What is a Sacro-Iliac Joint Injection?
Sacro-Iliac Joint Injection is an injection of long-acting steroid (“cortisone”) in the Sacro-Iliac joint; a large joint in the low back and buttocks where the hip joint joins the spine.
What is the purpose of it?
The steroid injected reduces the inflammation and/or swelling of tissue in the joint Space. This may in turn reduce pain, and other symptoms caused by Inflammation/irritation of the joint and surrounding structures.
How long does the procedure take?
The actual injection takes only a few minutes.
How is it actually performed?
You will be lying on your stomach, under x-ray control. You are monitored with EKG, blood pressure cuff and blood oxygen-monitoring devices. The skin in the back is cleaned with antiseptic solution and then the injection is carried out. After the injection, you are placed on your back or on your side.
Will the procedure hurt?
The procedure involves inserting a needle through skin and deeper tissues (like a “tetanus shot”). There is some discomfort involved. However we numb the skin and deeper tissues with a local anesthetic using a very thin needle prior to inserting the needle into the joint.
Will I be “put out” for this procedure?
No. The procedure is done under local anesthetic.
What should I expect after the procedure?
Immediately after the injection you may feel that your pain is gone or considerably less. This is due to the local anesthetic injected. This will last only for a few hours. Your pain will return and you may have a “sore back” for a day or two. This is due to the mechanical process of needle insertion as well as initial irritation from the steroid itself. You may start noticing pain relief starting the 3rd-5th day from the effects of the steroid.
What should I do after the procedure?
You should have a ride home. We advise you to take it easy for a day or so after the procedure. You may want to apply ice to the affected area. Perform your normal activities as you can tolerate them.
Can I go to work the next day?
Unless there are complications, you should be able to return to your work the next day. The most common thing you feel is a sore back.
How long will the effects of the procedure last?
The immediate effect is usually from the local anesthetic injected. This wears off In a few hours. The cortisone starts working in about 3 to 7 days and its effect can last for several days to a few months.
How many procedures do I need to have?
If the first injection does not relieve your symptoms in about a week or two, we will usually not repeat the block. If you respond to the injections and still have residual pain, you may be recommended for another injection.
Can I have more than three injections?
In a six-month period, I generally do not perform more than three injections. This is because the medication injected lasts for about six months. If three injections have not helped you much, it is very unlikely that you will get any further benefit from more injections. Also,giving more injections will increase the likelihood of side effects from cortisone.
Will the Injection(s) help me?
It is very difficult to predict if the injection will indeed help you or not. Generally speaking patients who have a recent onset of pain may respond much better than the ones with a long-standing pain.
What are the risks and side effects?
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects and the possibility of complications. The most common side effect is pain-which is temporary. The other risks involve; infection, bleeding, worsening of symptoms etc. The other risks are related to the side effects of cortisone: these include weight gain, increase in blood sugar (mainly in diabetics), water retention, suppression of the body’s own natural production of cortisone etc. Fortunately, the serious side effects and complications are unusual.
Who should not have this injection?
If you are allergic to any of the medications to be injected, if you are on a blood thinner (e.g. Coumadin, Plavix, Heparin), if you have an active infection going on, or if you are pregnant, you should not have the injection.