WHAT IS IT? A SI injection is performed with a long acting steriod and local anesthetic. The sacroillic joints are located in the back where the lumbosacral spine joins the pelvis. They are paired (right and left) and are surrounded by a joint capsule like the finger joints. HOW IS IT DONE? The patient is given a local anesthetic before a small spinal needle is inserted under fluoroscopic guidance into the SI joint or ligaments. Local anesthetic and steriods are injected. WHAT SHOULD I EXPECT AFTER THE INJECTION? Immediately after the injection, you may feel that your pain may be gone or quite less. This is due to the local anesthetic injected. This only last for a couple of hours. Your pain may return and you may have a sore back for a day or two. This is due to the mechanical process of needle insertion as well as intial irritation from the steriod itself. You should start noticing pain relief starting the 3rd to 5th day which may last days to months. HOW LONG DOES IT TAKE? Thirty minutes WILL THE INJECTION HURT? This procedure is done under local anesthesia which makes the procedure easy to tolerate. WHAT SHOULD I DO AFTER THE PROCEDURE? You may want to apply ice to the affected area. After the first day, you can perform activity as tolerated. CAN I GO TO WORK THE NEXT DAY? Yes. Unless there are complications, you should be able to return to your work the next day. The most common thing you may feel is soreness in the neck or back. HOW MANY INJECTIONS CAN I HAVE? In a six month period, we generally do not perform more than three injections. Giving more than three injections will increase the liklihood of side effects from cortisone. Also, if three injections with fluoroscopic guidance have not helped you much, it is very unlikely that you will get any further benefit from additional injections. WHAT ARE THE RISKS AND SIDE EFFECTS? This procedure is safe when performed in a controlled setting. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is temporary discomfort. The other risks involve, infection, bleeding, worsening of symptoms. As with other types of injections, you should not have the procedure if you are currently taking blood-thinning medicine (Coumadin). Side effects related to cortisone include: fluid intention, weight gain, increased blood sugar (mainly in diabetics), elevated blood pressure, mood swings, irritability, insomnia, and suppression of body's own natural production of cortisone. Fortunately, the serious side effects and complications are uncommon. You should discuss any specific concerns with your physician.
