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Sacroiliac Joint Injection

A sacroiliac joint injection is an injection of an anti-inflammatory steroid (e.g., dexamethasone, methylprednisolone or triamcinolone) into the sacroiliac joint. The sacroiliac is a joint located between the tailbone ("sacrum") and pelvic bone ("ileum"). Thus, the name "sacroiliac" joint comes from the two bones that make up the joint. Generally, the joint does not move. There are conditions, such as family history, trauma, childbirth, the type of work you have done, etc., that result in the joint developing degenerative changes resulting in chronic pain.

How long does the procedure take?

The injection takes only a few minutes. Please allow about an hour for the procedure; this will include talking to your doctor before the procedure, signing the informed consent, positioning in the room, and observation by the recovery room nurse afterwards.

What medicines are injected?

The injection consists of a mixture of local anesthetic (e.g., lidocaine) and the steroid medication.

Will it hurt?

Our procedures begin by injecting a small amount of local anesthetic through a small needle. It feels like a little pinch and then a slight burning as the local anesthetic starts numbing the skin. After the skin is numb, the procedure needle feels like a bit of pressure at the injection site. You may also feel some pressure from within the sacroiliac joint capsule. If you experience any pain during the procedure, your doctor will inject more local anesthetic as needed.

Will I be "put out" for this procedure?

No. This procedure is done under local anesthesia.

How is the procedure done?

The procedure is done with you lying on your stomach. Your blood pressure and oxygenation will be monitored. In addition to your doctor and the x-ray technician, there will be a nurse in the room at all times if you have any questions or discomfort during the procedure. The skin is cleaned with antiseptic solution and then the procedure is done. Small needles are placed within the joint capsule and a small volume (about two to three milliliters) is placed in the joint.

What should I expect after the injection?

After the injection, your pain may be gone or considerably less. This is due to the effect of the local anesthetic and lasts only for a few hours. Your pain may return and you may have some soreness at the injection site for a day or so. Pain relief starts one to two days after the procedure.

What should I do after the procedure?

We advise the patients to take it easy for a day or so after the procedure. Perform the activities as tolerated by you. Your recovery room nurse will advise you about applying ice to the site.

Can I go back to work the same day?

You should be able return to work. Your doctor or recovery room nurse will discuss this with you.

How long do the effects of the medication last?

Long-term effect of the medication cannot be predicted. The immediate effect is from the local anesthetic injected, this wears off in a few hours. The steroid works in one or two days and its effect can last for several days to a few months.

How many injections do I need to have?

This will vary with each patient; your doctor will discuss this with you.

Can I have more than one injection?

If the first injection is successful but the pain returns, you are eligible for another injection. Your doctor will discuss this with you.

How will I know if the injection will help?

It is difficult to predict how helpful injections will be. Patients who have the symptoms described above will do well. Since there are several pain generators in the spine, the degree of response will vary. Patients with recent onset of pain may respond much better than ones with longstanding pain.

What are the risks and side effects?

This procedure has very few risks. With any procedure, there are some risks and side effects you should know about. Commonly encountered side effects are increased pain from the injection (usually temporary), infection, bleeding, nerve damage, or no relief from your usual pain. Side effects of the injected steroid may include weight gain, increase in blood sugar (particularly in diabetics), water retention, suppression of the natural production of steroids, or temporary suppression of the immune system.

Who should not have this injection?

The following patients should not have this injection: if you are allergic to any of the medications to be injected, if you are on a blood-thinning medication (e.g. coumadin, injectable heparin), or if you have an active infection going on.

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