Sacroiliac injections are done to reduce pain originating in the sacroiliac joint located between the sacrum and the ilium.
The sacroiliac joint can cause pain in the lower lumbar region and in the pelvis (posterior area). Pain can also radiate to the lower limbs (posterior area), more often in the proximal area. The goal of the injection is to reduce pain and to confirm it originates from the sacroiliac joint.
The results are satisfactory if the diagnosis is confirmed. The duration of pain relief is variable.
With the patient lying on the stomach, the skin is disinfected and a local anesthetic is applied as needed. The procedure is performed under fluoroscopic guidance to direct the needle to the sacroiliac joint. A very small amount of contrast agent is injected to ensure the needle is properly positioned. A solution containing a mixture of cortisone and anesthetic is then injected into the joint. The needle is removed and the patient returns to the waiting room for about 20 minutes to confirm there is no allergic reaction to the injected substances.
Patients may experience an increase in pain for a few hours post-injection. Applying ice and using a simple analgesic, such as acetaminophen, help to reduce the pain. Flushing (redness and heat) of the face may occur and is a potential side effect, not an allergic reaction. Women’s menstrual cycle may be disrupted. People with diabetes may experience increased blood-sugar levels for a few days. The lower limbs may temporarily feel weaker and more sensitive due to the anesthetic.
Complications are essentially related to the injection, the anatomy involved and the substances injected. Complications are very rare. Using radiography to confirm the injection’s pathway enhances the safety of the procedure. The risks of complications, such as infection or hemorrhaging, are the same as for any other type of injection, and are quite exceptional.
Fluoroscopy-guided injections are contraindicated during pregnancy. Report all allergies to medications or contrast agents to the physician.