Dr Thomas E Smith MBBS (Hons) MD FRCA FFPMRCA
What are sacroiliac joints?
The sacroiliac joints are a pair of small joints that join the spine to the pelvis. We normally are unaware of them, but they are important joints that bear heavy loads when we are standing and walking. They normally have very limited movement. Their function is to combine stability with a little cushioning effect. They may become painful either due to wear and tear (also called degenerative change) or injury. Pain is then felt around the sacroiliac joints and can spread into the buttocks and legs.
What are sacroiliac joint injections
Under x-ray control, local anaesthetic and corticosteroid are injected into the targeted sacroiliac joints and their supporting ligaments.
What is the aim of sacroiliac joint blocks?
The aim is to calm down the inflammation and pain from the sacroiliac joints, leading to reduced pain and improved physical functioning. The medication effect of the injections lasts a variable time – from weeks to many months or longer.
What are the risks?
Sacroliliac joint injection is a commonly performed procedure and is very low risk. Possible side effects and complications include:
- Stiffness and soreness for a few days after the treatment due to local trauma from the needles. You should take your normal painkillers regularly and do gentle stretches
- Diabetics may experience Increased blood sugar level for a few days
- A skin infection where the needle is inserted, such as redness or swelling – this occurs in one per 1000 cases
- Bleeding / bruising at the injection site.
- Temporary numbness / weakness from the local anaesthetic that is injected during the procedure – this usually resolves in a few hours. This can affect your back/neck and limbs
- Allergy to injected drugs – this is estimated at one case per 40,000.
- Permanent nerve injury to a nerve supplying the leg or trunk, which is very rare
Are there any alternatives?
Procedures for back pain are generally considered after trying less invasive treatments, such as:
- physiotherapy
- medication
What happens on the day of the procedure?
Please remember to bring with you:
- dressing gown and slippers
- any medication you normally would take (unless otherwise advised)
- something to read, and your mobile phone.
A nurse will admit you will be given a gown to change into. You can put your own dressing gown on over this gown while you wait.
Please note the time stated on your letter will earlier than the time of your actual procedure. Time is required for the admission process and to make sure that you are prepared and ready for your procedure. Sometimes there can be additional delays due to previous cases over-running. A friend or relative will be able to stay with you while you wait.
All women of child-bearing age will be asked to provide a urine sample for a pregnancy test. You must tell us if you could be pregnant. X-rays are safe for adults, but may harm your developing baby, so they aren’t usually done during pregnancy.
Take all your medication as usual, unless advised not to. If you take blood thinning drugs or diabetes medication, then please inform the pain service at least two weeks before your injection, to help us manage these.
Will I feel any pain?
The procedure may be performed either with you awake or sedated. Dr Smith will discuss this with you. Local anaesthetic will be used but some brief pain with the injections can be expected.
What happens after the procedure?
You will need to stay in the Procedure Facility for at least 30 minutes after your procedure so your recovery can be monitored and we are sure that it is safe for you to go home.
Please arrange for a responsible adult to drive you home or accompany you home.
You will be able to leave as soon as your nurse is satisfied that you are well enough and that there is a responsible adult to accompany you.
What do I need to do after I go home?
Although you might feel fine, your reasoning, reflexes, judgement and co-ordination skills can be affected for up to 12 hours (24 hours if you have sedation) after your procedure. Please rest at home for the remainder of the day and follow the advice and instructions that the doctors and nurses have given you.
For 12 hours after the procedure (24 hrs if you have had sedation), do not:
- drive any vehicle, including a bicycle
- operate machinery
- cook, use sharp utensils or pour hot liquids
- drink alcohol
- make important decisions or sign any contracts
Some people feel pain relief immediately after the procedure. Some people feel no immediate change but pain relief develops over subsequent days. If you experience some initial soreness you should take your usual painkillers and rest until it settles.
Will I have a follow-up appointment?
Yes. You will have either a clinic or telephone appointment.