Why is a Sacroiliac Joint Injection Performed?
Conditions Treated With Sacroiliac Joint Injections
SI joint injection can be helpful for the diagnosis and treatment of SI joint pain. It can occur due to:
- Trauma (for example, a fall, a work injury, or a vehicle accident)
- Pregnancy and childbirth
- Surgery of the hip or spine (e.g., laminectomy or lumbar fusion)
Diagnostic Use:
A complete history and physical examination, including provocative testing, is done. SI joint diagnostic injection is given if there is a high suspicion of SI joint pain. An anesthetic is injected into the SI joint during diagnostic blocks. If the patient feels 75% pain alleviation while executing previously painful motions for the duration of the anesthetic medication, the diagnosis of SI joint dysfunction can be made.
Therapeutic Use:
A local anesthetic is combined with corticosteroid medication to relieve pain in the SI joint. Intra-articular or peri-articular therapeutic SI joint injections are available. Intra-articular injections are better than peri-articular injections.
Pain Management:
Your pain may be relieved immediately after the local anesthetic injection. Your pain may reoccur as the numbing medication wears off. You may experience some soreness at the injection site, and your pain may worsen for a day or two after the procedure. Most people get the benefits of the steroid medicine within 2-3 days. An ice pack used three or four times a day can help relieve pain at the injection site.
Minimally Invasive Sacroiliac Joint Fusion:
Pain in the lower back, abdomen, groin, buttocks, or legs may result from inflammation or irritation of the SI joints. This procedure can stabilize the SI joints by grafting the sacrum to the ileum with instrumentation, bone graft, or both to fuse the bone, limiting movement. When both SI joints require surgery, the first joint is treated first, and the second joint surgery is arranged after the first has recovered completely.
Procedure:
Under the influence of general anesthesia, you will lie on your stomach. Your surgeon makes a small incision on your buttocks, usually 2 to 3 cm long. Gluteal muscles are dissected to access the ileum and make a small hole. The hole of the ileum is widened to allow the implants to reach the sacrum.
If a bone transplant is necessary, it is put in the joint space after the area has been cleaned. The implant instruments are then guided into the ileum passage and inserted with pins, screws, or a mallet. Standard sutures can seal the incision in layers. The procedure mostly takes about an hour, and you will be hospitalized for a day or two to recover.
The following are some of the benefits of minimally invasive sacroiliac joint fusion:
- Post-operative pain reduction
- Blood loss reduction
- Less harm to adjacent tissues
- A smaller incision
- Fewer complications
- Recovery time is less.
How is a Sacroiliac Joint Injection Performed?
The Sacroiliac Joint injection procedure is done in an operating room or a separate procedure room. The entire treatment often takes only a few minutes, and the patient gets discharged the same day.
After obtaining informed consent, the patient lies face down on the radiography table on their stomach. For the patient’s comfort, a pillow could be placed beneath the hips. During the procedure, the doctor will monitor the patient’s vitals (such as pulse rate and blood pressure).
The skin above the sacroiliac joint injection is washed with an iodine-based solution (e.g., Povidone-Iodine) or an antiseptic containing alcohol (chlorhexidine 0.5 percent in 70 percent alcohol). Throughout the injection procedure, the doctor will use sterile gloves.
A local anesthetic is used to numb the needle insertion site for the patient’s comfort. Once the needle has entered the sacroiliac joint under fluoroscopy guidance, contrast – a ‘dye’ that shows up on an X-ray – is injected to confirm needle placement and the spread of solution within the joint. After effectively guiding the needle into the joint, diagnostic or therapeutic medicines are injected into the joint.
A local anesthetic (generally lidocaine or bupivacaine) is frequently given to the joint to identify rapid pain relief and to confirm the sacroiliac joint as the source of the patient’s pain.
An anti-inflammatory medication (generally a corticosteroid) may help reduce inflammation within the joint, which in turn may help alleviate pain for a long period (typically for several months, up to a year). This fluid is injected into the sacroiliac joint for therapeutic purposes.
