What are Sacroiliac Joint Injections?

Sacroiliac joint injections explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors

A sacroiliac joint injection is a treatment approach for patients who are suffering from sacroiliac joint pain. Reports indicate that approximately 15-30% of individuals tend to suffer from persistent and nonspecific back pain that is due to irritation of the sacroiliac joint. Clinical trials have shown that injecting steroids into the tissue surrounding the joint or directly into the sacroiliac joint provides patients with more pain relief than placebo injections. Furthermore, the effects of the injections were reported to last for at least one month.

How are Sacroiliac Joint Injections Performed?

Sacroiliac JointThe sacroiliac joint is a large structure that connects the spine to the hips. More importantly, it helps the spine bear the weight of the limbs and the upper body. This joint also provides individuals with maximum stability and prevents injuries by only permitting a limited range of movement. Furthermore, the sacroiliac joint is referred to as a diarthrodial joint because it connects the sacrum at the base of the spine to the pelvic bone (the ileum). The region where these two structures meet is covered by a thin layer of cartilage. A fibrous capsule also encases this region and thick synovial fluid cushions the joints.

A sacroiliac joint injection involves administering medication to the area that surrounds the fibrous capsule membrane. Local anesthesia is applied to the skin and then an imaging device, such as an X-ray or fluoroscope, is used to guide the thin needle that is inserted into the vertebral space near the sacroiliac joint.

Contrast dye is also injected to help ensure that the needle will be properly placed before the steroids are injected and to make sure that the medication will be appropriately distributed to the targeted region. The steroids are then injected into the areas where the largest amount of inflammation was observed. This reduces the chances of exposing healthy tissue to the steroids.

This is a brief, non-surgical procedure that is easy to perform. It can also be administered in an outpatient setting with local anesthetics. An anxiolytic may be given to patients who experience a high level of anxiety before receiving the injection to help them relax. It has been reported that most patients who receive sacroiliac joint injections begin to feel a reduction in pain that is almost immediate. In addition, patients are briefly monitored after the injection to determine their level of pain relief and the presence of any side effects.

Conditions Related To Sacroiliac Joint Injections

Sacroiliac Joint PainAnesthesiologists typically administer sacroiliac joint injections to treat nonspecific back pain that has become chronic due to injured, irritated, or inflamed nerves in the sacroiliac joint. Pain that is the result of problems in the sacroiliac joint is hard to diagnose, but it generally starts after a back strain or a recent injury. Reports have shown that approximately 50% of the individuals who received a confirmed diagnosis of sacroiliac joint pain were able to describe the event that more than likely caused the pain to begin.

Repetitive movements, falls, and motor vehicle accidents are the most common causes of this type of injury. These types of events, however, are not the only reasons that sacroiliac joint pain occurs and previous studies have identified several factors that increase the risk of developing sacroiliac joint pain. The factors include pregnancy, gait and biological abnormalities, differences in the length of an individual’s legs, scoliosis, or a persistent strain.

When pain develops due to problems from the sacroiliac joint, it is typically hard to pinpoint the exact location in the lower back where the pain is being felt. Therefore, when a physician is trying to establish a treatment regimen, it is important to determine the patient’s level of impairment. For instance, some patients lose their strength, balance, and flexibility; all of which can hinder the ability to engage in physical therapy without experiencing serious pain. A physician may also request that conventional methods (e.g., medication) be utilized before a steroid injection is recommended.

Conclusion

A sacroiliac joint injection is an effective treatment for patients suffering from debilitating back pain that has been caused by the irritation of nerves in the sacroiliac joint. This method of treatment is usually recommended when pain has started to affect an individual’s ability to walk or perform other types of movement.

A sacroiliac joint injection is a brief and non-surgical procedure that can be performed in an outpatient setting. Many patients have reported experiencing almost immediate pain relief following the injection and clinical reports attribute the effectiveness of this treatment to the ability of steroid injections to dramatically reduce inflammation.

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References

  1. Chou R, Atlas SJ, Stanos SP, Rosenquist RW. Nonsurgical interventional therapies for low back pain: A review of the evidence for an American Pain Society Clinical Practice Guideline. Spine. 2009;34(10):1078-1093.
  2. Cohen SP, Chen Y, Neufeld NJ. Sacroiliac joint pain: A comprehensive review of epidemiology, diagnosis and treatment. Expert Rev Neurother. 2013;13(1):99-116.
  3. Hansen H, Manchikanti L, Simopoulos TT, Christo PJ, Gupta S, Smith HS, Hameed H, Cohen SP. Pain Physician. 2012;15(3):E247-78.
  4. Jee H, Lee JH, Park KD, Ahn J, Park Y. Ultrasound-guided versus fluoroscopy-guided sacroiliac joint intra-articular injections in the non-inflammatory sacroiliac joint dysfunction: A prospective, randomized, and single blinded study. Arch Phys Med Rehabil. 2013;9:[Epub ahead of print].
  5. Manchikanti L, Hansen H, Pampati V, Falco FJ. Utilization and growth patterns of sacroiliac joint injections from 2000 to 2011 in the medicare population. Pain Physician. 2013;16(4):E379-90.
  6. Simopoulos TT, Manchikanti L, Singh V, Gupta S, Hameed H, Diwan S, Cohen SP. A systematic evaluation of prevalence and diagnostic accuracy of sacroiliac joint interventions. Pain Physician. 2012;15(3):E305-44.
  7. Spiker WR, Lawrence BD, Raich AL, Skelly AC, Brodke DS. Surgical versus injection treatment for injection-confirmed chronic sacroiliac joint pain. Evid Based Spine Care J. 2012;3(4):41-53.