Understanding Sacroiliac (SI) Joint Injections
A sacroiliac (SI) joint injection is a minimally invasive treatment used to ease pain caused by inflammation or irritation in the joint where the spine meets the pelvis. By delivering numbing medicine and a steroid directly into the joint, this approach can help calm irritated tissues, reduce inflammation, and improve mobility. While relief varies from person to person, many find these injections helpful when SI joint pain limits daily activities or does not respond to conservative care.
How the Injection Works
The SI joints connect the sacrum (tailbone) to the ilium (part of the hip bone). These joints help support body weight and absorb impact with movement. When the joint becomes inflamed, irritated, or strained, pain may develop in the lower back, pelvis, hips, or legs.
An SI joint injection delivers two medications:
- Local anesthetic, which provides immediate but temporary relief.
- Steroid medication, which reduces inflammation and offers longer-lasting improvement within 24–48 hours.
Common causes of SI joint pain include osteoarthritis, gout, ankylosing spondylitis, pregnancy, abnormal gait patterns, and injuries.
Preparing for and Undergoing Treatment
Before treatment, patients taking blood thinners such as Warfarin, Coumadin, or Plavix will need to pause these medications under medical guidance. Individuals with diabetes should avoid taking their diabetes medication until after the injection is complete.
During the procedure, patients receive IV medication to help them relax. The injection area is cleaned, and X-ray guidance is used to precisely place the needle into the SI joint. The anesthetic and steroid are then injected. A brief burning or stinging sensation may occur as the numbing medicine takes effect.
The procedure typically takes less than 30 minutes. After a short monitoring period, patients may go home with a designated driver.
Benefits and Conditions Treated
SI joint injections can help reduce pain in the lower back, buttocks, hips, pelvis, and upper legs, especially when symptoms worsen with standing from a seated position or shifting weight onto one leg. Patients may also experience improvement in stiffness, burning sensations, numbness, or leg weakness related to SI joint inflammation.
These injections can be helpful for patients whose pain stems from inflammatory conditions, joint degeneration, pregnancy-related strain, abnormal gait patterns, or injury. Relief may allow individuals to return to daily activities with greater comfort or participate more effectively in physical therapy.
Aftercare, Risks, and When to Seek Attention
After the injection, patients should avoid driving, strenuous activity, and applying heat to the area for 24 hours. Mild numbness, weakness, or temporary soreness is common. Diabetic patients may notice short-term elevations in blood sugar due to the steroid.
Complications are uncommon but may include bleeding, infection, or allergic reaction. Patients should contact their physician if they develop persistent redness, drainage, fever, chills, or increasing pain at the injection site.