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Sacroiliac Joint Injection
What is the sacroiliac joint and why is a
sacroiliac joint injection helpful?
The sacroiliac joint is a large joint in your
lower back and buttocks region. When the joint becomes
painful, it can cause pain in its immediate region or it can
refer pain into your
groin,
abdomen,
hip, buttock or
leg.
A sacroiliac joint injection serves several purposes.
First, by placing numbing medicine into the joint, the
amount of immediate
pain relief you experience will help confirm or deny the
joint as a source of your pain. That is, if you obtain
complete relief of your main pain while the joint is numb it
means this joint is more likely than not your pain source.
Furthermore,
time-release cortisone will be injected into the joint
to reduce any presumed inflammation, which on many occasions
can provide long-term
pain relief.
Although there are numerous ways to treat
sacroiliac joint dysfunction, sacroiliac joint
injections work powerfully to reduce your inflammation and
they can provide months of relief.
What will happen to me during the procedure?
If needed, an IV will be started so that adequate relaxation
medication can be given. After lying on an x-ray table, the
skin over your lower back/buttock will be well cleansed.
Next, the
physician will numb a small area of skin with numbing
medicine (anesthetic) which stings for a few seconds. The
physician then will use x-ray guidance to direct a very
small needle into the joint. He will then inject several
drops of contrast dye to confirm that the medication only
goes into the joint. A small mixture of numbing medication
(anesthetic) and
anti-inflammatory cortisone will then be slowly
injected.
What should I do and expect after the procedure?
20-30 minutes after the procedure, you will move your back
to try to provoke your usual pain. You will report your
remaining pain, (if any) and also record the relief you
experience during the next week in a pain diary. You may or
may not obtain improvement in the first few hours after the
injection, depending on if the sacroiliac joint is your main
pain source.
On occasion, you may feel numb, slightly weak or have an odd
feeling in your leg for a few hours after the injection. You
may notice a slight increase in your pain lasting for
several days as the numbing medication wears off before the
cortisone is effective. Ice will typically be more helpful
than heat in the first 2-3 days after the injection. You may
begin to notice an improvement in your pain 2-5 days after
the injection. If you do not notice improvement within 10
days after the injection, it is unlikely to occur. You may
take your regular medications after the procedure, but try
to limit them for the first 4-6 hours after the procedure,
so that the diagnostic information obtained from the
procedure is accurate. You may be referred for physical or
manual therapy after the injection while the numbing
medicine is effective and/or over the next several weeks
while the cortisone is working.
On the day of the injection, you should not drive and
should avoid any strenuous activities. On the day after the
procedure, you may return to your regular activities. When
your pain is improved, start your regular
exercise/activities in moderation. Even if you are
significantly improved, gradually increase your activities
over 1-2 weeks to avoid recurrence of your pain.
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