SI Joint


What is the Sacroiliac Joint (SI Joint)?

The sacroiliac joint is a small firm joint that lies at the junction of the spine and the pelvis. This joint does only minimal movement, but if it becomes painful it can radiate to the lower back, buttocks, groin, or legs. Patients who have SI Joint syndrome usually have a history of trauma, either falling on your buttocks or a motor vehicle accident during which the knees hit the dash board. Repeated rotation as seen in golfers, pitchers, ballet dancers, and ice skaters can result in this syndrome.

What are some of the Symptoms of Sacroiliac Joint Injury?

Since the joint is not easily palpated or manipulated it becomes a difficult problem in diagnosis. There are various test such as the Patrick’s and Gaenslen’s Test that will help Dr. Jagodowicz make a diagnosis. Many other problems such as hip arthritis, back pain, and sciatic pain can mimic SI joint pain.

How is the procedure performed?

A SI Joint injection is performed by Dr. Jagodowicz in an operating room setting as an outpatient procedure. You will be lying on your stomach on a special x-ray table. All precautions will be taken to ensure a sterile environment during the procedure. A local anesthetic will be used to numb the skin over the injection site. Dr. Jagodowicz will then direct a special spinal needle, using x-ray guidance, into the SI Joint. When proper placement has been confirmed by fluoroscopy (x-ray) using a contrast dye, a combination of numbing medicine (Xylocaine) and a steroid (Depo Medrol or Kenalog) is injected into the joint space.

Is the Procedure Painful?

You may feel some pressure sensation as the joint space is entered. You will receive sedation (usually by an Anesthesiologist) during the procedure and discomfort will be kept to a minimum. Post procedure, you may experience some injection site tenderness for several days. Cool compresses for 15 minute intervals on and off will usually control the discomfort for the first day.

Are there any Risks or Side effects from the Procedure?

Any time there is an injection through the skin, there is a risk of infection. This is why sterile conditions are used for this procedure. Although rare, nerve injury may occur.

Who should not have this procedure?

If you are on blood thinning medication (e.g. Coumadin, Plavix), or if you have an active infection or fever, you should not have the procedure. The procedure can be performed after a period of time when either blood thinning medication has been stopped, or when no active infection or fever is present. If you are pregnant, you should not have this procedure.

What are my Pre/Post Procedure Instructions?

Patients should have nothing by mouth for at least 6 hours prior to the procedure. You may take your regular medication (blood Pressure) with a sip of water. You will need a ride home and you should not drive yourself for at least 8 hrs after the block. You can return to normal activities the following day. If your pain is resolved or improved with injection of the Sacroiliac Joint, you may experience recurrence of pain later on. We usually repeat the process at least one additional time to ensure that there are no false positives or negatives as to pain relief. A longer lasting resolution to the problem can be performed by using a heating needle-radiofrequency “strip lesioning” of the affected SI Joint.