A sacroiliac joint injection is an outpatient procedure to treat chronic lower back or leg pain from an inflamed or injured sacroiliac joint. The sacroiliac joints are the two joints in the lower back, which connect the lower part of the spine (sacrum) to the pelvis (iliac bone).
The sacroiliac joints have a layer of cartilage which covers the bones, which acts as a “shock absorber” during movement. Trauma (falls, injuries, car accidents), hip or spinal surgery (e.g., laminectomy and lumbar fusion), and disease processes (e.g., gout, rheumatoid arthritis, psoriasis and ankylosing spondylitis) can damage or wear away at the cartilage and cause inflammation in the sacroiliac joints. This can lead to severe, sometimes debilitating pain in the lower back, buttocks, abdomen, groin or legs.
Dr. Sonia Pasi offers sacroiliac joint injections to select patients at Advanced Pain Consultants. In this treatment, a local anesthetic (numbing medication) is mixed with an anti-inflammatory drug (steroid medication) and injected in or around the joint. Doctors have been performing sacroiliac joint injections for several decades. It is considered a very safe and effective way of reducing inflammation and providing pain relief for an extended period of time.
A sacroiliac joint injection is best-suited for patients who have chronic or radiating pain stemming from a strain, agitation or injury in the sacroiliac joints. More conservative treatment measures (such as physical therapy, anti-inflammatory medications, chiropractic care, massage, etc.) may have been tried, but without any reduction in pain symptoms. While this treatment is most effective when the pain is coming from the sacroiliac joints, it can also help relieve pain that is emanating from other joints as well.
Sacroiliac joint injections cannot be administered to patients with active infections (who are taking antibiotics), extremely high blood pressure, uncontrolled diabetes or heart disease. Patients with these medical conditions will need to postpone having the sacroiliac injection until after their condition improves or is under control. Patients who are taking blood thinners (e.g., aspirin, Coumadin, Plavix, Pletal) will need to stop these medications 5 to 7 days before having the injection.
The best way to know find out if a sacroiliac injection is right for you is by scheduling a consultation with Dr. Pasi. She will conduct a comprehensive physical examination, which will include an assessment of your health history and medical imaging (such as x-rays or an MRI). This will help Dr. Pasi determine whether a sacroiliac injection can meet your pain management goals.
Dr. Pasi performs sacroiliac joint injections in Advanced Pain Consultants’ office or at an outpatient medical facility. Patients stay awake during the procedure, although local anesthesia will be used to numb the injection site and patients will have the option of being lightly sedated to help them relax. The treatment itself only takes about 15 minutes, and patients go home the same day.
Once the anesthesia has taken effect, Dr. Pasi will begin the procedure by directing a fine needle into the affected sacroiliac joint using x-ray imaging for guidance. She may inject several drops of contrast dye to verify that the needle is in the proper position. Once she’s confirmed that the needle in the correct place, Dr. Pasi will inject the mixture of the numbing medicine (anesthetic) and anti-inflammatory medicine (cortisone/steroid). The injection site will then be cleansed with an antiseptic soap and alcohol and bandaged. The patient will be monitored for an appropriate time in the recovery area (usually 20-30 minutes) before being discharged to go home.
Patients are advised to take it easy the rest of the day, but can normally return to work and their normal activities the day after the injection. The pain will be gone immediately after the injection, but this is due to the local anesthetic. Once this wears off, the pain may temporarily return before the steroid medication that was injected begins taking effect.
The majority of patients who undergo this treatment experience significant pain relief. Results are not immediate though. Sacroiliac injections use a slow-release steroid drug which typically takes 2 to 3 days to begin taking effect.
Results do vary from patient to patient. For some people, the effects of the injection last a few weeks, while others experience pain relief lasting for up to six months or more. In a minority of patients, the injection provides little or no relief. The only way to know whether the injection will effective is try it and then wait and see.
Patients who eat a healthy diet, do not use tobacco, are at their ideal body weight, exercise regularly and have good sleep habits tend to respond better to the injections than those with less healthy lifestyles. Utilizing additional, simultaneous pain treatments such as physical therapy, pain relief medications, chiropractic treatments, acupuncture and massage therapy can help to prolong the pain reducing response of the injection.
Some patients may require one or two additional injections, after the first, before the full benefit is felt. If the first injection does not relieve the patient’s symptoms after a week or two, a second injection may be provide an “additive” benefit. If a second injection is done and there is still residual pain, a third may be recommended. However, if after three injections, the pain is still bad, a fourth would not be advised since it probably wouldn’t provide any further benefit.
If you’re suffering from pain in the lower back, legs or buttocks, a sacroiliac joint injections may be a treatment option for you. Please call Advanced Pain Consultants at (919) 510-7901 to schedule a consultation and learn more about sacroiliac joint injections. During your appointment, Dr. Pasi will carefully evaluate your condition to determine if this treatment is right for you, or if another therapy might be more effective. Contact us today and take the first step to feeling better!
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