SI Joint Injection
PROCEDURES
SI Joint Injection
The Sacroiliac joint (SIJ) is formed where the pelvic bones join at the base of spine, or sacrum. This joint can be a source of pain like any other joint, and it may cause hip, low back or buttock pain. Sacroiliac joint dysfunction may also be associated with radiation of pain into the groin and/or back of the thigh.
Your physician may recommend one of the following:
Sacroiliac Joint Injection: X-ray guidance is used to insert a thin needle in to one or both SI joints and steroid and local anesthetic are carefully injected.
Alternatively, Platelet Rich Plasma (PRP)/Platelet Rich Fibrin (PRF) can be injected in some cases.
What happens during an injection?
Patient is placed on a fluoroscopy table or an exam table. The site of the injection is identified using x ray machine or ultrasound machine. The skin and site of injection area are cleaned with antiseptic solution. A local anesthetic is used to numb your skin and subcutaneous tissue.
The doctor will then insert a thin needle advancing gently towards the target site. X-ray guidance or ultrasound guidance is used throughout to ensure the safe and proper position of the needle. A contrast dye if needed is injected to ensure correct placement of the needle in the target site. When the needle is confirmed to be in the correct position, the doctor will inject the steroid medication mixture.
How long does an injection take?
The correct positioning on the table, identification of the injection site and skin preparation with antiseptic solution takes 10 minutes or less. The actual injection time varies on the type of procedure and is usually completed in 5 minutes or less. The injection can take slightly longer if your anatomy is challenging due to age, previous surgery, presence of hardware, etc.
Do I need insurance authorization or approval before I can schedule the procedure?
Yes! Every commercial insurance payor and most government advantage programs require preauthorization prior to proceeding with the injections or procedures. We try our very best to get the preauthorization approvals in a timely manner but there are factors that are beyond our control. Most insurance companies have their own internal teams that reviews these requests on case-by-case basis.
There is a prerequisite checklist that some insurance companies follow, and these can include but not limited to duration of symptoms, modalities trialed, medications trialed, imaging results (MRIs or X rays). We must document this information in an accurate and thorough manner in your office visit note, hence, the first visit with the provider is a consultation visit to start the insurance authorization and approval process.
How will I feel afterwards?
You will likely feel a quick relief after a SIJ injection due to injection of local anesthetic in to the joint. The full effect of the steroid us usually experienced within 48-96 hours. Occasionally you may feel numbness in your legs that is temporary and usually resolves as the local anesthetic start to wear off.
Please bring an escort with you for precautionary measures.
How much relief can I expect and how long will the relief last?
These are the most difficult questions to answer as outcomes vary from patient to patient.
Some patients get excellent relief that can last months to years, and some unfortunately get no relief whatsoever.
There are various factors at play which results in variable outcomes. These include but not limited to duration of ongoing symptoms, severity of underlying condition, anatomical variations and challenges, previous history of spinal surgery, age, and their physiologic response to steroid based medications.
Most patients require a series of injections few weeks apart based on their response to initial injection to maximize benefit and longevity.
What about follow up visit?
You will be scheduled for a follow-up visit in 1-2 weeks after your injection. At this visit, you and your doctor will discuss the outcome of your previous injection and plan for the next steps based on response.