The sacroiliac joint connects the bone at the base of the spine (sacrum) to the large pelvis bones (ilium). There are two sacroiliac joints, one on each side of the body, connecting the sacrum to each side of the pelvis. These joints act as shock absorbers and transmit weight and forces between the upper body and the legs.
Pain in the lower back, buttock, or hip may originate from these sacroiliac joints, and if that is the case, a sacroiliac joint injection is a great way to find out for sure and to treat the pain.
There are two types of sacroiliac joint injections: diagnostic and therapeutic. During a diagnostic injection, the healthcare provider will only inject a numbing medicine into the joint. If the patient experiences pain relief, then the sacroiliac joint is likely the cause of their pain.
During a therapeutic injection, the physician injects numbing medicine and steroid medicine to treat pain originating from the sacroiliac joint and to decrease inflammation.
The physician will review the patient’s medical history and current medications. Patients diagnosed with diabetes or who use any blood-thinning medicines should ask their physician if they need to take any special precautions.
It’s important to discuss all medication with the healthcare provider prior to the procedure. Patients may need to stop taking certain medicines a few days before the injection. In addition, patients should tell their healthcare provider if they:
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Have any allergies
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Have an infection, fever, or any other recent health problem
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Have had any problems with contrast dyes, past injection procedures, or other medicines
The healthcare provider may instruct patients to avoid eating or drinking after midnight the night before the procedure.
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The patient will lie face down on an X-ray table and receive medicine to help them relax. The skin on their lower back and buttocks will be cleaned and the healthcare provider will use medicine to numb the skin around the injection area.
Next, the provider will insert the needle tip into the sacroiliac joint using X-ray guidance. Patients may experience some discomfort as the needle enters the joint.
The provider will then inject the X-ray contrast dye to confirm that the needle tip is in the joint, after which the medicine will be injected. This medicine may include local anesthetic to block the pain and a steroid to reduce inflammation.
Patients may feel a temporary stinging or burning during the shot. At the end of the procedure, the needle will be removed and a bandage applied.
The procedure is generally safe with few serious risks. Potential side effects include:
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Infection at the injection site
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Bleeding at the injection site
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Nerve damage
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Leg weakness
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Increased pain
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Allergic reaction to the medicine
Patients who receive steroid medicine in their shot may experience:
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Temporary increases in blood sugar levels for 1 to 2 days
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An allergic reaction
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Flushing of their face
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A sacroiliac joint injection involves injecting medicine into the sacroiliac joint to diagnose or treat lower back pain originating in the joint.