Sacroiliac Joint Injection

Excerpt

Sacroiliac (SI) joint pain is a common etiology of low back pain. Studies have shown that 10% to 27% of mechanical low back pain is secondary to SI joint pain. It can occur with or without lower extremity pain. Dysfunction of the SI joint occurs with degenerative conditions or with an imbalance between the SI joints. Patients with true and apparent leg length discrepancy, advanced age, inflammatory arthritis, pregnancy, trauma, and previous spine surgery are at increased risk of SI joint pain. Classically, SI joint pain is often reported as pain below L5, and certain physical exam maneuvers such as FABER, Gaenslen’s, and compression tests can elicit pain stemming from SI joint dysfunction. If SI joint pain is bilateral and symmetric, then a suspicion for inflammatory causes such as ankylosing spondylitis should be raised. When indicated, a SI joint injection is used to aid the diagnosis and treat of SI joint pain. This procedure involves introducing a local anesthetic or a mixture of local anesthetic and corticosteroids into the SI joint. Once sustained and adequate pain relief is achieved, the patient can return to normal function or a physical therapy regimen can be implemented.