A sacroiliac joint injection delivers medication into the joint where your lower spine connects to your pelvis. When this joint is inflamed or not moving well, it can cause pain in the low back, buttock, hip or groin. An SI joint injection may help reduce that pain and can also help confirm whether the joint is the source.
You have two sacroiliac joints, one on each side of the sacrum, the triangular bone at the base of your spine. They absorb shock and transfer weight between your upper body and legs. They don’t move much, but when they move too much, too little or become inflamed, they can be a surprisingly common source of low back pain.
During an SI joint injection, your provider places a local anesthetic and usually a corticosteroid inside the joint. The anesthetic works quickly, and the steroid may reduce inflammation over the following days.
SI joint pain can feel a lot like pain from a herniated disc or the hip. If numbing the joint brings significant short-term relief, that’s a strong sign the SI joint is involved, which helps guide the rest of your treatment plan.
Your provider may consider a sacroiliac joint pain injection for:
inflammation of one or both SI joints
pain from a joint that moves abnormally
affecting the SI joint
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a fall or a lifting injury that strained the joint
usually on one side, that worsens with standing, climbing stairs or rolling over in bed
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Some people also feel SI joint pain in the hip or groin, which is why a careful exam matters.
An SI joint injection may be an option if:
Injections may not be appropriate if you have an active infection, a bleeding problem or certain allergies, or if you’re pregnant. Your provider will review your history before recommending one.
Your provider reviews your medications, especially blood thinners, and explains the procedure. You may be asked to rate your pain beforehand
You’ll lie face down. After the skin is cleaned and numbed, your provider uses imaging guidance to place the needle inside the joint, which is important because the SI joint is hard to reach accurately without it.
You’ll rest briefly, then try movements that usually cause pain and note how you feel. Most people go home shortly after the procedure.
Many people return to normal routines within a day, avoiding strenuous activity as directed. If a steroid was used, it may take a few days to work, and relief can last from weeks to months depending on the person.
An SI joint injection often works best alongside physical therapy that strengthens the core, hips and pelvis. → /treatments/physical-therapy/ If relief is short-lived, your provider may discuss other options, such as radiofrequency ablation
Side effects are usually minor and temporary: soreness at the injection site, a brief increase in pain and, with steroids, flushing, sleeplessness or elevated blood sugar. Infection, bleeding and nerve irritation are rare. Your provider will discuss your individual risks.
Call our office if you develop a fever, redness, warmth or swelling at the injection site, pain that keeps getting worse, or new numbness or weakness in a leg.
Seek emergency care right away if you lose control of your bladder or bowels, have sudden leg weakness, or have trouble breathing.
Many plans cover SI joint injections when they’re medically necessary. Some require prior authorization. Our team can help you confirm your coverage.
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Common signs include pain below the belt line on one side, pain when standing on one leg or climbing stairs, and pain that improves when lying down. Because these signs overlap with other problems, an exam and sometimes a diagnostic injection are needed to know for sure.
The skin is numbed first, so most people feel pressure and mild discomfort. Some soreness afterward is normal.
It varies widely. Some people have relief for several months and others for a shorter time. Your provider will follow your response.
Repeat injections may be an option if the first one helped, but steroids are limited in how often they can be given. Your provider will decide based on your response.
Schedule an evaluation at our Rego Park office to find out whether your SI joint may be causing your pain.
