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Sacroiliac Joint Injection

What are sacroiliac injections?

The sacroiliac joints are found in your lower back on the left and right hand sides, just inside the buttock muscles. These joints are located in the pelvis between the large bone (ilium) of your pelvis and the sacrum.  

SIJ diagram

 

Pain can arise from the sacroiliac joint from wear and tear in the joint or other causes. A needle can be inserted into the sacroiliac joint using guidance from X Ray or Ultrasound in order to inject drugs which may reduce the pain from the joint and the nerves surrounding it..  Once the needle is correctly positioned into the joint a mixture of local aaesthetic with or without a locally acting steroid is injected.  The steroid acts only around the area it is injected into and does not have the same effects as taking long-term steroids.

Where is the injection carried out?

You will be asked to attend the Day Surgery Unit for half a day (morning or afternoon) On the day you will be greeted by a nurse who will look after you until you go home. You may be asked to change into a gown and will be taken to one of the operating theatres for the procedure. 

How is the injection done?

You will be asked to lie on your front on a special table that allows us to use an X Ray machine to guide the injections.  The dose of XRays used is tiny: the machine intensifies a very small XRay dose in a similar way to army night vision goggles.  X-ray pictures are taken throughout to ensure the needle is in the correct area. Alternatively, we sometimes do the injection using the images from an ultrasound machine to guide the needle into the right place.

The skin overlying the joint is sterilised and a small amount of local anaesthetic is injected with a tiny needle to numb the skin.  Following this fine needle is placed into the joint.  Once correct position is confirmed a small amount of local anaesthetic and sometimes steroid is injected into one or more of the affected joints.  

The steroid acts only around the area it is injected into and does not have the same effects as taking long-term steroids.

Does it hurt?

You do not need a general anaesthetic for this procedure.  Sometimes, on contacting the tender joint, there can be some temporary discomfort: the doctor will ensure pain is kept to a minimum by using local anaesthetic.   Once the procedure is over you may have some tenderness over the injection site but no worse than after any other type of injection.

How long will it all take?

Although the procedure itself usually only takes 10-15 minutes you will be asked to stay for up to an hour or so after the injection in the Day Surgery Unit before going home.

At home:

You may move around freely at home unless you have been advised to the contrary by a member of staff. Indeed, the patients who do best after this procedure are normally those who make use of the pain relief from the procedure to increase the amount of activity and exercise they do. You do not need to do any specific back exercises unless you have been instructed to do so.

Possible complications:

  • You may have mild discomfort at the site of the injection; this should last no longer than 48 hours. In a number of patients it can make your symptoms worse for about a week.
  • Very rarely you may get a numb leg which lasts for a few hours.
  • As for any procedure, we have to warn you that there are very small chances of rare complications such as infection.  
  • If you have diabetes your blood sugar level can temporarily become less well controlled.
  • Very rarely people can be allergic to the injection, which results in redness and itching. This is not serious, but we need to know for future treatments.  Very occasionally you may feel some flushing sensations for the first day or two after the injection, as a normal side effect of the steroid.
  • Serious complications with this procedure are extremely rare, but if problems arise please consult the Pain Clinic Office, or your own doctor who will contact the Pain Clinic if necessary.

(Please see general comments on the Procedures page)

You can download our Pain Service's information sheet on this procedure from this link.

  

  

 

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Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
email: pain.webmaster[at]glos.nhs.uk

Page updated 22/6/2016