What Can I Expect After a Sacroiliac Joint Injection?

A sacroiliac (SI) joint injection is the injection of local anesthetics or corticosteroids into the SI joint to treat pain.

A sacroiliac (SI) joint is a joint in the lower back that connects the bones of the spine and tailbone (sacrum) to the hip bones (iliac crests). The main function of the SI joint is to absorb shock between the upper body and pelvis and legs. Small movements at the joints help with shock absorption and forward/backward bending. The SI joint is fairly susceptible to lower back pain.

A sacroiliac (SI) joint injection is the injection of local anesthetics or corticosteroids into the SI joint to treat pain. The SI joint injection can be used as a treatment or as a diagnostic technique. SI joint pain can be caused due to the following conditions:

• Rheumatoid arthritis
• Gout
• Psoriasis
• Fracture
• Cancer
• Congenital deformities (deformity present from birth)
• Infection
• Pregnancy: A hormone called relaxin released excessively during pregnancy causes excess motion at the SI joint.
• Previous spinal surgery
• Ankylosing spondylitis (inflammatory arthritis affecting the spine and large joints)

You should avoid a sacroiliac (SI) joint injection if you have the following conditions:

• Bleeding disorder
• Infection at the planned site of injection
• Allergic to the contents of the injection
• Pregnancy
• Uncontrolled diabetes mellitus
• Congestive heart failure
• Blood thinner use
• Cancerous tumors at the SI joint or the nearby areas
• Unable to remain still for the procedure

Some of the instructions that you need to follow before and on the day of injection are as follows:

• You should inform your doctor if you are on blood thinners such as Coumadin (warfarin) or heparin or any prescription medicines.
• You should refrain from alcohol, cigarette smoking, or recreational drugs before the procedure.
• You should stop taking anti-diabetic medications prior to the procedure.
• You should not consume solid foods or fluids on the night prior to the procedure.

The physician first injects a contrast at the lower back area. This helps to outline the joint, which can be viewed under a fluoroscope. Once the physician identifies the sacroiliac (SI) joint, a syringe filled with steroid and a local anesthetic is injected into the joint space. The solution should enter the space with minimal resistance. The physician may reposition the needle in case of any resistance. The ultrasonographic technique can enhance the accuracy of the SI joint injection.

A sacroiliac (SI) joint injection improves pain immediately. You can expect pain and soreness at the injection site for a day or two after the surgery. The steroid medications may take two to three days to show its result. You may have temporary numbness or weakness in your legs caused by the anesthetic.

A sacroiliac (SI) joint injection works almost immediately. There is an immediate improvement in pain. However, once the numbing effect of the anesthesia wears off, your pain might return.

The complications of a sacroiliac (SI) joint injection include the following:

• Allergic reactions to the anesthetic agents 
• Infection at the site of injection
• Increased blood sugar level
• An increase in pain
• A sudden drop in blood pressure