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Sacro-Iliac Joint Injection

The sacro-iliac joint is a joint in the pelvis, which is connected by ligaments. The joint helps support the spine. When it becomes inflamed, it can lead to lower-back pain or leg pain.

When this happens, your physician may recommend a sacro-iliac joint injection as part of your treatment for pain.

The procedure involves injecting anesthetic and a steroid medication into the joint. The numbing medication typically wears off in a few hours, while the steroid provides longer-lasting pain relief and begins to work within 24-48 hours.

Patient guidelines (PDF) ›

Procedure overview (PDF) ›

What is the goal of sacro-iliac joint injection?

The goal of a sacroiliac joint injection is to provide pain relief so that you are able to resume normal activities. In many cases, we will prescribe a course of physical therapy to help you return to a normal level of activity.

What happens before treatment?

You will be escorted to a room where a nurse will conduct a pre-procedure interview.

The physician who will perform the injection reviews your medical history, previous imaging studies, current medications and physical exam results in order to help plan the best approach for the injection. If you have not had a physical exam prior to the injection, the physician will perform an exam at this time.

What happens during the procedure?

You will remain awake during the entire process. Blood pressure, heart rate and breathing are continually monitored.

After you are lying face down on the procedure table, the injection site is cleansed with an antiseptic. This procedure involves inserting a needle through the skin, muscle and soft tissues, so there is some slight discomfort involved.

An injection of local anesthetic will be administered in the area where you are experiencing pain. The physician then directs a needle with the use of X-ray guidance and deposits the medication.

This procedure takes approximately 30 minutes.

Should I limit my activity or change my diet after the injection?

You will remain awake during the entire process. Blood pressure, heart rate and breathing are continually monitored.

After you are lying face down on the procedure table, the injection site is cleansed with an antiseptic. This procedure involves inserting a needle through the skin, muscle and soft tissues, so there is some slight discomfort involved.

An injection of local anesthetic will be administered in the area where you are experiencing pain. The physician then directs a needle with the use of X-ray guidance and deposits the medication. This procedure takes approximately 30 minutes.

Are there any side effects caused by sacro-iliac joint injection?

Side effects are uncommon following an injection; however, you may experience the following:

  • Immediately after the injection, you may feel that your pain is gone or is much less. This pain relief is often the result of the local anesthetic and will usually only last a few hours. Your usual pain will follow. Pain relief from the steroid medication usually takes several days to appear.
  • You may experience mild pain at the site of injection for several days. You may also experience a temporary increase in your usual pain after the injection. You can apply ice to the area for as long as 15 minutes, three to four times a day.
  • You may experience some dizziness during or soon after the injection.

For diabetic patients

If you have diabetes, it is important to know the steroid can cause an elevation in your blood sugar level for up to two weeks after the injection. You should check your blood sugar more often than usual for several days after an epidural steroid injection. If your blood sugar is elevated, please contact the doctor who  manages your diabetes for instructions on how to change your diet and/or adjust your diabetes medication.

Are there any restrictions after sacro-iliac joint injection?

Yes. You should follow these restrictions after the procedure:

  • Do not drive for the remainder of the day.
  • Do not take a tub bath or soak in water (pool, hot tub) for 24 hours after the injection.
  • Wait three days post-procedure before resuming physical therapy.

What are the medications used for sacro-iliac joint injection?

Sacroiliac joint injections are performed with a mixture of different medications given for specific reasons:

  • Lidocaine or bupivacaine are local anesthetics that are used to numb the area of injection; this numbness usually wears off within two to six hours.
  • Triamcinolone (Kenalog®) is a steroid used to treat inflammation and pain. The effects of this steroid may take up to 10 days to appear.
  • Lopamidol, an X-ray contrast agent, may be injected into the area to confirm correct placement.

When should I call my doctor?

You should call your doctor immediately if any of the following occurs:

  • Swelling, redness, bleeding or discharge from the site of the injection
  • A fever greater than 100˚F
  • New or worsening back or neck pain
  • New numbness or weakness in your arms or legs
  • Difficulty with urination after the injection, such as suddenly losing control of your bladder
  • Difficulty with bowel movements after the injection, such as suddenly losing control of your bowels
  • You develop a new headache after the procedure
To be seen by one of our specialists, call 949-UCI-PAIN (949-824-7246) or request an appointment online ›

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