treatment. The patient is initially briefed about the procedure and prepared beforehand so that he is relaxed.
The patient is asked to lie face down on his stomach on the radiography table. A pillow may be placed under the hips for patient comfort. The skin overlying the sacroiliac joint is sterilized. After the exact area to be injected is located using live x-ray guidance (fluoroscopy), the skin overlying the joint is numbed with a local anesthetic.
A needle is advanced into the sacroiliac joint. A small amount of water-soluble dye may be injected to confirm proper needle position. Once this is confirmed, a mixture of anesthetic and anti-inflammatory medication (steroid) is injected into the joint space. The needle is then slowly withdrawn.
After the procedure, the patient is monitored in the recovery area and discharged on the same day. Upon discharge, they will be asked to evaluate their improvement in the succeeding week and report for follow-up. Repeat injections may be performed up to three times, if needed, every two weeks.
A Sacroiliac Joint Injection is a minimally invasive, safe, and effective means of treating low back pain that is unresponsive to other forms of treatment. If you want more information about treating chronic low back pain, contact our Pain Management Specialist who will examine you and conduct tests to determine the cause of your back pain. Make an appointment with the NYC’s top board-certified interventional pain management physician to know if sacroiliac injections are a treatment option for you.