Sacroiliac Joint (SIJ) Injection

The SIJ has been shown to be a source of pain in 10-27% of suspected cases of chronic low back pain. Patients with medical conditions such as gout, rheumatoid arthritis, Marie-Strumpell or ankylosing spondylitis, psoriasis, fracture, malignancy, congenital deformity, or infection can also develop pain in the SI joint.

Injection therapy of the sacroiliac joint involves the administration of a local anesthetic and anti-inflammatory medication (corticosteroid) into or around the joint and the nerves that innervate it.  A good result immediately following injection therapy indicates the correct area has been identified as the source of the pain. Pain relief from injection therapy can be immediate and may last days, weeks or months. Your doctor may recommend a follow-up treatment called Radiofrequency Ablation of the Sacroiliac Joint to provide even longer lasting pain relief.

An illustration of the injection.

Treatment

The nerve supply to the sacroiliac joint is somewhat complex. The sensory pain nerves may correspond to upper lumbar, lower lumbar, or sacral area. Therefore, injection either into and/or around the joint may be required to bring pain relief. Injections are performed under guided fluoroscopic guidance and an injection dye may be used to assure proper location of the injection is achieved.  At Novocur, SIJ injections are easily accomplished without the need for sedation. Local anesthetic is all that is required making recovery very quick and easy.

One double-blinded study analyzed the effectiveness of SIJ injection and found that at 1 month following a SIJ injection, patients described a >70% pain relief in 83% of the joints injected with an anti-inflammatory corticosteroid. No pain relief was reported in the placebo-injected joints. The study illustrates a very high rate of pain relief following injection treatment of SIJ pain.

In cases of very short pain relief following injection, Novocur can provide the next level of treatment, which involves the use of Radiofrequency Ablation. The nerves that supply sensory pain signals from the SIJ are treated with radiofrequency heat energy. A disruption in the communication of pain signals results in 6-12 months of pain freedom.

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