FAQ’s on Sacroiliac (SI) Joint Injections

The juncture of the sacrum and the right and left iliac bones form the Sacroiliac (SI) joint. At the bottom of the spine lies the sacrum, a triangular-shaped bone, positioned below the lumbar region. Most of the bones of the spine have mobility. The sacrum is made of five fused vertebrae that are stationary. The pelvis is made of two large bones, the iliacs. The sacrum and iliac bones are connected by a collection of strong ligaments.

These joints are expected to support the entire weight of the upper body when the patient is erect (which places a huge amount of stress upon them), resulting in arthritis and deterioration of cartilage in the SI joints.

Sacroiliac (SI) Joint Injections are injections of corticosteroids that are given in the area of the sacroiliac joint to relieve pain symptoms felt by chronic pain sufferers.

What can be gained, what are the goals, expectations, and hope when a patient receives sacroiliac joint injections?

Patients may enjoy relief from chronic pain conditions, regain lost mobility, and become able to return to a more productive and enjoyable quality of life. The goal of the sacroiliac joint injection is to break the cycle of chronic pain and provide relief, and for most patients this can be expected.

How is the sacroiliac joint injection procedure performed?

With the aid of fluoroscopy imaging (a type of X-ray imaging for real-time diagnostic films), the pain specialist will precisely insert a needle into the sacroiliac joint and inject a local anesthetic.

If this alleviates pain in the patient, confirming the diagnosis, then the physician will inject a corticosteroid into the joint as well. This corticosteroid is what provides the long-term pain relief.

How long does procedure to perform?

The procedure takes about thirty minutes, including an observation period after the injection to watch for negative side effects. The procedure is typically administered every two to three weeks, and may be performed up to three times within a six month period. The effects of the local anesthetic will be immediate, but the long-term effect of the corticosteroid may take anywhere from several days after the first injection, to two or three procedures, before its maximum effects occur in the patient eliminates the pain symptoms fully.

How long do the effects from sacroiliac joint injections last?

The long term effects of the corticosteroids vary from patient to patient, for some it may last days or weeks, for others the effects may last for months at a time. Many patients experience relief nearly the entire time between office visits, but most still rely on opioid pain relievers to supplement the injections.

What are the risks and/or side effects of sacroiliac joint injections?

While the benefits of sacroiliac injections are high, there are risks and side effects. The risks and side effects may be as simple as bruising or infection at the injection site. Other side effects may include: fever, headache, water retention, hiccups, insomnia, increased appetite, facial flushing, increased heart rate, and abdominal cramping or bloating.

Studies show only about 5% of patients experience some form of side effect, and they usually dissipate within a few days after the procedure. In the worst case scenarios, although very rare, there is the possibility of increased pain, nerve injury, avascular necrosis, or even paralysis.

What conditions are treatable with sacroiliac joint injections?

Sacroiliac joint injections are primarily used to treat lower back pain caused by bulging and herniated discs, which cause pain by applying pressure to the nerve roots in the affected area. The injections are also used to treat sciatica and sacroiliac joint dysfunction.

How effective are sacroiliac joint injections for the relief of pain?

The effectiveness of sacroiliac joint injections may vary from person to person but for the majority of patients the pain relief is substantial, with some patients benefiting from as much as 80-90% relief that may last for months.