Sacroiliac Joint Injections

If you’re suffering from low back pain, the sacroiliac joint could be to blame. Not only does sacroiliac joint pain cause pain in the lower back, but it can also be felt in the hips and legs. Not surprisingly, this can keep a person from enjoying their standard quality of life. A sacroiliac joint injection is both a helpful diagnostic and treatment tool, helping patients to experience needed relief. The Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas are equipped to administer this minimally-invasive treatment method with the goal to help their family of patients regain their active lifestyle, pain free. 

What Causes Sacroiliac Joint Pain?

There are many reasons why a person might experience sacroiliac joint pain, and it’s helpful to understand the anatomy of the joint to understand what factors go into the feelings of pain. 

The sacroiliac joint is a major weight-bearing joint that is located in the lower back at the sacrum (base of the spine) and the pelvis. It bears the weight of the upper body, which is then spread into the pelvis, hips, legs and feet. There are many muscles and ligaments that help to support the sacroiliac joint, as well as nerves that help provide sensation from the body to the brain. Any inflammation that is experienced in the joint can lead to the nerves in the low back to become irritated, which creates pain sensations. Also, pain can be felt if the ligaments become too tight or too loose. 

The most common causes of pain include: 

• Traumatic injury
• Pregnancy (walking with added weight) and/or childbirth (stretching of the joint itself)
• Hip or spine surgery
• Arthritis
• Repetitive stress from continued exercises
• Infection
• Leg length discrepancy
• Wear and tear due to age

What Does Sacroiliac Joint Pain Feel Like?

Sacroiliac joint pain can feel like a dull ache, a sharp pain, or a sudden stabbing pain. It can also feel like numbness, tingling, or weakness in the legs, and can be felt on only one or both sides of the body. The pain may radiate from the lower back into the buttocks, hips, or thighs, and could also be felt in the groin, feet or legs. Symptoms can feel similar to sciatic pain. 

Most patients report pain that worsens when sitting for extended periods of time, or climbing stairs. Against what you might think, the pain tends to decrease with light exercise. 

What Does a Sacroiliac Joint Injection Involve?

The procedure itself involves an injection of an anesthetic and steroid into the sacroiliac joint where the irritated nerves are located. The medication helps to reduce pain by numbing the targeted nerves, as well as reduce inflammation and irritation. The medication also spreads to nearby areas in the joint, working to help reduce pain sensations overall. The entire procedure is an out-patient procedure (meaning that the patient returns home the same day), and generally takes around 30 minutes or less. 

In addition to a general treatment of steroid and anesthetic medication, there are also additional injections and treatments that help to reduce pain stemming from the sacroiliac joint. These include: 

• Alternative therapies: acupuncture and chiropractic care, which helps to keep the spine aligned and balanced, have been proven helpful for reducing pain sensations in specific areas all over the body, especially sacroiliac joint pain. 
• Sacroiliac joint Traumeel injections: this is an option for patients who cannot or who would like to avoid an injection of steroid medication because Traumeel is a homeopathic natural anti-inflammatory medication with very few side effects
• Medial and lateral branch blocks: targeting the medial and lateral branches, which are located in the sacroiliac joint, can help to both diagnose and treat the cause of pain. If these blocks prove helpful, the patient could benefit from radiofrequency ablation
• Radiofrequency ablation (RFA): this procedure involves ablating, or destroying, the medial and lateral nerves with the goal to stop pain sensations from being sent to the brain. This provides patients more long-term relief, usually a few months or up to a few years
• Transcutaneous electrical stimulation (TENS) unit: TENS therapy utilizes a mild electrical current via patches on the skin that replaces pain sensations with a tingling or buzzing sensation. The benefit is that patients are able to control the frequency, intensity and duration of the current, and can utilize this therapy to enjoy long-term pain relief. 
• Spinal cord stimulation: similar to TENS, spinal cord stimulation provides long-term pain relief but utilizes a mild electrical current via a small electrode that is placed in the epidural space of the spine. If the trial period proves useful, the patient can have a permanent device implanted, and can control the level of stimulation. 

The goal of all sacroiliac joint injections is to help the patient improve their quality of life by being able to enjoy basic, everyday tasks as well as exercises without pain symptoms. Many of these options can be used in conjunction with one another, such as physical therapy, chiropractic care and a steroid injection. 

Can Sacroiliac Joint Pain Be Prevented?

While sacroiliac joint pain can’t always be prevented, especially in the event of a traumatic injury or due to giving birth, there are steps that a person can take to reduce their chances of experiencing pain. Additionally, it’s important to partner with a pain management specialist when pain is experienced so that the pain can be treated as soon as possible and so that additional complications don’t arise. 

Specific lifestyle changes that a person can make to avoid sacroiliac joint pain include: 

• Safely performing daily exercises
• Managing stress, anxiety and depression
• Enjoying a healthy diet and maintaining a healthy weight
• Practicing meditative exercises, such as yoga
• Using proper lifting techniques when lifting something heavy
• Setting up an ergonomic workstation if you work at a desk for extended periods of time

If you are suffering from sacroiliac joint pain that you feel in your lower back, hips and lower extremities, please schedule an appointment with the Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas today. We know that sacroiliac joint pain can greatly diminish a person’s quality of life, and are committed to helping our patients find needed pain relief as comfortably and as safely as possible. 

The sacroiliac joints are the joints that connect your pelvis to your lower spine (lower back). Either too much or too little movement in one of the SI joints can cause lower back pain and/or leg pain. See sacroiliac joint dysfunction for more details.

This painful condition can be treated with medications, physical therapy, an intra-articular steroid injection, radiofrequency ablation, and surgical stabilization.

A sacroiliac joint injection is both a diagnostic and a therapeutic injection. The procedure begins with the patient lying on his or her stomach. The area around the sacroiliac joint is numbed with a local anesthetic. Through the anesthetized area, a needle is then placed intra-articularly into the sacroiliac joint under fluoroscopic guidance. Once the needle is placed into the joint, contrast is injected to confirm that the needle is in the joint. Once needle placement is confirmed, the joint is injected with an anesthetic and a steroid. This injection is both diagnostic and therapeutic. The anesthetic injected into the joint is diagnostic while the steroid is therapeutic. This means that the patient will experience temporary pain relief following the injection if the joint is the source of their pain. Once the anesthetic wears off, the pain from the joint will return. The therapeutic steroid then takes 1 to 2 weeks before it starts to work to give the patient longer lasting pain relief. Each patient responds differently to steroids. This means that patients may receive pain relief for several days to years depending on their individual response.