Sacroiliac Joint Steroid Injection

A straightforward Guide for Patients

What is a sacroiliac Joint Steroid Injection?

The sacroiliac (SI) joints connect the base of your spine (sacrum) to the pelvis. These small joints allow limited movement but can be a source of significant low back, buttock, and hip pain when inflamed or irritated. Arthritis, injury, or mechanical stress can cause SI joint pain.

SI joint injections are a safe, minimally invasive, non-surgical treatment that can help relieve inflammation and pain in the SI joint. They are also used diagnostically to determine if the SI joint is the source of pain.

Goal of the Injection

The purpose of an SI joint injection is to:

  • Deliver sa teroid (cortisone or corticosteroid) and a local anesthetic directly into the SI joint
  • Reduce inflammation and pain
  • Improve mobility and daily activities
  • Help determine if the SI joint is the primary source of pain, guiding further treatments

The Procedure

  1. You will lie on your stomach on the exam table in a sterile procedure suite.
  2. X-ray guidance is used to precisely locate the SI joint.
  3. The skin is numbed with local anesthesia, and a small needle is placed into the joint.
  4. A small amount of a steroid and an anesthetic is injected.
  5. After the injection, you will be monitored briefly in the recovery area before being discharged home.

After the Procedure

Follow these instructions to support healing and recovery:

  • Resume activity as tolerated; some soreness is normal
  • Avoid soaking in a bathtub or lake for 24 hours; showers are allowed
  • Keep a record of your pain and symptoms in the hours following the injection
  • You may be asked to perform movements that normally cause pain to help assess whether the injection relieved your symptoms
  • The care team will call the next day to check your response to the injection

If Sedation is Used

  • No solid foods for 8 hours before the procedure
  • Clear liquids allowed up to 2 hours before (water, broth, clear juice without pulp, tea, coffee without cream)
  • No gum, candy, or mints 2 hours prior
  • The care team will review your medications and instruct you which to take

Failure to follow these instructions may result in cancellation or rescheduling

Potential Risks

SI joint injections are generally safe, but as with all medical procedures, rare complications can occur:

  • Pain at the injection site
  • Minor infection (very rare)
  • Temporary increase in pain
  • Bleeding, especially in patients taking blood thinners (e.g., Warfarin, Plavix, Xarelto, Aspirin, Heparin, Lovenox, Brilinta)
  • Nerve irritation or, extremely rarely, nerve or spinal cord injury
  • Allergic reaction to medications (local anesthetic, steroid, contrast dye)
  • Inability to complete the injection due to technical or anatomical difficulty

Insurance Requirements

Insurance companies may require:

  • Physical therapy or provider-directed Home Exercise Program (typically 4- 6 weeks)
  • Imaging such as X-ray or MRI
  • Documentation of failed conservative treatments