A sacroiliac joint injection delivers corticosteroid and local anesthetic directly into the SI joint under fluoroscopic guidance. This procedure serves as both a diagnostic test (confirming the SI joint as the pain source) and a therapeutic treatment (reducing inflammation and pain).
Conditions treated include sacroiliac joint dysfunction, sacroiliitis, SI joint arthritis, SI joint sprain or injury, pregnancy-related SI joint pain, and post-fusion adjacent SI joint pain.
Due to the complex, irregular shape of the SI joint, fluoroscopic guidance is essential for accurate placement. Therapeutic relief from the steroid lasts 1-3 months.
Under fluoroscopic guidance, a thin needle is directed into the lower portion of the SI joint. Contrast medium is injected to confirm intra-articular placement, ensuring the medication reaches the joint space rather than surrounding tissues. Once proper placement is confirmed, a mixture of corticosteroid and local anesthetic is injected.
The local anesthetic provides immediate diagnostic information — if the patient's typical pain is relieved, the SI joint is confirmed as the pain generator. The corticosteroid then works over the following days to reduce inflammation.
The procedure is performed on an outpatient basis and typically takes 15-20 minutes. Patients are positioned prone on the procedure table. After sterile preparation and local anesthesia, the physician advances the needle into the SI joint.
Patients may feel pressure during needle placement but should not experience sharp pain. Following the injection, patients are monitored for 15-30 minutes before discharge.
Patients may experience temporary numbness or mild soreness for 1-2 days. The anti-inflammatory effect of the corticosteroid begins within 2-7 days, with full benefit typically appreciated within 2 weeks.
Depending on clinical response, a series of injections may be recommended. Most insurance plans allow up to 3-4 injections per year.
SI joint injections are most effective when the primary pain mechanism is inflammatory. The procedure is contraindicated in patients with active infection, coagulopathy, uncontrolled diabetes, or known allergy to contrast media or injectate components.
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