A sacroiliac (SI) joint injection – also called a sacroiliac joint block – is primarily used either to diagnose or treat low back pain and/or sciatica symptoms associated with sacroiliac joint dysfunction.
The sacroiliac joints lie next to the spine and connect the sacrum ( the low back area below the waist) with the hip on both sides. There are two sacroiliac joints, one on the right and one on the left. Joint inflammation and/or dysfunction in this area can cause pain.
The purpose of a sacroiliac joint injection is to both diagnose the source of a patient’s pain, and to provide therapeutic pain relief.
The diagnostic part of the SI joint injection is used to help confirm a suspected diagnosis of sacroiliac joint dysfunction (pain from the sacroiliac joint). This is performed by using numbing medication (eg.lidocaine or marcaine)when injecting the sacroiliac joint. The injection is performed under fluoroscopy (x-ray guidance) for accuracy. Once the needle has entered the sacroiliac joint, contrast is injected into the joint to ensure proper needle placement and proper spread of medication. The numbing medication as well as a steroid medication is injected into the joint. The steroid is the treatment portion of the injection.
We then will ask the patient keep a pain journal to record the effect of the medicine.
If the therapeutic sacroiliac joint injection is successful in reducing or eliminating the patient’s pain, it may be repeated up to three times over the year. If a portion of the pain has resolved it Dr. Barrack may repeat the injections shortly thereafter with the goal of even greater improvement.
The Sacroiliac Joint Injection Procedure
The Sacroiliac Joint injection procedure is usually performed in an operating room or a dedicated procedure room. The entire procedure usually takes only minutes, and the patient goes home the same day.
The following outlines the typical injection procedure:
To maintain sterility, the skin overlying the sacroiliac joint injection is cleansed using an iodine based solution (e.g. Povidine-Iodine) or an alcohol-based antiseptic (e.g. chlorhexidine 0.5% in 70% alcohol). Sterile gloves are used throughout the entire injection procedure
For the patient’s comfort, the needle insertion site is often numbed using local anesthetic. Once the needle enters the sacroiliac joint under fluoroscopy guidance, contrast – ‘dye’ that shows up under x-ray – is injected to verify needle placement within the sacroiliac joint and to verify spread of solution within the joint.
Once the needle has been guided into the joint successfully, the medications( numbing medicine and steroid) are injected into the joint.
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