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FAQs on SI Joint Injections in Phoenix, Arizona

 

A sacroiliac (SI) joint injection involves inserting a steroidal agent and local anesthetic directly into the joints of the very low back region. The procedure is used to provide relief of pain associated with sacroiliac joint disease, low back pain, and arthritis.

What causes sacroiliac joint pain?

The SI joints have some cartilage covering the bone, and the cartilage allows for some movement. In addition, SI joint cartilage acts as a shock absorber between bones. When joint cartilage wears away, bones rub against one another, leading to arthritis. SI joint dysfunction is caused by the arthritis. Other conditions that contribute to SI joint pain include rheumatoid arthritis, ankylosing spondylitis, injury related to trauma, and psoriasis.

Will the injection hurt?

Most people say that the medicine burns and stings a little, but the procedure for the most part is not uncomfortable. However, expect some mild soreness for a few hours after the procedure.

How do I prepare for the procedure?

Before the procedure, you should not eat or drink for 6 hours. In addition, take medicines only with a small amount of water. If you have an active infection or illness, be sure to make the doctor aware of this. Also, notify the physician of any blood thinners you take, such as warfarin and Coumadin. Those agents must be held for a few days before the procedure.

What happens during the SI joint injection procedure?

After the doctor reviews the risks and benefits of the procedure, he/she will have you sign a consent for services form. After you are positioned on the procedure table, the injection site is cleaned with an antiseptic solution. The skin is numbed using a local anesthetic. Using real-time x-ray, a needle is guided into the SI joint, and the medication is injected. Following the injection, a bandage is applied.

What medications are injected into the SI joint?

The doctor will inject a corticosteroid, with or without an anesthetic agent. Commonly used corticosteroids are triamcinolone, dexamethasone, and methylprednisolone.

What can I expect after the procedure?

After the SI injection procedure, the area will feel sore for a few hours. You are monitored in the recovery area for 30 minutes, and given some crackers and juice. After you are alert and mobile, you will be discharged. Most patients return to work and usual activities within 1-2 days. Expect immediate pain relief from the local anesthetic, but as this wears off, the pain may return. The steroidal agent starts working after 2-3 days. You can use ice packs for 20-minute intervals for pain relief.

Does the SI joint injection work?

In a study involving 46 patients, researchers analyzed the effectiveness of an SI injection for treatment of pain over a 2-year follow-up time. The injections involved 80 mg of triamcinolone acetonide and bupivacaine. The pain was assessed using a visual analog scale. Using this scale, at six months, the overall success rate of the SI joint injection was 89%.

Will I have restrictions on the day of the procedure and soon after?

You are not permitted to drive for the remainder of the day after the procedure, and should rest. Arrange to have someone drive you home. Do not apply heat to the injection site, and avoid soaking in a tub or shower. After the injection, resume your normal activities as tolerated.

Resources

Sahin O, Harman A, Akgun RC, & Tuncay IC (2012). An Intraarticular Sacroiliac Steroid Injection Under the Guidance of Computed Tomography for Relieving Sacroiliac Joint Pain: A Clinical Outcome Study with Two Years of Follow-Up. Archives of Rheumatology, 27(3), 165-173.

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