Sacro Iliac Joint Injection

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SACROILIITIS – PAIN AT THE JUNCTION OF THE HIP AND SPINE – SACROILIAC JOINT INJECTIONS
What is the sacroiliac (SI) joint?
The SI joint connects the large triangular-shaped bone at the end of the spine (the sacrum)
to the two hipbones (iliac bones). The SI joints are designed for stability, not mobility.
However, it is subject to degenerative and inflammatory arthritis as well as mechanical
dysfunction.
How is SI joint pain diagnosed?
The history may reveal a precipitating injury, such as a fall, lifting a heavy object, or
turning. The pain is a one-sided ache that radiates to the buttock, groin, and/or thigh area.
It rarely goes below the knee. The pain is worsened by loading the joint, as occurs during
prolonged sitting, standing, or bending. There is tenderness over the joint area, and the
crossing the leg of the affected side typically reproduces the pain. The diagnosis is
confirmed if an SI joint injection with numbing medicine takes away the pain completely.
What should I expect during an SI joint injection?
In an SI joint injection, the doctor will use X-ray guidance to visualize the joint. He or
she will clean off the skin overlying the joint, then you will feel a pinch and burn while
the doctor numbs up the skin. Then the doctor will place a needle into the joint itself. If
the joint is inflamed, oftentimes the patient will experience a familiar zing of pain in the
area. It is not uncommon for the patient to say “that’s the spot!”. Then, the doctor will
confirm they are in the joint using contrast dye. Once confirmed, the doctor will injection
numbing medicine and steroid into the joint.
What should I expect after an SI joint injection?
The SI joint injection is both diagnostic and therapeutic. If this is the cause of the pain,
then it should feel better right away while the numbing medicine is working. The
numbing medicine wears off after 6-12 hours, and patients may experience a return of
their pain. The steroid medications take 3-7 days to treat the inflammation in the joint
and give long-lasting relief.
Ok, I had an SI joint injection and my pain was better the first day but I did not
experience any long-lasting relief. Now what?
This confirms that the SI joint is likely the pain generator, but it may be too degenerative
or inflamed to respond to steroids. In this case, you may be a candidate for a procedure
called an SI neurotomy.

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