NY Spine Medicine

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Joint injections

A sacroiliac joint injection places local anesthetic (pain-relieving medication) in the sacroiliac joint, the region of your lower back and buttocks where your pelvis joins the spine. Once the sacroiliac joints become painful, they may cause pain in the lower back, buttocks, abdomen, groin, or legs. The degree of relief experienced during the injection will help to confirm or deny the joint as a source of pain. The cortisone (steroid) will reduce inflammation that may exist within the joint(s).

Procedure Preparation

There is very little preparation needed for this procedure. In fact, you may decide to go ahead with this procedure during your initial consultation in our Midtown Manhattan outpatient clinic. The procedure will be fully explained to you before you decide to proceed.

Please bring any previous imaging study results (MRI, CT, x-rays) such as films, reports, or CD-ROMs to your initial appointment. If you do not have current images, we may refer you to have them done prior to the procedure.

If you come by car, you will need a driver to take you home after your appointment. You will be able to go home unaccompanied via subway or taxi.

Please notify our physician if you are nursing or if there is a chance you may be pregnant.

Please be prepared to discuss any medications that you are currently on with our physician, or bring you medication bottles with you to your appointment.

During the Procedure

A small area of skin will be numbed using an anesthetic. This medicine stings for several seconds.

Using x-ray guidance (fluoroscopy), your physician will advance a thin needle adjacent to your spinal column at the location of the facet nerve. X-ray guidance ensures accurate placement of the needle.

A small amount of contrast (dye) is injected to ensure proper needle position inside the joint space.

Next, a small mixture of numbing medicine (anesthetic) and anti-inflammatory (steroid) medication is injected. One or several joints may be injected depending on the location of your usual pain.

After the Procedure

There is very little recovery time after this procedure. Many patients return to work the same day.

You may experience numbness from your symptoms for up to six hours after the injection.

Your usual symptoms may then return and may possibly be worse than usual for a day or two.

The beneficial effects of the steroids usually require 2-3 days to be effective, in some cases it may take as long as 5-7 days. If there is no change in your symptoms after a week, consult with your doctor to investigate other possible causes of your pain.

If an initial injection provided a certain amount of relief, a second injection might strengthen the pain relief effect (known as "stacking"). Some patients have relief in the first few weeks, but the pain returns in the following weeks and months, additional injections will increase your relief of pain.

Keep track of how long your pain relief lasts and report it to your physician. If there is no change in the pain, then we can investigate other possible sources of your pain. The effects of the treatment are an important part of determining the problem and planning future treatment programs.

To get the maximum benefits of this procedure, you will go through a course of physical therapy to strengthen your body and avoid future pain.

Possible side effects

Although side effects from this procedure are rare, our physician will review any possibilities with you before your procedure. Possible side effects include facial flushing, occasional low-grade fevers, hiccups, insomnia, headaches, water retention, increased appetite, increased heart rate, and abdominal cramping or bloating. These side effects occur in less than 5% of patients and usually disappear within 1-3 days after the injection. If you experience any side effects, please feel free to contact us at any time.

Your leg(s) may feel numb for a few hours. This is fairly uncommon, but does occasionally happen.