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Four Things You Need to Know About SI Joint Injections

If you’ve been experiencing lower back pain or other symptoms of SI joint dysfunction, your doctor may at some point recommend an SI joint injection.

Here are four things you should know about SI joint injections before you get one.

  1. Why it’s done
  2. What it feels like
  3. What the results mean
  4. What to do next

1. The reason for SI joint injections

An SI joint injection may be for diagnostic or therapeutic purposes. A diagnostic injection is to help determine whether your pain is coming from your SI joint. It’s part of the diagnostic pathway and typically follows a set of SI joint dysfunction tests. Trained SI joint treatment physicians will know these tests well.

A therapeutic injection is to help manage pain after you’ve been diagnosed. Learn more about the differences, what to expect, and potential side effects in this article.

2. What an SI joint injection feels like

It’s important to record your feelings after both types of SI joint injections. It may seem counterintuitive, but, after a diagnostic injection, if you have significant reduction in your SI joint pain, then the SI joint is a likely source of your pain.

The medication used in this injection (a local anesthetic such as lidocaine) is intended to be temporary, to help diagnose the source of pain, so the pain will likely return when the local anesthetic wears off. Consider keeping a pain diary to record how you feel hours and days after the injection to help with diagnosis.

A therapeutic injection typically contains a mixture of local anesthetic, to provide immediate pain relief, and corticosteroid, to provide longer term relief by reducing inflammation. It may be recommended as part of your conservative (or non-surgical) care plan but does not typically provide long term relief.

Because corticosteroids can cause side effects, your doctor will likely prescribe only two or three therapeutic SI joint injections over a 12-month period.

3. What the results mean

Diagnostic injections: 

If the diagnostic SI joint injection provides any relief, it’s a sign that at least some of your pain is likely from your SI joint. With this diagnosis, you’ll be prescribed non-surgical, conservative care therapies, including pain management and physical therapy, to help alleviate the pain.

Therapeutic injections: 

As part of your care, you may be prescribed up to three therapeutic SI joint injections in the first year.

4. What to do next

These conservative therapies might be all you need to feel better. If the pain lasts longer than six months despite following an SI joint non-surgical treatment plan, it’s time to ask about SI joint fusion. If your doctor is unfamiliar with SI joint fusion, you can find a physician who is trained in SI joint treatments in this database.

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