Sacroiliac joint pain is a condition of chronic pain emanating from the Sacroiliac joint located at the base of the spine. The Sacroiliac joint is the joint at the base of the spine between the Sacrum and the Ilium; this joint connects the spine to the pelvis.
- Excessive tightness of the muscles
- Pregnancy (due to natural widening of the pelvis)
- An unusual difference in the length of the legs
- Deterioration of the cartilage
- Trauma from impact (fall injury)
What symptoms are associated with Sacroiliac joint pain?
Symptoms of Sacroiliac joint pain are:
- Lower back pain, most often located on one side
- Pain in the hip
- Discomfort associated with bending over, also from standing after extended periods sitting
- Discomfort and pain lessen when lying down
How is Sacroiliac joint pain diagnosed?
Typically your Colorado pain doctor will perform a physical exam and there are several provocative maneuvers to check for SI joint related pain. In order to verify the diagnosis an MRI or CT scan may be performed in order to get a clear image of the skeletal structure.
What treatments are available for Sacroiliac joint pain?
For lesser pain, OTC medications like Ibuprofen, Naproxen sodium, and Acetaminophen may help somewhat, but for chronic conditions your doctor may prescribe opioid analgesics or sacroiliac block injections (also called a sacroiliac joint block). For conditions non-responsive to injections the patient may be a candidate for a radiofrequency nerve ablation.
The general progression is if the SI joint injection works and wears off, then either a repeat injection is indicated or the radiofrequency procedure is performed to obtain longer term pain relief.
What are expectations when a patient receives a sacroiliac joint injection?
The patient has a reasonable expectation of experiencing some level of pain relief from this procedure. Over 50% of patients achieve at least 50% pain relief. And the pain relief usually lasts for a few weeks to a few months.
How is the sacroiliac joint injection performed?
The patient is placed on an exam table, the area to be injected is cleansed with antiseptic solution and then topical anesthetic is used to numb the area to be injected. Using fluoroscope guidance (a type of x-ray machine) to ensure proper needle placement, the needle is then inserted into the area to be injected. A contrast dye is then injected to ensure the proper nerves are being treated, and then the numbing medications, a mixture of local anesthetic and a corticosteroid are injected. Often the patient will experience immediate temporary relief from the local anesthetic, but it can take two to three days for the steroid to be effective.
How long do sacroiliac joint injections last?
The level and duration of relief from the injection can be different for different people depending on how well they respond to the medications used. For some patients relief may be one or two weeks, for others it can last for several months. It can take several treatments before maximum relief is felt.
What risk or side effects are possible with these injections?
Slight bruising or bleeding at the injection site is possible. Very rarely infection at the injection site may occur but this is minimized by keeping the site clean. In very rare cases nerve damage is possible but this is minimized to nearly zero with the use of the fluoroscope.
How successful are they the relief of pain for the condition?
Most people that receive the sacroiliac joint injection will experience relief from chronic pain on some level. Discuss your condition with your Colorado pain management doctor to see what the best course of action is for your condition.