Download Sacroiliac Joint Injections - St. Joseph Mercy Ann Arbor

Patient Information
Sacroiliac Joint Injections
ST. JOSEPH MERCY
PAIN INSTITUTE
Sacroiliac Joint - front side
Sacroiliac Joint - back side
St. Joseph Mercy
Ann Arbor
734-712-PAIN (7246)
St. Joseph Mercy
Brighton
810-844-7705
St. Joseph Mercy
Canton
734-398-8705
St. Joseph Mercy
Chelsea
734-593-5670
Introduction
The sacroiliac joint is located in the pelvic area. This is the joint between the
hip bone (iliac crest) and the sacrum (buttocks or tailbone area). This injection
is often used for low back pain. This pain can occur on one side or both sides
simultaneously and radiate (also have pain in) to the buttock, groin or thigh area.
This pain can also travel down to the knee area. During exam there will be an
increase in pain with pressure put over the sacroiliac joint area.
Common causes for sacroiliac joint pain is trauma, changes in posture or gait,
arthritis and some chronic bowel conditions. Diagnosis can be done by exam by
a physician but he may need further studies to verify this. Regular xray films can
often reveal problems with the joint but sometimes a CT scan or bone scan are
needed. At times the doctor may inject an anesthetic (numbing) and/or a steroid
medicine into the joint to see if this is the area causing the pain. Other forms of
conservative treatment may include massage, joint manipulation, physical
therapy and non-steroidal medications (NSAIDS).
Procedure
• A doctor in a clinical setting performs this procedure. You will be positioned
on a treatment table on your stomach and the area involved will be prepped
with a topical antiseptic wash.
• Your blood pressure, pulse and oxygen level are monitored during the
procedure. It is not necessary for you to have IV sedation during this
procedure, however it is available to you if needed. For sedation, we may use a
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Procedure (continued)
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combination of sedative (versed) and a pain medication (fentanyl) that will help to relax you and make
you more comfortable but not necessarily make you sleep during the procedure.
Since nerves cannot be seen on x-ray, the needles are positioned by using bony landmarks that
indicate where the nerves usually are. Fluoroscopy (x-ray) is used to identify those bony landmarks.
After confirming these landmarks the doctor will inject a small amount of local anesthetic (like
lidocaine) to numb the skin and deeper tissues in the surrounding area. A brief burning or stinging
sensation may accompany the administration of the local anesthetic.
The doctor then advances a small needle into the area using x-ray guidance. The placement of the
needle into the sacroiliac joint may be confirmed using a small amount of contrast dye. This show on
x-ray the location, flow of medicine, and confirms the needle is in the correct space.
The doctor will then inject the steroid and anesthetic medicines. This may cause a cramping or spasm
similar to your usual pain. This discomfort usually disappears quickly.
Immediately after the procedure you will be taken to the recovery room. After a brief recovery period,
the nurse will give you follow up and discharge instructions.
Preparation
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You must have a driver with you who will remain in the area during your appointment time.
Have nothing to eat or drink for six hours before your appointment time.
If you are diabetic, be sure to discuss fasting and medication schedules with the doctor.
Please inform the staff of all the prescriptions ad over-the-counter medications you take including
herbal and vitamin supplements. It is especially important that you inform the doctor if you are taking
any blood thinners like Coumadin, Plavix, Ticlid, Aggreox, Heparin or Lovenox, Pletal, Aritxtra, or
Dabigatran.
Please inform staff of any allergies including iodine or latex.
Please inform the doctor if you are currently experiencing symptoms of a cold, flu, fever, infection, or if
taking any antibiotic medication.
Since we use x-ray guidance, please inform the staff if you think you may be pregnant. If your are still
menstruating we will perform a urine pregnancy test before the procedure.
Please inform the staff if you have experienced in the past any sensitivity to contrast dye.
After Procedure
• The nurse will give you complete discharge instructions before discharge.
• You may experience weakness and/or numbness in your legs with a sacroiliac joint injection. Special
considerations for safety may need to be followed for several hours after.
• Do not drive for the remainder of the day
• You may resume medicine and diet as before.
• Although you may feel much better immediately after the injection (due to the anesthetic), there is a
possibility your pain may return within a few hours. It typically takes 3-5 days for the steroids to become
effective so it is not unusual for you to experience a slight increase of paint for a few days. Some people
will get immediate relief while others may require as long as a week to see any results.
• Avoid any strenuous activities for the day. Depending on how you feel you may resume normal activities
and return to work the following day.
• The risks will be discussed with you as well as when to call for medical advice if needed after the
procedure
• You may need more than one injection. They are often given one to three months apart.
• Please feel free to discuss any further questions or concerns with a St. Joseph Mercy Pain Institute staff
member.