Sacroiliac Joint Injections

Description

The sacroiliac joints are next to the spine and connect the sacrum with the hip. There are two sacroiliac joints in total, one on the left and one on the right side of the body. Inflammation of the sacroiliac joints can lead to debilitating pain.

A sacroiliac joint injection is a procedure involving the injection of local anesthetic and a steroid medication into the sacroiliac joint, which reduces inflammation and provides immediate pain relief. The purpose of a sacroiliac joint injection is two-fold:

  • Diagnostic: A sacroiliac joint injection can assist in confirming a suspected diagnosis of sacroiliac joint dysfunction. After injection of the local anesthetic into the joint, the patient’s response is carefully noted. If the patient experiences 75-80% pain relief, a diagnosis of sacroiliac joint dysfunction is tentatively made. Typically, a second diagnostic injection is performed to confirm the results of the first injection.

  • Therapeutic: Sacroiliac joint injections can provide relief from the pain associated with sacroiliac joint dysfunction. The injection of corticosteroid into the joint helps to reduce inflammation and alleviate pain. After a patient undergoes a sacroiliac joint injection, they can begin physical therapy to achieve further improvements. Injections may be repeated up to three times per year.

Indications

Indications for a diagnostic sacroiliac joint injection include:

  • Low back pain lasting at least 3 months

  • Diagnosis is uncertain following physical examination and imaging studies

  • At least 4-6 weeks of failed conservative therapy

Indications for a therapeutic sacroiliac joint injection include:

  • Low back pain lasting at least 3 months

  • Conservative treatment for 4-6 weeks fails

  • Evidence of a positive response to a prior diagnostic sacroiliac joint injection