A Sacroiliac Joint injection is an injection of numbing medicine and corticosteroid in the Sacroiliac joints – which are located in the back of the pelvis.
WHAT IS THE PURPOSE OF IT?
The numbing medicine helps determine if the sacroiliac joint is the cause of your pain. The steroid injected reduces the inflammation and swelling of tissue in the joint space. By reducing this inflammation, this may help reduce your pain.
HOW LONG DOES THE INJECTION TAKE?
The actual injection only takes a few minutes. You can expect to be in the procedure room for about 15 minutes for positioning, placing monitors, preparation, and the procedure.
What is injected?
The injection usually consists of the corticosteroid (methylprednisolone, triamcinolone, celestone) and a local anesthetic (lidocaine or bupivicaine).
Will the injection hurt?
Most patients tolerate the injection very well. Numbing medicine is placed under the skin that feels like a poke and a burn. After that, you most likely will only feel pressure. If you feel any pain during the injection, more numbing medicine can be given. If you choose, you may have intravenous sedation to help you relax.
Will I be "put out" for this procedure?
No. The safest way to do this procedure is under local anesthesia. You may choose to have intravenous sedation, which will help you relax, but you will always be awake during the procedure to minimize the chance of any nerve damage.
How is the injection performed?
You will be lying on your stomach on an x-ray table. We will monitor your blood pressure, heart rhythm, and blood oxygen. Your skin will be cleansed with an antiseptic. After the injection, you will be placed on a bed and moved to the recovery area.
What should I expect after the injection?
You may or may not feel better immediately after the injection. The numbing medicine injected can wear off after several hours. You may have a sore back for several days after the injection. This is due to the needle insertion as well as the chemically irritating effect of the steroid. The steroid is a long and slow acting medication that can take up to 5 days before starting to work and up to 2 weeks before taking full effect.
What should I do after the procedure?
We recommend that you limit strenuous physical activity the day of the injection. You will bring someone with to drive you home the day of the injection. There is absolutely no driving the day of the injection. You may go about your normal daily activities as tolerated excluding strenuous physical activity.
Can I go to work the next day?
Unless otherwise directed by your physician, you may return to work the next day. Some patients may have a sore back for up to 3 days which can be alleviated with ice and ibuprofen.
How long will the effect of the medication last?
The effect of the steroid can last anywhere from several days to several months. The purpose of the injection is to decrease swelling and inflammation to decrease pain. Over time, your body may heal itself How many injections do I need? If the first injection does not relieve your symptoms after two weeks, a second injection may be recommended. If the second injection doesn’t relieve your symptoms after an additional two weeks, a third injection may be recommended. The effects of the injections are additive if spaced at these time intervals. We generally would not perform more than 3 steroid injections in a 6-month time period. More than this may increase the steroid load in your body increasing the likelihood of suffering from side effects. If 3 injections did not provide a lasting benefit, it is unlikely that any further steroid injections would provide further benefit What are the risks and side effects? Overall, the procedure is very safe. As with any procedure, there are risks. The most common side effect is pain, which is temporary. Any time a needle is punctured through the skin, there is a chance of bleeding or infection that is very rare. Other rare side effects include nerve damage or worsening of pain., which are extremely unlikely.
Who should not have these injections?
If you are allergic to corticosteroids, specific local anesthetics, or ionic contrast, please notify your physician. Also, if you are taking any blood thinners (Coumadin, Plavix, Warfarin, Lovenox, Aspirin) please let your physician know ahead of time to help devise a safe plan for the injection.
