INTRODUCTION

Sacroiliac (SI) joint injections are a common diagnostic procedure used to identify the cause of back pain. These injections involve injecting an anesthetic medication into the SI joint to temporarily alleviate pain and help doctors determine the source of the pain. This guide aims to provide you with information on the injection process, including the injection site, goals of the procedure, preparation, expected outcomes, potential complications, and post-procedure care.

ANATOMY

Understanding the involved body parts:

During a sacroiliac joint injection, a needle is inserted into the sacroiliac joint, which connects the sacrum and the iliac bone. The SI joint is located in the lower back and can be identified externally as two small dimples on each side of the belt line. The SI joint is a larger joint in the body, characterized by a wavy surface that allows slight sliding, tilting, and rotation movements. It is held together by strong ligaments, primarily at the back of the joint. While the SI joint provides minimal motion in adults, it plays a crucial role as a shock absorber and reduces stress on the pelvis and spine.

RATIONALE

What are the goals of the procedure?

A SI joint injection is performed to determine if the SI joint is the source of your back pain. It is primarily a diagnostic procedure that provides temporary pain relief. By injecting a combination of local anesthetic and cortisone into the joint, inflammation and swelling can be reduced, resulting in pain relief that can last for several weeks. If the injection confirms the SI joint as the cause of your pain, further treatments may be recommended to provide long-term pain reduction.

PREPARATIONS

How should you prepare for the procedure?

To prepare for the procedure, your doctor may instruct you to fast (remain “NPO”) for a specified period of time before the injection. It is essential to follow these instructions and refrain from eating or drinking anything during that time, except for taking your usual medications with a small amount of water if instructed. You may also be asked to discontinue certain medications that affect blood clotting to reduce the risk of excessive bleeding. It is crucial to inform your doctor about any blood-thinning medications you are taking. Arranging transportation to and from the procedure location, wearing loose-fitting clothing, and using a bactericidal soap before the procedure are also recommended.

PROCEDURE

What happens during the procedure?

During the procedure, you will be taken to the procedure area, where an intravenous line (IV) will be started for administration of medications and to ensure rapid response in case of any complications. Fluoroscopic guidance, which involves the use of an x-ray machine, is employed to ensure precise needle placement. Once the needle is correctly positioned, a small amount of radiographic dye is injected to confirm its location. The medication is then injected, and the needle is removed. Following the procedure, you will be monitored in the recovery area until you are stable and free from any allergic reactions. The temporary numbness and weakness caused by the anesthetic will subside before you can be discharged.

COMPLICATIONS

What are the potential risks?

While complications are rare, it is important to be aware of possible complications associated with SI joint injections:

  1. Allergic Reaction: There is a risk of allergic reactions to the medications used during the procedure. Allergic reactions can range from mild reactions like hives or rashes to severe reactions that restrict breathing. Most allergic reactions occur immediately during the procedure and are promptly treated. Inform your doctor about any known allergies to the medications used.
  2. Infection: Infections can occur at the injection site or within the joint. Strict sterile techniques arefollowed during the procedure to minimize the risk of infection. Signs of infection include increasing redness, swelling, pain, and fever. Prompt medical attention is necessary if any of these symptoms occur. Infections are typically treated with antibiotics, and in some cases, surgical drainage may be required.
  3. Increased Pain: In some instances, the injection may initially cause increased pain, usually due to temporary muscle spasms around the injection site. This discomfort is typically short-lived and subsides within a few hours or days. If increased pain persists or begins several days after the injection, it may indicate an infection, and you should contact your doctor.

AFTER CARE

What should you expect after the procedure?

Assuming everything goes as planned, you will be allowed to return home shortly after the procedure. It’s important to follow any post-procedure instructions provided by your doctor. You may experience temporary numbness and weakness due to the anesthetic, but these effects will resolve. If the injection confirms that the SI joint is the source of your pain, your doctor may recommend further treatments, such as physical therapy, to help strengthen muscles and restore normal movement. Be sure to report any persistent or worsening symptoms to your doctor for appropriate follow-up care.

Please note that while this guide provides valuable information, it does not cover all possible details and complications. If you have any specific concerns or questions about your sacroiliac joint injection, consult with your healthcare provider for personalized advice and guidance.

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