Sacroiliac Joint Injection
If you suffer from chronic low back or buttock pain that has failed to respond to conventional treatments, you may benefit from this simple and easy to perform therapy.
What is a Sacroiliac Joint Injection?
The sacroiliac joint, located in the lower back above the tailbone, is the largest joint in the human spine. Inflammation of the sacroiliac joint (sacroiliitis) is often overlooked as a cause of low back and buttock pain.
A sacroiliac joint injection is not only a simple method to determine whether or not pain is emanating from the sacroiliac joint, it is also a way to potentially eliminate it. This procedure is easy to do and is typically performed using fluoroscopy.
Sacroiliitis is often overlooked as a cause of cause of low back and buttock pain. Typical treatments for pain in these areas, like epidurals, will be totally ineffective for sacroiliitis. The sacroiliac joint injection is a targeted treatment specific to sacroiliitis.
A sacroiliac joint injection is indicated to not only diagnose sacroiliac joint pain (aka sacroilitis), but to also potentially treat it. The procedure isolates the specific nerve endings within the joint and alleviates pain at the source. If you experience pain relief for even a few hours after a sacroiliac joint injection, there is a strong likelihood the pain is coming from the sacroiliac joint.
For many patients who have been unable to get their low back or buttock pain under control with other types of treatments, this procedure is an easy minimally-invasive means to diagnose the source of pain and potentially treat it – all at the same time. If the procedure works and the patient reports a reduction of pain, the doctor may choose to repeat the procedure. This is to make sure the pain relief was not coincidental, or maybe the result of the medication escaping the joint and working on a different part of the low back and/or buttock. This, however, is a rare occurrence.
In the event the relief from the procedure is short-lived, your doctor may recommend a procedure called radiofrequency ablation (or RFA) of the sacroiliac joint. RFA works by applying complex radio waves to the nerves OUTSIDE the sacroiliac joint to eliminate the pain. This may provide longer lasting relief to the joint.
The amount of treatments varies on the severity of the pain and the length of time it has persisted.
Relief after a sacroiliac joint injection can vary from one person to the next, and also depend on what medication the physician has used on the joint. When local anesthetic is used, pain relief can begin in a matter of minutes (if Bupivacaine is used this may take as long as an hour).
Some physicians may elect to inject a combination of cortisone and local anesthetic. In this case, the patient may feel initial relief as soon as an hour after the procedure, only have the pain to return later that day when the anesthetic wears off. A few days later, though, the cortisone starts working on the pain.
Is a Sacroiliac Joint Injection Right for Me?
If you suffer from chronic low back and/or buttock pain that has failed to resolve with medications, physical therapy and other conservative therapies, a sacroiliac joint injection may be an option for you. The procedure should be performed under the strict supervision of a board-certified pain management specialist.
Contact the Ainsworth Institute to set up an initial evaluation to find out if you are a candidate for a sacroiliac joint injection.
Before the Procedure
Below is a short list of common instructions. Specific information will be provided by the physician.
Stop blood-thinning medication 2 days prior to the test
Do not take any aspirin product 5 days prior to the test
Stop anti-inflammatory medication 5 days prior to the test
Stop pain medication 8 hours prior to the test
Do not eat or drink 6 hours prior to the test
Arrange for someone to drive you home
Once you arrive:
Typically, the patient arrives at the medical facility, completes paperwork, and is interviewed by a clinician about his or her history, condition, current medications, and known allergies. The patient then changes into a hospital gown and is placed on a hospital bed. A nurse monitors the heart function (EKG), blood pressure, blood-oxygen levels (finger oximeter), and other vital signs.
An intravenous line is placed through which the patient receives medication for relaxation. The patient is awake during sacroiliac joint injection and may be asked to respond to the physician’s questions during the procedure.
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Procedure - Patient Details
The procedure is performed in a sterile setting similar to an operating room. The injection site is cleaned and draped. The patient is positioned in such a way that the physician has access to the sacroiliac joint. This involves he/she lying face down with a cushion under the lower abdomen for support. Skin-numbing medication is injected into and around the procedure site.
The fluoroscopic C-arm (named for its characteristic C-shape) is then positioned over the patient. Fluoroscopes are a type of video X-ray that project X-ray images in real-time on monitors in the procedure room. The fluoroscope is used to make sure the injection is done properly and in exactly the right place.
Diagnostic injections may include an anesthetic, steroid, and/or antibiotic. During or immediately after the injection, the physician may ask the patient about his or her symptoms.
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Risk Factors
A sacroiliac joint injection, like other medical procedures, may present risks. Complications include risk of infection, low blood pressure, headache, and injury to nerve tissue. The physician will discuss the potential risks and benefits of this procedure with the specific patient.
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The Ainsworth Institute is Here to Help
If you are suffering from chronic pain that has failed to respond to treatment and would like to see if you may be a candidate for this exciting treatment option contact the Ainsworth Institute of Pain Management today. Schedule an appointment with one of our Board Certified Physicians to learn more about a sacroiliac joint injection and see if you are a candidate for treatment.
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