Patient Information – Sacroiliac Joint Injection
What is a sacroiliac joint injection?
A sacroiliac joint injection is an injection into a joint at the bottom of the spine where it joins the pelvis known as the sacroiliac joint. The sacroiliac joints allow movement and stabilise the spine. Age related changes, inflammation and injury may cause pain in some people. The injection contains local anaesthetic often with a small amount of steroid. The sacroiliac joint injections may be used to diagnose and treat certain types of back pain. It is used for localised pain where simpler measures have not helped enough. It may help your pain by reducing some of the pain signals from the joint. Pain relief is usually short-lived though some people can get significant and lasting pain relief from
these injections. It is not a cure. The injection is usually undertaken alongside other treatments such as physiotherapy.
How do we do it?
A sacroiliac joint injection is carried out as a day case procedure in an operating theatre. You will be carefully positioned and the skin around the injection site will be cleaned with an antiseptic solution or spray; this can feel very cold. You may feel a stinging sensation as local anaesthetic is injected to numb the skin and surrounding tissues. The site of the injection is located via x-ray or ultrasound imaging. The Consultant will direct the injection into the sacroiliac joint and usually inject contrast (a solution that is visible under X-Ray) to ensure the needle is correctly positioned. When the injection is made, you may feel pressure, tightness or a pushing sensation in your back.
What will happen to me after the injections?
After the injection you will be taken to a recovery area where nursing staff will monitor you. You will be advised when to get dressed and be given assistance to help to ensure that you can stand safely after the procedure. Depending on how long your consultant or nurse want you to stay for recovery, you will usually be able to return home soon after your injection, if all your observations are normal. Please ensure that you have made arrangements for someone to collect you after the procedure. If you don’t, your procedure may be cancelled. It is unsafe for you to drive home immediately after the procedure. If you do so your motor insurance will be invalid.
What can I do after my procedure?
Ideally, you should arrange for someone to stay with you for 24-hours but, failing that, you should at least have access to a telephone. You should not drive, operate machinery, sign legal documents, provide childcare unsupervised or drink alcohol until fit to do so. If in doubt, please discuss these issues with your Consultant or Pain Practitioner for further advice.
Will I experience any side-effects?
As with any procedure, side-effects may occur. These are usually minor but there are risks with this procedure.
Side-effects may include;
• Mild local tenderness and/or bruising at the site of the injection. This usually settles over the first few days.
• The local anaesthetic may spread causing some numbness and/or weakness in the lower limb. If this happens, the effect is temporary and will quickly get better over minutes or hours.
• The steroids can have varied effects ranging from flushing, menstrual disturbances, weight gain, increase in blood sugar levels and worsening of mental health issues. These effects are temporary and are more likely with repeated steroid injections.
• Infection. This is rare. You should seek medical help if there is local warmth or redness where you had the injection, or if you feel hot and unwell. This may need antibiotic treatment.
• There are important nerves in the spine, but serious nerve injury is very rare.
• Injection treatments do not always work and may not help your pain.
• In rare circumstances, steroid use can damage your eyesight. You should report any new vision problems (such as blurred or distorted vision) to your doctor.
What can I expect in the days afterwards?
You may experience some soreness or aching at the injection site. Please keep the area of the injection dry for 24-hours following the procedure. Do not worry if your pain feels worse for a few days as this sometimes happens. Take your regular pain relief and medications as normal and this should settle down. Steroid can take up to 2-weeks to take effect on your pain. Try to keep on the move about the house whilst avoiding anything too strenuous.
What follow-up will be arranged?
One of the Advanced Practitioners in the pain team will call you 6-8 weeks after your injection to review your response. A member of the Pain Admin team will contact you to arrange this appointment after your injection. We will also send you a post-injection pain questionnaire via text
or email to help us better understand the benefits the injection has had on your pain and quality of life.
If having read this information, and discussed any questions or concerns with your clinician, you would like to proceed with an injection, we will ask for your consent. You are free to change your mind after this at any time.