Sacroiliac Joint Injection
What is a Sacroiliac Joint Injection (SIJI)?
The Sacroiliac Joint (SIJ) is a high-friction non-moving joint between the sacrum (part of the spine) and the ilium bone (part of the pelvis). It is subject to a variety of twisting and shearing forces in everyday life, and can become painful as a result. It can be helpful for the diagnosis and treatment of some people's back pain to check whether an injection of local anaesthetic and cortisone into the joint can relieve pain.
What is The Purpose of a SIJI?
Placing local anaesthetic and a high-concentration solution of cortisone into the SIJ can diagnose whether the joint is a source of pain, and also treat it for several weeks or months at a time. Your pain specialist will explain which of these is the major focus of your injection on this occasion.
How is a SIJI Performed?
You lie on the operating theatre table while x-rays are taken to establish where the needle should go. After a sterile preparation, local anaesthetic is used to numb the skin and superficial tissues. The needle is passed through the anaesthetised tissue into the joint under x-ray guidance. When the needle looks to be in the right position, adequate placement is confirmed by injecting a little contrast dye. If the dye doesn't spread in a pattern which confirms that it's in the joint, it is repositioned until the right pattern is seen.
Once the needle is confirmed to be in the joint, some diluted local anaesthetic and a high-strength cortisone is put down the needle.
We offer light sedation as part of the procedure if you would like it, though it isn't essential to the success of the injection. The sedation means you won't remember the injection but it's a long way short of a full general anaesthetic. You won't be able to drive for 24 hours after having sedation, and you will have to fast for 4 hours before you arrive.
What Happens After The Procedure?
You will be observed in the recovery room for 30-60 minutes and be free to leave the hospital soon after that. You may notice some temporary numbness down your leg after the injection. This is due to the fact that around 10% of people have a small gap in the ligaments at the front of the SIJ, and a little of what is injected can leak out. There are nerves directly in front of the SIJ which can be affected by the local anaesthetic, and this is where the numbness can come from. If you are having difficulty walking safely, you may need to be observed for longer, or (rarely) overnight so we can be sure you're able to manage when you leave the hospital.
If you have pain at the site of the injection you should use a cold pack and some paracetamol (Panadol, Herron, Panamax)or ibuprofen (Herron Blue, Nurofen) in the recommended doses for a couple of days.
You will be given a Pain Diary to record the pain levels or any other symptoms you notice over the next few days. This should be returned to Pain Matrix once completed as it helps us plan your further care and monitor how well we are doing our procedures.
In the case of numbness, which has not gone away after 24 hours, or any loss of control over bladder or bowel, you should contact Pain Matrix, or attend an Emergency Department and ask that they contact us if it is after hours.
Please make sure you have made a follow-up appointment with your Pain Specialist. You should ring Pain Matrix following your procedure if one has not already been arranged.