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SI Joint Injections

If you're struggling to find relief from sacroiliac joint (SI) joint pain, injections with a corticosteroid might be the right treatment for you. Read more to learn about the benefits of SI joint injections for treatment of sacroiliac joint pain.

13 Jun 2023 • 5 MIN Vincent Giampapa MD
SI Joint Injections

SI Joint Injection

The sacroiliac joints, or SI joints, are the largest axial joints in the human body, connecting the lower spine to the pelvis. These joints provide stability and support the weight of the upper body. However, sometimes they can become painful due to injury, inflammation, degeneration, or dysfunction. 

 

SI joint pain can affect daily activities and quality of life, and managing it may require targeted interventions like SI joint injections to help alleviate pain and inflammation. Read more to find out what the procedure entails, whether or not it's right for you, and the benefits and risks associated with SI joint injections.

 

Why Would I Need a SI Joint Injection?

Your doctor may consider SI joint injections for the following reasons:

  • Diagnostic Purposes: If you have been experiencing chronic low back pain, buttock pain, or radiating leg pain and your healthcare professional suspects the SI joint is the source of your discomfort, an SI joint injection may be recommended as a diagnostic tool. By injecting a local anesthetic into the joint, your doctor can confirm if the SI joint is the cause of your symptoms by assessing whether or not your symptoms have subsided.
  • Therapeutic Treatment: SI injections can help reduce inflammation, alleviate pain, and improve overall function in individuals with SI joint dysfunction or inflammation. By combining a local anesthetic and a corticosteroid injected into the joint, immediate pain relief and longer-term anti-inflammatory effects can be achieved, allowing for improved mobility and participation in activities previously limited by pain.
  • Preparatory Step for Rehabilitation: In some cases, the injection can temporarily relieve pain, enabling individuals to engage in physical therapy or other rehabilitative exercises effectively. This facilitates strengthening, stretching, and other therapies aimed at restoring SI joint function and reducing pain in the long term. Look at SI Joint Pain for exercises to alleviate SI joint pain. 
  • Alternative to Surgery: If conservative treatments have not provided sufficient relief, healthcare professionals may suggest SI joint injections as an intermediate step before considering surgical interventions. This approach allows individuals to explore less invasive options before pursuing more extensive procedures.

 

Before undergoing an SI joint injection, seeking guidance from a licensed healthcare professional who can assess your condition, symptoms, and medical history is crucial. Your healthcare professional will consider your individual needs and determine whether it is an appropriate treatment option.

 

What is the SI Joint Injection Procedure? 

SI joint injections are typically performed in an outpatient setting, such as a clinic or ambulatory surgical center, by a qualified healthcare professional, interventional pain specialist or anesthesiologist. The procedure generally follows these steps:

  1. Preparation: The patient lies on an examination table, either on the stomach or side, depending on the healthcare professional's preference and the patient's comfort. The skin in the injection area is thoroughly cleaned, and a sterile drape is placed over the site.
  2. Local Anesthesia: The healthcare professional administers a local anesthetic to numb the skin and underlying tissues near the SI joint injection site.
  3. Needle Placement: Guided by fluoroscopy (real-time X-ray) or ultrasound imaging, the healthcare professional carefully inserts a thin needle into the targeted SI joint. Imaging guidance ensures accurate needle placement, increasing the procedure's effectiveness.
  4. Contrast Dye Injection (Optional): A contrast dye may be injected to confirm the needle's accurate positioning within the joint. This step helps ensure the medication reaches the intended area and improves diagnostic accuracy.
  5. Medication Injection: Once the needle is correctly positioned, the healthcare professional injects local anesthetic and corticosteroid into the SI joint. The medication spreads within the joint, targeting inflammation and providing pain relief.
  6. Post-Injection Observation: Following the injection, the patient may be monitored briefly to assess any immediate response or adverse reactions. The healthcare professional will provide post-injection care instructions and discuss potential side effects or limitations.

 

How Long Will a SI Joint Injection Last?

Pain relief can often be experienced within 24 to 48 hours following the injection. According to a study conducted in 2017, individuals who do not respond initially to sacroiliac joint injections are unlikely to experience significant pain relief later.

 

Typically, individuals can expect significant pain relief for at least six weeks, with some experiencing improvements for up to 6 months.

 

It is generally advised not to exceed three steroid injections within a one-year timeframe.

 

What are the Benefits of a SI Joint injection?

SI joint injections offer several benefits for individuals suffering from SI joint-related pain. 

  • They provide targeted pain relief by injecting an anesthetic and medication that can help to reduce inflammation, alleviate discomfort, and improve overall mobility and function. 
  • SI joint injections can serve as a diagnostic tool by determining if the SI joint is the source of the pain. If the injection provides temporary pain relief, it confirms the involvement of the SI joint and helps guide further treatment options. 
  • SI joint injections are minimally invasive procedures that can be performed on an outpatient basis, resulting in shorter recovery times, fewer complications, and minimal scarring. 

 

What are the Risks of a SI Joint Injection?

While SI joint injections can provide significant benefits, it's important to know of the potential risks associated with the procedure. 

  • As with any injection, there's a risk of infection at the injection site. Although rare, it's essential to monitor for signs of infection, like increased pain, swelling, redness, or fever, and promptly seek medical attention if these symptoms occur.
  • Bleeding or bruising at the injection site. While this is generally minimal, individuals with bleeding disorders or those taking blood-thinning medications should inform their healthcare provider before undergoing the procedure.
  • In very rare cases, nerve damage can occur during the injection, leading to temporary or permanent sensory or motor deficits. However, the likelihood of this complication is low when an experienced healthcare professional performs the procedure.
  • The effects of SI joint injections may be temporary. While many individuals experience prolonged pain relief, the duration can vary, and additional injections or alternative treatments may be necessary for sustained benefit.
  • Corticosteroid medications used in SI joint injections can have potential side effects, including elevated blood sugar levels, weight gain, mood changes, and increased susceptibility to infections. It's important to discuss any existing medical conditions or medications with your healthcare provider to evaluate the suitability and potential risks of the injection.

 

Overall, while the risks associated with SI joint injections are generally minimal, it's crucial to thoroughly discuss with your healthcare provider, weigh the potential risks and benefits, and then make an informed decision based on your circumstances.

 

Conclusion

While SI joint injections may be beneficial for a number of reasons, it's important to consult with a healthcare professional to evaluate whether or not this treatment option is best for you. Check out  How to Reduce Joint Discomfort, Stiffness, and Pain While Improving your Range of Motion to learn about way to lower inflammation associated with joint pain and discomfort. Consider adding a joint supplement to your supplement regimen like Healthycell’s Joint Health & Mobility microgel. 

 

 

About the Author

 

Dr. Giampapa is a world-renowned medical doctor, inventor, and surgeon specializing in anti-aging medicine. He recently received a nomination for the Nobel Prize for his groundbreaking stem cell research, as well as the Edison Award for the Healthycell nutritional supplement for cell health. He was also awarded the A4M Science & Technology award for his development of the BioMarker Matrix Profile – the first computer program to measure aging.