This procedure is used to treat patients suffering from pain in their sacroiliac joint (SI joint). It is also used as a diagnostic tool in that it helps therapists locate the source of pain that may or may not be emanating from the SI joint.
The SI joints, which are in your lower back, connect your spine to the pelvis, and thus, the entire lower half of the skeleton. Although these joints are small and don’t move very much, they perform a critical role in the body. They help absorb all of the damaging shock forces of the upper body before balancing and transmitting their weight to the hips and legs. When these joints become inflamed or irritated, they may cause pain in the lower back, buttocks, abdomen, groin or legs.
A SI joint injection involves placing numbing and steroidal medicine into the irritated joint or joints. The amount of immediate pain relief experienced will help confirm or rule out the joint as the source of pain.
Along with steroidal medications such as Depomedrol or Kenalog, numbing medications similar to ones used in dentists’ offices are injected into the SI joints during this procedure. These injections usually take anywhere from a half an hour to an hour to complete.
If your procedure is scheduled in the morning, please don’t drink any liquids or eat any solid foods after midnight. If your injection is scheduled in the afternoon, you may have water or apple juice that morning, up to two hours before the procedure.
If you are taking any blood thinners such as Coumadin and Plavix, you must stop taking them a week before your injection. Let your primary care doctor and Pain Management Center physician know before you stop taking your blood thinners.
Before the procedure, you will have an intravenous (IV) catheter placed in your arm or hand. This IV will provide you with fluid and medication that may make you feel a little drowsy. You will then be placed on your stomach and your back will be numbed with a local anesthetic before a small needle is inserted into the lower back near your SI joints. Once the needle is in place, the steroidal/numbing medication will be injected.
When the procedure is over, the numbing medicine may make your legs feel temporarily weak. Therefore, you should limit your activity for the day of your procedure. Someone should accompany you home after the injection because you will not be able to drive. You can usually resume normal activity the day after your procedure.
Once the numbing medication wears off, your pain will likely return. The steroid medication may provide longer lasting pain relief, but probably won’t begin working for 24 to 48 hours after the injection.
You may experience bruising or tenderness at the injection site(s) and your pain may get worse a day or two after the injection.