Sacroiliac Joint Steroid Injection
Also known as an SI injection, these steroidal shots are used to help people with extreme lower back pain or sciatica. The sacroiliac joint is located at the base of the spine. This vertebrae at the base of your spine is called the sacrum. It is connected to your pelvic bone, which then goes on to connect to your hips and legs. The point where the sacrum and pelvic bone meet is the sacroiliac joint. There are two sacroiliac joints, one on each side of the sacrum. This is an area that if inflamed, can cause a lot of pain and difficulty functioning. Sciatica happens when the sciatic nerve becomes pinched, which is in that same area. Sciatica can cause pain that travels down the legs as well. These issues are where a steroid injection can hopefully help.
Sacroiliac joint pain causes
There are several different things that can cause the sacroiliac joint to become inflamed. One is through becoming injured, which can put stress on the joint or even fracture the sacrum. This can be very painful and can take a long time to heal. Bone spurs can also develop which can harm this joint. Another problem that can cause issues with this joint is arthritis, which usually happens with age. Aging can cause other issues with the SI joint, as the discs in the spine can become hard or even tear over time. This can put pressure on the muscles surrounding the joint, causing it to become inflamed. Whatever the reason for the inflammation, many times the sacroiliac joint becoming inflamed is extremely painful and needs to have some kind of treatment.
Before getting an injection, some other treatments are available to try. Some other forms of pain management such as muscle relaxers, NSAIDs, or narcotics may be helpful with the inflammation and pain. Doctors who specialize in pain management may be able to help you figure out what works best for your specific situation. Sometimes physical therapy may help as well, but it can be difficult for this area of the body.
Why get a steroid injection?
When a part of the body is inflamed and causing pain, the inflammation of the muscles and the joint itself may be the main problem. Sometimes, injecting a steroid directly into the affected area can bring down that inflammation and let that area return to normal. Other times, a steroid shot can decrease that inflammation for long enough that you can have surgery or start a more rigorous round of physical therapy.
What it does
These injections do not solve underlying issues, they just help manage the pain and inflammation. However, they can help, and that might be enough to make it worth it. You can only receive a few injections per year, because the steroids can weaken the joint and cause it to have other issues if the injections are done too frequently.
How does it work?
Getting a sacroiliac joint steroid injection is a relatively simple process. These injections must be performed by a doctor, and they are usually done in a hospital. This is because the doctor needs to use a fluoroscope to be able to perform the procedure. A fluoroscope is a machine that basically takes and displays an x-ray in real time. When the doctor uses one of these, they can see exactly where they are placing the needle and can ensure that it will not cause any nerve damage or other problems.
First, the area where the needle will be inserted into the skin is cleaned and a numbing agent is applied. A smaller needle injects a numbing medication into the skin and surrounding area of the joint. Then, a contrast solution is injected. At this point, the doctor will ask the patient to perform some simple stretches. This will help the doctor see where the pain is coming from. This can also help the doctor to diagnose what exactly is wrong. Then, depending on that diagnosis, the doctor will inject a steroid solution directly into the joint. This can relieve pain for some time. Depending on the severity of the problem, it can relieve the pain for a short time like a week, or maybe even several months to a year.
Sacroiliac joint pain relief
Steroid injections can relieve the pain in the SI joint, hopefully for quite some time, but relieving the pain entirely may be a different story. At times the injections may not work, which may send doctors down an alternative path for treatments. Some other options for pain relief include something known as radiofrequency denervation. This is when the nerves that are causing the pain are burned so that they cannot deliver signals to the brain. Another option is electric stimulation.
A very rare option is surgery. Surgery should only be used after other options have been tried but have not worked. Always consult with your doctor before deciding on surgery. In this case, the main surgery used for this kind of pain is sacroiliac joint fusion. This is when the joint is completely fused together with metal hardware. It can be a long recovery, but it can be a permanent solution for the pain. If the cause of your pain is from injury where the sacrum was damaged or fractured, surgery may also be needed in order to repair the injured bone.
What Can I do next?
If you are feeling severe lower back pain that may be coming from this area, see an orthopedic doctor as soon as possible. If you are diagnosed, you can receive treatment before nerve damage might occur. This can be irreversible and can become very limiting if left untreated. If you have been diagnosed with Sacroillitis or sciatica, talk to your doctor about steroid injections as an option for pain relief. They may be able to help you see if it is a viable option for your treatments. Becoming pain-free is life changing for many people. Schedule an appointment today!