SACROILIAC JOINT (SIJ) INJECTIONS
The sacroiliac joint (SIJ) is a common source of buttock pain due to conditions such as trauma, osteoarthritis (age related changes to the joint), autoimmune conditions such as ankylosing spondylitis, pregnancy, and altered mechanics from a lumbar spine fusion or due to a hip or knee condition (including replacements).
A corticosteroid injection into the joint can be performed in hopes of alleviating pain. Results are variable and are not guaranteed. However, it is a treatment option when a patient’s pain is not improving over time with other conservative treatment including medications, physical therapy and/or chiropractor care.
The injections are performed under fluoroscopic guidance (x-rays). Because they are considered advanced procedures, they will need to be approved by your insurance carrier.
The injections are extremely safe. Injection site soreness/discomfort can occur. Rare but serious risks include infection and bleeding. A patient can also develop side effects from the medications used (steroid, anesthetic, or contrast). Steroids can cause temporary facial flushing, anxiety, trouble sleeping, irritability, increases in blood sugar and blood pressure.
PROCESS INVOLVING A SACROILIAC JOINT STEROID INJECTION:
1. Discussion with medical provider if there is a medical indication for the injection.
2. If the patient wants to proceed, IBJI’s authorization team will seek insurance approval for the injection. Most private insurance companies require documentation for failed conservative treatment (medications and a formal physical therapy program). The patient does not need do anything.
3. Once your injection has been approved, Dr. Garala’s secretary will call you to schedule your injection; please review Pre-Procedure Information. Dr. Garala usually performs injections Monday and Thursday afternoons, and Friday mornings. The injection will be performed on the 3rd floor of the Glenview office. You do not need a driver for this procedure.
4. After you check in, you will be taken to the fluoroscopy suite (special x-ray room). You will be asked on lay on your stomach on the x-ray table. The injection site (buttocks) will be exposed. Your skin will be sterilely cleansed. The area will be numbed with an anesthetic. The spinal needle will then be introduced and guided to the targeted area, where a steroid solution will be injected.
6. After your injection, your injection site will be cleansed again and a bandaid will be applied. You can remove the bandaid the next day. If it naturally falls off before then, no need to replace it.
7. Go home or even back to work, but take it easy. There is nothing you will do that will impact the efficacy of your injection, but try to avoid strenuous activities that day. You can resume all your typical activities the next day.
8. It can be 1-3 days for a steroid to begin taking an effect; peak effect can take 1-2 weeks. Unless stated otherwise, Dr. Garala would like you to schedule a 2 week follow up appointment to assess your response and if any additional treatment is warranted.
The lays in the prone position on the x-ray table while live x-rays help guide the spinal needle into the sacroiliac joint.