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Sacroiliac Joint Injection

The sacroiliac joint connects the lowest part of the spine, the sacrum, to the adjoining bones of the pelvis, the iliac bones, that are present on either side of the sacrum. In an adult there is minimal movement at these joints. However, in a female, they play an important role during delivery where they relax and increase the flexibility of the pelvis.

An injury or arthritis can cause inflammation of the sacroiliac joints, causing pain. Sacroiliac joint injections, containing cortisone and a local anaesthetic, can reduce the inflammation and decrease the intensity of pain.

The benefits of sacroiliac joint injections vary. In most patients, the pain subsides within 10-15 minutes after the injection and may provide pain relief for up to 6 months or more. In some patients, it may not provide much pain relief. In cases of recurring pain, the injection may be repeated, or alternative pain management techniques will be discussed with you.

Preparation before the injection

You should inform the doctor if:

  • You have any cough, cold or any systemic or skin infection such as a wound, boil or rash as infection could spread to the spine. If necessary, the doctor will reschedule the injection for a later date once the infection resolves.
  • You are a diabetic. Cortisone injections may cause transient elevation in blood sugar and may require a temporary adjustment of your blood sugar medication.
  • You are on any blood thinning medication
  • You think you are pregnant

Procedure

Sacroiliac joint injection is an outpatient procedure performed by a radiologist. The patient would lay face down in a CT scanner. The injection site is sterilised, and local anaesthetic is injected to numb the area. A fine needle is then inserted through the skin and tissues into the sacroiliac joint, under guidance from CT Fluoroscopy imaging. Once the position of the needle has been confirmed, a mixture of cortisone and local anaesthetic is injected into the inflamed sacroiliac joint through the needle.

After the Injection

Some patients may experience mild discomfort in the back while most patients are free from pain. Patients are able to walk freely and are observed for 10 minutes following the procedure. You should avoid driving for the rest of the day, after the injection. You may return to work the following day, but strenuous activity should be avoided for the initial few days. The intensity of activities can be gradually increased over time.

Risk and Complications

Sacroiliac joint injections are safe but as with other medical procedures there are risks involved. Some of the risks associated with sacroiliac joint injection include infection and nerve damage. Bleeding at the injection site is rare but can occur in patients with bleeding disorders and those on blood thinning medications.