Lower back and shooting leg pain can be extremely debilitating and effect quality of life. In some cases, lower back pain can be caused from the sacroiliac (SI) joint. To diagnose and treat this type of pain, a SI joint injection, also known as a sacroiliac joint block, can be used. PAIN DOCTOR Pain & Regenerative Medicine offers sacroiliac joint injections to accurately diagnose and treat patients in the Dallas, Ft. Worth and Arlington communities and return to a pain free way of life.
What is SI Joint Pain?
The sacroiliac joint is located below the lumbar spine and above the tailbone (coccyx). This joint connects the sacrum (triangle bone at the bottom of the spine) with the pelvis. There are two sacroiliac joints are on the right and left side of the spine. This joint is a strong structure with limited motion and acts as a shock absorber.
Little is known on the exact cause of SI joint pain. Joint motion such as hypermobility (instability) or hypomobility (fixation) can be one cause. Patients who report symptoms of deep pain in the lower back accompanied with shooting leg pain may have sacroiliac joint dysfunction. Pain in the sacroiliac joint is more common in young and middle-aged women.
What is a Sacroiliac Joint Injection?
A sacroiliac joint injection is used to diagnose and treat SI joint pain. This is an in-office procedure. To begin, a local anesthetic is used to numb the sacroiliac joint. A fluoroscopy (x-ray guidance) is used to increase injection accuracy. The needle is then placed in the sacroiliac joint – a contrast dye is injected into the joint to ensure proper needle placement through the fluoroscopy.
A numbing medication is then injected into the SI joint. The patient is asked to reproduce the pain by performing normally painful activities. If the patient experiences 75-80% relief during the duration of the anesthetic, a tentative diagnosis of SI joint dysfunction is made. A second diagnostic injection is then performed using a different medication to confirm initial diagnostic. If the second diagnostic provides 75-80% pain relief a diagnosis can be given that the SI joint is the source of pain.
Once a diagnosis is confirmed, a sacroiliac joint injection can be used to alleviate pain. Performed using the same technique as the diagnosis injection, an anti-inflammatory medication (corticosteroid) is instead injected into the SI joint to reduce inflammation and alleviate pain. Following the injection, patients remain in the office for 30 minutes to ensure no complications. Risk involved is relatively minor and occurs infrequently. Risks include: allergic reaction to the medication, bruising and/or soreness at injection site and if very rare cases infection.
If a patient experiences prolonged relief for a long duration, the injection may be repeated up to three times per year, typically in conjunction with physical therapy and rehabilitation. For patients who do not experience relief there are a variety of alternative pain management solutions to discuss.