Sacroiliac Joint Injections Specialist

What is Sacroiliitis?

Sacroiliitis is inflammation of the sacroiliac joint.  This joint connects the tailbone to the hip bones. It bears the weight of the upper body and is a very common place to have pain. Rest, Ice, stretching, physical therapy, and core strengthening are conservative measures to help the pain.  If the pain persists or is severe then a sacroiliac joint injection may be indicated.

What can I expect from a sacroiliac joint injection?

Sacroiliac Joint injections are meant to help sacroiliitis or inflammation of the sacroiliac joints.  It utilizes a numbing medicine and steroid medicine.  The numbing medicine should help for 6-8 hours.  The steroid takes 2-3 days, sometimes up to 1 week to fully work.  Therefore, most people feel good the day of the procedure, back to normal (or worse due to the needle poke) the following day, and then start to feel better the day after that.

The side effects are similar to that of all procedures and include: bleeding, infection, and nerve damage. The chance of this happening is very rare as the doctor uses a c-arm fluoroscope machine to guide him. Potential side effects to the steroid medication include high blood sugar, facial flushing, and difficulty falling asleep. This only lasts about a day. 

Reduce procedural discomfort by applying ice for 15-20 minutes every 2-3 hours to reduce injection site swelling and irritation. NSAIDs and/or Tylenol are also recommended.

Why can it hurt worse the day after the injection?

The initial numbing medicine only lasts for 6-8 hours, then it is completely gone.  The steroid medication takes 2-3 days, sometimes up to a week to reach its peak effect.  Additionally, insertion of the needle through the skin, tissue and into the joint will cause some local inflammation similar to when you get a flu shot.  This local irritation may cause additional discomfort until the steroid medication starts working.  Over the counter medications such as Tylenol or ibuprofen work well for this in addition to rest and ice.

The pain has returned, what now?

Steroid injections last for variable amounts of time.  Some people get complete relief from a single injection, some get no relief, and most people fall somewhere in between.  The goal is for the injection to last at least 3 months.  These injections can be repeated, but should be limited to ~4/year, or roughly every 3 months. Core strengthening to help stabilize the SI joints is the most important factor in prolonging the relief from the injections.