When a patient has inflammation in one of their sacroiliac joints, they can have pain in the hip on that side and the pain can go down into the leg. To calm the inflammation, Dr. Trujillo uses corticosteroid injections into the inflamed joint. This can provide pain relief for a period of weeks or even months.
What is the sacroiliac joint?
The sacroiliac joints lie next to the spine and connect the sacrum with the hip on both sides. The sacrum is a shield-shaped bony structure that is located at the base of the lumbar spine. There are two sacroiliac joints, one on the right and one on the left. These can become inflamed causing pain in the hip, back, and possibly the corresponding leg.
Who is a good candidate for sacroiliac joint injections? What are the symptoms?
The signs and symptoms of a patient’s pain originating in the sacroiliac joint start in the lower back and buttock. The pain may radiate to the lower hip, groin, or upper thigh. Pain is usually on one side. Patients may also experience numbness or tingling in the leg or a feeling of weakness in the leg.
Symptoms may worsen with sitting, standing, sleeping, walking, or climbing stairs. The joint can be painful with sitting or sleeping on the affected side.
When should I contact Summit Healthcare about possible sacroiliac joint steroid injections?
This depends on you. If your pain that began in your lower back and buttocks has radiated out to the lower hip, groin, or upper thigh, it’s probably beginning to affect your lifestyle. You’re experiencing pain when walking, climbing stairs, maybe even just sitting or sleeping.
These impacts on your life won’t go away without treatment. This is a good time to explore treatment, and these corticosteroid injections are a good first step. Not only will they reduce your pain, but they will give Dr. Trujillo the diagnostic ability to pinpoint the source of your pain.
What are the benefits of having sacroiliac joint steroid injections?
These injections by Dr. Trujillo can relieve the patient’s pain to an extent that they don’t need to consider nerve ablations or other more involved procedures. Once the pain has resolved, Dr. Trujillo can put the patient on a physical therapy program that can strengthen the muscles in the area to provide better support. The combination of steroid injections and PT can resolve the problem, or at least make the pain manageable to the degree the person can return to normal activities.
Sometimes these injections have a twofold purpose. First, Dr. Trujillo may inject anesthetic into the joint. If this provides immediate pain relief, then it is verified that the sacroiliac joint is the cause. This may open the door for a potential nerve ablation procedure to stop the offending nerve from sending pain signals. Beyond that diagnostic purpose, these injections with corticosteroid will aim to calm inflammation in the sacroiliac joint.
Are you sedated for Sacroiliac joint steroid injections?
There isn’t any need for sedation. Dr. Trujillo locally anesthetizes the area where he will be making the injection. Then he uses x-ray guidance to ensure proper placement.
How are these sacroiliac steroid injections done?
The first step in these treatments is to numb the area with a local anesthetic. Next, a needle inserted using fluoroscopy (x-ray guidance) to guide Dr. Trujillo precisely to the sacroiliac joint. Once the needle has entered the joint, a vial with corticosteroid is attached to the needle and it is injected directly into the joint. Once all of the steroids has been injected, the needle is removed, and the treatment is complete. A small bandage is placed over the injection site.
How successful are sacroiliac joint steroid injections?
These injections usually provide relief for most patients, although results can vary. Most of our patients from Show Low and the surrounding areas who have these injections with Dr. Trujillo notice an improvement in pain 2-5 days after their injections. This relief typically lasts for a period of weeks, but it can last for months.
Often, just as important as relieving the pain is the diagnostic ability of these injections. Once Dr. Trujillo has injected the corticosteroid into your inflamed sacroiliac joint, if this relieves your pain then we have found the source of the pain radiating down into your buttocks and legs. This now gives us the target of other treatments, such as radiofrequency ablation, if they are needed.
What happens if I don’t treat my sacroiliac joint pain?
These situations won’t likely improve without treatment. These steroid injections are a good first step to easing your pain, and to making sure of the source of your pain. Because sacroiliac pain is often due to osteoarthritis in that joint, the condition won’t improve. That means you’ll have to endure more and more pain, and it will infringe on your lifestyle to an increasing degree.
These are not complicated or difficult procedures for Dr. Trujillo, and the corticosteroid can provide effective pain relief for months in many patients. Plus, by lessening the pain, the patient is then able to handle physical therapy, which can strengthen the muscles in the area to better support the sacroiliac joint. This can work overtime to continue to decrease the pain. Or, if more aggressive treatment is necessary, these injections allow Dr. Trujillo to isolate the source of your pain, making it possible to use a treatment such as radiofrequency ablation to block the nerve causing the pain.
What are possible side effects with sacroiliac joint injections?
Following the injection, we keep the patient in our Show Low offices for 30 minutes to ensure that aren’t any immediate reactions or complications. The risks with these injections are minor and rare. They are:
- Risks related to the medications used in the injection
- Bruising and/or soreness at the injection site
- Infection at the injection site, in deeper tissues, or in the joint
How long can I expect my pain to be relieved with sacroiliac joint injections?
The duration of your pain relief can vary between patients, but most patients have substantial pain relief for a period of weeks or months. That’s because the corticosteroid calms the inflammation in the joint that is causing the patient’s pain.
How often can I have sacroiliac joint steroid injections?
If you have found these injections to provide long-term pain relief, these corticosteroid injections can be repeated up to three times per year.
How long after these injections can I drive?
Patients cannot drive for 12 hours after these injections. You will have mild soreness at the injection sites for one to two days, but it is not acute.
What is the aftercare for sacroiliac joint steroid injections?
Twenty to 30 minutes after your injection, you will move your back to try to provoke your usual pain. We will have you keep a pain diary for the next week or so. Immediately after your injection, you may have an odd feeling in your leg that can last for a few hours. Your pain may actually increase for a day or two as the lidocaine in the injection wears off and the corticosteroid hasn’t yet fully begun to reduce inflammation. Icing is usually more helpful than heat for the first 2-3 days after your injection.
On the day of your injection, you shouldn’t drive and should avoid any strenuous activity. On the second day you can return to most of your normal activities. As your pain continues to improve you can gradually return to regular exercise activities.
You should begin to notice an improvement in your pain in 2-5 days after your injection. If you don’t have any improvement after 10 days, it’s unlikely to occur. Now Dr. Trujillo knows the sacroiliac joint is not the source of your pain.