Sacroiliac Joint Injections

A sacroiliac joint injection is generally indicated for buttock pain, which may radiate to the thigh or lower leg. When diagnosing sacroiliac joint pain, there are several physical exam maneuvers that your clinician may have you perform. One of these maneuvers is the Patrick test or Faber maneuver. During this maneuver, you will lie on your back, and the heel of the painful side will be placed on the opposite knee. The clinician will then apply pressure on the flexed knee and the opposite buttock area. This test is considered positive for sacroiliac joint dysfunction if pain is elicited in the affected buttock.


How do sacroiliac joint injections help my pain?

Once the diagnosis of sacroiliac joint pain is made, you can schedule a sacroiliac joint injection. During this injection, medication is placed into the sacroiliac joint to help alleviate the buttock pain, which comes from this inflamed joint. The medication injected is generally a combination of steroids and anesthetics.


What should I expect during the procedure?

You will be lying face down on an X-ray table during the procedure. Live X- rays, known as fluoroscopy, will be taken to ensure proper positioning. Your buttock area, over the sacroiliac joint, will then be cleaned with an antiseptic solution and a sterile drape will be placed over this area to keep it clean for the procedure. A local anesthetic will then be injected into your skin to make it numb. The needle will then be inserted through the numbed skin and slowly advanced into the sacroiliac joint space using fluoroscopy to guide the needle. Once the needle is in the sacroiliac joint space, a small amount of contrast will be injected under live X-ray to ensure that the medication will spread properly. After this, the corticosteroid will be slowly injected into the sacroiliac joint space. Once the injection is complete, the needle will be withdrawn and a dressing will be placed over the injection site.


What should I expect during the procedure?

Some patients will experience immediate relief, however, it usually takes 24 to 72 hours for the effects of the steroid medication to take effect and it may be up to 1 week before the maximum benefits are achieved. Sacroiliac joint injections target the pain being caused by the inflamed nerves in your buttock area and may not relieve pain caused by muscular problems, which can continue to cause pain after the procedure. You may continue to require oral medications or other interventional procedures to achieve better pain relief.
In general, if the injections are successful, most patients will experience at least 6 months of pain relief after the initial series of injections. You may return for future injections when the pain returns.

Common Conditions Treated by Sacroiliac Joint Injections