Sacroiliac Joint Injections

What are sacroiliac pain causes?

Your sacroiliac joint is located at the base of the spine and the pelvis. This joint is a major weight-bearing joint. The weight from your upper body is transmitted down the spine, through the sacroiliac joint and into the pelvis, hips, and lower extremities.

The sacroiliac joint is supported by many muscle groups and ligaments that are richly innervated by free nerve endings and spinal nerve roots. When there is inflammation to the sacroiliac joint, though, this abundance of nerves can become irritated which can lead to intense lower back pain. This type of pain typically worsens when sitting for long periods or performing twisting motions. On the other hand, it usually lessens with exercise.

You may experience pain in the sacroiliac joint when the ligaments in that area become either too loose or too tight. This can occur from the following:

• Trauma (e.g., a fall, work injury, or car accident)
• Pregnancy and childbirth
• Hip or spine surgery (e.g., laminectomy or lumbar fusion)

In addition, uneven wear or an imbalance in the pelvis can lead to sacroiliac pain. This can occur when one leg is shorter or weaker than the other.

A condition called degenerative sacroiliitis can also be caused by autoimmune diseases or as a result of an abnormal gait due to injury (and wearing a walking boot after surgery on the foot or ankle).

Sacroiliac joint pain symptoms

Symptoms of sacroiliac joint issues include:

• Weakness
• Numbness
• Tingling
• Radiating pain on one or both sides of the body

Some of the other symptoms of sacroiliac joint pain resemble sciatic pain. As noted above, pain is usually worse with long periods of sitting or standing. It may also worsen when moving between sitting and standing or when climbing stairs.

How do sacroiliac steroid injections work?

Sacroiliac joint steroid injections involve injecting two medications into the sacroiliac joint at the location of the irritated nerve roots.

This injection includes both a long-lasting steroid and a local anesthetic (e.g., lidocaine and bupivacaine). Steroid injections for sacroiliac pain work to numb nerves in the area. The combination medicine then spreads throughout the joint and surrounding areas, reducing inflammation and irritation. The entire procedure usually takes less than 15 minutes.

Steroid injections for sacroiliac pain can be just one part of a comprehensive treatment plan to reduce pain and inflammation and help you get your life back. There are other similar types of injections and treatments available for sacroiliac joint pain that include the following.

Sacroiliac joint traumeel injections

Traumeel is a homeopathic natural anti-inflammatory medication that has very few side-effects. When steroid medications are not indicated, this can be a good replacement medication.

Medial and lateral branch blocks

The medial and lateral branches innervate the sacroiliac joint. Injections that block these nerves can both diagnose the location of pain and treat it.

Further, if your pain is better after joint injections, you may be a candidate for radiofrequency ablation procedure.

Radiofrequency ablation

If a medial and lateral branch block provide pain relief, you may be a good candidate for the long-lasting relief of radiofrequency ablation.

This is a procedure that destroys the nerves that send pain signals. These nerves typically grow back, but people report pain relief ranging from three months to three years. Learn more about this procedure in the following video.

Transcutaneous electrical stimulation (TENS) unit

A TENS unit can help relieve sacroiliac pain by replacing it with a mild electrical current. This current is directed over the skin to the most painful area through small patches that conduct electrical current. You control current intensity and duration.

The brain cannot perceive the pain it previously felt, but now feels a tingling or buzzing sensation. TENS therapy may also cause the brain to release endorphins (the body’s natural pain fighters).

Spinal cord stimulation

Spinal cord stimulation also uses electrical currents, but these are delivered below the skin.

A small electrode is placed in the epidural space of the spine, and electrical current is directed through that electrode. If you experience pain relief, your doctor can place a permanent system with battery and electrodes under the skin.

Chiropractic manipulation

If your sacroiliac joint is out of alignment due to injury, chiropractic care may help.

This complementary medical practice works to keep the spine balanced and aligned through both manual adjustment and using specialized equipment.

Acupuncture

Acupuncture is a complementary therapy that originally began in China over 3,000 years ago. It is gaining acceptance and popularity in western medicine for the treatment of many conditions, including sacroiliac pain.

Research continues to explore the use of acupuncture in the treatment of many chronic pain conditions.

How can steroid injections for sacroiliac pain help me?

Steroid injections for sacroiliac pain can help ease pain and inflammation that is causing lack of mobility and challenges in everyday life. One of the bonuses of this treatment is that it allows you to work through other rehabilitative therapies, like exercise, physical therapy, and chiropractic care.

You can combine steroid injections with lifestyle changes for best results, too. These can include:

• Designing an ergonomic workstation (i.e., with a proper chair and desk)
• Using proper lifting techniques to protect your lower back
• Making healthy changes to diet
• Increasing your daily exercise
• Managing stress
• Adding meditative exercise (e.g., yoga and t’ai chi)