Sacroiliac Joint Injections Melbourne

What are Sacroiliac Joint Injections?

Sacroiliac joint injections are one potential approach for alleviating pain stemming from the sacroiliac joints. These joints, situated at the lower part of the spine where the sacral spine segments connect with the pelvic bones, can be a source of persistent discomfort.

The procedure involves injecting a corticosteroid and local anaesthetic medication directly into the sacroiliac joint, often targeting the lowermost portion for maximum effectiveness. This injection aims to reduce inflammation and provide relief from pain associated with conditions such as sacroiliitis or sacroiliac joint dysfunction.

Sacroiliac joint injections are commonly utilised both diagnostically and therapeutically. 

As a diagnostic tool, they help clinicians identify whether the sacroiliac joint is the source of a patient’s pain. If the injection provides temporary relief, it indicates that the sacroiliac joint is likely contributing to the discomfort.

Additionally, sacroiliac joint injections can serve as a therapeutic intervention for managing chronic pain. By delivering corticosteroids directly into the affected joint, inflammation is reduced, leading to pain relief and improved mobility for the patient.

Overall, sacroiliac joint injections are a valuable component of comprehensive pain management strategies, offering both diagnostic insight and therapeutic benefits for individuals experiencing persistent sacroiliac joint pain.

What do Sacroiliac Joint Injections Address?

Sacroiliac joint injections primarily address pain and inflammation associated with conditions affecting the sacroiliac joints. These injections are specifically targeted at mitigating discomfort arising from:

• Sacroiliitis. This is an inflammation of the sacroiliac joint, which can cause localised pain, stiffness, and discomfort in the lower back, buttocks, and thighs.
• Sacroiliac Joint Dysfunction. Dysfunction or instability of the sacroiliac joint that leads to chronic pain, impaired mobility, and discomfort, particularly during activities that involve the lower back and pelvis.
• Chronic Lower Back Pain. Individuals experiencing chronic lower back pain that is attributed to sacroiliac joint dysfunction or inflammation may benefit from sacroiliac joint injections.
• Pain Referral. Sometimes, pain originating from the sacroiliac joint can radiate to other areas of the body, such as the hips, groin, or legs. Sacroiliac joint injections can help alleviate referred pain by targeting the source of inflammation directly.

By delivering corticosteroids and local anaesthetic medication directly into the sacroiliac joint, these injections aim to reduce inflammation, alleviate pain, and improve the overall function and mobility of the affected joint. 

They play a crucial role in both diagnosing the source of sacroiliac joint-related pain and providing therapeutic relief for individuals suffering from persistent discomfort in the lower back and pelvic region.

How do Sacroiliac Joint Injections Alleviate Chronic Pain?

Sacroiliac joint injections provide relief for chronic lower back pain in several ways:

• Reduction of Inflammation. Corticosteroids, such as cortisone, are commonly used in sacroiliac joint injections. These medications have potent anti-inflammatory properties. By injecting corticosteroids directly into the sacroiliac joint, inflammation is reduced, which in turn helps alleviate pain. Inflammation is often a primary contributor to the chronic pain experienced in conditions like sacroiliitis and sacroiliac joint dysfunction.
• Pain Relief. Along with corticosteroids, sacroiliac joint injections may also include local anaesthetics. These anaesthetics temporarily numb the nerves in the area, providing immediate pain relief. This numbing effect can offer significant comfort to individuals experiencing persistent sacroiliac joint pain.
• Diagnostic Utility. Sacroiliac joint injections can serve a dual purpose by not only providing therapeutic relief but also aiding in diagnosis. If the injection provides significant pain relief, it suggests that the sacroiliac joint is likely the source of the individual’s pain. This diagnostic information can guide further treatment decisions and help tailor a more targeted approach to managing chronic pain.
• Promotion of Healing. By reducing inflammation and providing pain relief, sacroiliac joint injections create a more favourable environment for healing. This can facilitate the repair of damaged tissues within the joint and surrounding structures, contributing to long-term pain management and improved functional outcomes.

Overall, sacroiliac joint injections offer a multifaceted approach to alleviating chronic pain associated with sacroiliac joint dysfunction, facet joint syndrome, sacroiliitis, and related conditions. 

By targeting inflammation, providing pain relief, aiding in diagnosis, and promoting healing, these types of nerve block injections play a crucial role in comprehensive pain management strategies for individuals with persistent sacroiliac joint pain.

Why Would You Get Sacroiliac Joint Injections for Chronic Pain?

Sacroiliac joint injections are used for chronic pain management for multiple reasons:

• Diagnostic Clarity. Chronic pain, especially in the lower back and pelvic region, can stem from various sources. Sacroiliac joint injections serve a diagnostic purpose by helping to pinpoint whether the sacroiliac joint is the source of the pain. If the injection provides significant pain relief, it indicates that the sacroiliac joint is likely contributing to the discomfort, providing clarity for further treatment decisions.
• Targeted Relief. Sacroiliac joint injections deliver medication directly into the affected joint, offering targeted relief. Corticosteroids injected into the joint space work to reduce inflammation, a common contributor to chronic pain in sacroiliac joint-related conditions like sacroiliitis and sacroiliac joint dysfunction. This targeted approach can provide more effective pain management compared to systemic treatments.
• Immediate Pain Relief. Sacroiliac joint injections often include local anaesthetics alongside corticosteroids. These anaesthetics provide immediate pain relief by temporarily numbing the nerves in the area. This rapid onset of relief can offer significant comfort to individuals experiencing persistent and debilitating pain, improving their overall quality of life.
• Long-Term Benefits. In addition to providing immediate pain relief, sacroiliac joint injections can offer longer-term benefits. By reducing inflammation and promoting healing within the joint and surrounding tissues, these injections contribute to sustained pain management over time. This can lead to improved mobility, functionality, and overall well-being for individuals with chronic sacroiliac joint pain.
• Minimally Invasive. Sacroiliac joint injections are minimally invasive procedures that can typically be performed on an outpatient basis. Compared to surgical interventions or more invasive treatments, they carry lower risks and shorter recovery times. This makes sacroiliac joint injections an attractive option for individuals seeking effective pain relief without the need for extensive downtime or recovery.

Overall, sacroiliac joint injections can be a valuable tool in the approach to managing chronic pain associated with sacroiliac joint dysfunction. They can provide diagnostic clarity with minimal invasiveness as well as targeted relief and immediate pain alleviation. These factors make them a valuable component of treatment plans for individuals seeking relief from persistent sacroiliac joint pain.

Risks of Sacroiliac Joint Injections

Sacroiliac joint injections, like any medical procedure, carry certain risks. Some potential risks associated with sacroiliac joint injections include:

Here are some of the potential risks and complications:

• Injection Site Reactions. Some patients may experience temporary pain, discomfort, or bruising at the injection site.
• Flare up of pain. There may be a temporary flare up of pain which is usually a ‘pressure effect’ from the injection. This usually resolves within a few days.Proper patient counselling and management of expectations can help mitigate this risk.
• Infection.  Any invasive procedure carries a risk of infection. Though rare, infection can occur at the injection site or in the surrounding tissues, leading to complications that may require further treatment. Signs of infection include increased pain, swelling, redness, or drainage from the injection site.
• Bleeding. There is a risk of bleeding at the injection site, especially for patients taking blood-thinning medications. This can lead to hematoma (collection of blood) at the injection site.
• Allergic Reactions. Allergic reactions to the medications used in the injection, such as local anaesthetics or corticosteroids, are possible but uncommon. If a contrast dye is used during the procedure, there’s a slight risk of an allergic reaction to the dye, which may include rash, itching, or more severe reactions like anaphylaxis.
• Nerve Damage. There is a slight risk of injury to nearby nerves during the injection, which could lead to temporary or, in rare cases, permanent nerve damage. Proper technique, anatomical knowledge, and real-time imaging guidance can help reduce this risk.
• Nerve Root Injury. Although extremely rare, there is a risk of injury to the nerve roots during the injection, which can lead to neurological deficits, bowel and bladder dysfunction, numbness and weakness. 
• Steroid related side effects. Corticosteroids used in the injection can temporarily increase blood sugar levels in patients with diabetes. There may be transient flushing, mood swings and insomnia on the day of the procedure. 
• Exposure to X-Rays and CT. Minimal doses of radiation are used to reduce the lifetime risk of long term complications (such as cancer) due to exposure to X Ray and/ or CT scanning.
• Failure. The procedure may not provide the expected result or benefit.

It is essential that your doctor thoroughly discusses the potential risks and benefits of sacroiliac joint injections with you before proceeding with the procedure. Additionally, you should inform your healthcare provider of any underlying medical conditions, allergies, or medications you are taking to help mitigate potential risks.

The Process of Getting Sacroiliac Joint Injections

Getting sacroiliac joint injections typically involves the following steps:

1. Consultation and Evaluation. The first step is a consultation with a healthcare provider, usually a pain management specialist or an interventional radiologist. During this consultation, the healthcare provider will review the patient’s medical history, conduct a physical examination, and assess any imaging studies, such as X-rays or MRI scans, to determine the underlying cause of the pain and whether sacroiliac joint injections are appropriate.
2. Informed Consent. Once the decision is made to proceed with sacroiliac joint injections, the healthcare provider will explain the procedure, including its risks, benefits, and alternatives, to the patient. Informed consent will be obtained, and any questions or concerns the patient may have will be addressed.
3. Preparation. On the day of the procedure, the patient may be asked to fast for a certain period before the injection. They may be asked to change into a hospital gown. The procedure is generally performed in an outpatient radiology setting under CT guidance. Occasionally it may be performed under sedation anaesthesia in hospital under X ray guidance. If sedation anaesthesia is used, the patient will be asked to fast for 6 hours prior to the procedure. No fasting is required for radiology procedures. 
4. Positioning. The patient will be positioned on an examination table, either lying face down or on their side, depending on the preference of the healthcare provider and the patient’s comfort. Real-time imaging, such as fluoroscopy or ultrasound or CT, may be used to guide the needle placement during the procedure.
5. Cleaning and Sterilisation. The skin over the injection site will be cleaned and sterilised using an antiseptic solution to reduce the risk of infection.
6. Local Anaesthesia. A local anaesthetic will be injected into the skin and deeper tissues to numb the area and minimise discomfort during the procedure.
7. Injection. Using fluoroscopic guidance or ultrasound imaging or CT imaging, for precise needle placement, the healthcare provider will insert a thin needle through the skin and into the sacroiliac joint. Once the needle is correctly positioned, a combination of corticosteroid medication (to reduce inflammation) and a local anaesthetic (to provide immediate pain relief) will be injected into the joint.
8. Post-Injection Care. After the injection, the patient will be monitored for a short period to ensure there are no immediate complications. They may be advised to remain in the clinic for observation for a short time before being discharged. They will be provided with a Pain Chart to complete over the two weeks following the procedure.
9. Recovery. Patients can usually resume their normal activities shortly after the procedure, although some may experience temporary soreness or numbness at the injection site. It is essential to follow any specific post-procedure instructions provided by the healthcare provider, which may include avoiding strenuous activities for a brief period.
10. Follow-Up. Depending on the patient’s response to the injection, they may need to schedule a follow-up appointment with their healthcare provider to assess the effectiveness of the treatment and determine the need for additional injections or alternative therapies.

Overall, sacroiliac joint injections are a relatively straightforward outpatient procedure that can provide significant relief for chronic sacroiliac joint pain.

Preparing for Sacroiliac Joint Injections

Preparing for a sacroiliac joint block at the Persistent Pain Solutions clinic will require close communication with Dr Mittal and her team. 

Be sure to disclose all medications you may be taking and note that you may have to discontinue some or all of them immediately prior to the procedure.

Prior to your appointment, please inform us if:

• You are currently taking antibiotics.
• You have a pacemaker or defibrillator.
• You have any allergies.
• You have diabetes.
• You are taking any blood thinning medications.
• You are feeling unwell, as we may need to reschedule your procedure.

If you are having the procedure in hospital under sedation anaesthesia, you must also avoid eating or drinking anything in the six hours leading up to the procedure. However, you may continue to take medications with a small sip of water on the morning of the procedure. You will be advised to cease some other medications such as those for diabetes and blood thinning medications.

For your safety, we recommend arranging transportation to and from your appointment, as driving yourself is not advised within the 24-hour period following the procedure.

We generally recommend you take leave from work on the day of the procedure AND one day after the procedure, to rest and recover from the procedure. 

If you are receiving sacroiliac joint blocks, we advise you to refrain from undergoing any additional medical procedures, such as dental treatments or colonoscopies, within 48 hours before or after receiving a sacroiliac joint block. 

Dr Meena Mittal and her team will provide specific guidance tailored to your situation. It is important to adhere to your instructions diligently. If you have any concerns or queries, don’t hesitate to ask—we are here to support you throughout the process.

After Getting Sacroiliac Joint Injections (Follow-Up)

Following your sacroiliac joint block procedure, you are free to return home. 

There are no specific restrictions on your day-to-day activities. However, it is advisable to prioritise rest and engage in gentle activities during the initial 24 hours after your procedure.

Occasionally, you may experience some discomfort or bruising at the injection sites. Occasionally there is a temporary flare up of the pain.

You may commence physiotherapy one week after the procedure. You may return to hydrotherapy or a swimming pool/ spa two weeks after the procedure. 

We do not recommend any long distance or overseas travel for at least two weeks after the procedure. This is such that any issues or complications can be monitored and addressed in a timely manner. 

A follow-up appointment will be scheduled at 2 weeks post procedure to assess your response to the sacroiliac joint block. You will be requested to bring the post procedure Pain Chart such that the results can be analysed by Dr Mittal and next steps in your treatment plan can be discussed with you. 

After obtaining a diagnostic sacroiliac joint block, a positive test block is considered if there is a significant reduction in pain over the first 4-6 hours after the procedure. Once the local anaesthetic wears off, it is normal for pain to increase to its pre-procedure levels. You may then be offered procedures such as Sacroiliac joint radiofrequency denervation or neurotomy to provide longer lasting pain relief.

If the pain is not originating from the sacroiliac joints, there will be no change to the levels of pain after the sacroiliac joint block. This would be considered as a negative diagnostic block. 

After obtaining a therapeutic sacroiliac joint block, the steroid medication may take effect within a few days or sometimes within 1-2 weeks after the procedure. The expected pain relief is anywhere between 50-80% reduction in pain levels.  

The effectiveness of a therapeutic sacroiliac joint block can last anywhere from one to six months following the procedure. Occasionally the pain relief can last much longer.

If you experience unusual symptoms or have any other concerns after getting sacroiliac joint injections, please don’t hesitate to contact the team at Persistent Pain Solutions. We are here to alleviate your mind and provide peace of mind. 

Finding a Doctor Who Performs Sacroiliac Joint Injections Near You

For patients who suffer from chronic lower back pain, a pain specialist who can perform sacroiliac joint block injections may be able to provide some relief. 

Start by asking your general practitioner for a referral to a pain specialist who provides sacroiliac joint injections and similar treatments. You can also speak to family members, friends, or support groups (both online and in real life) for recommendations from those who have dealt with similar chronic pain-related challenges. 

Sacroiliac Joint Injections at Persistent Pain Solutions

Dr Meena Mittal at Persistent Pain Solutions provides sacroiliac joint injections as well as sacroiliac joint radiofrequency neurotomy procedures, all meant to alleviate chronic lower back pain. 

These procedures work by addressing the network of nerves around the sacroiliac joint at the base of the spine. 

Sacroiliac joint injections involve injecting a corticosteroid medication directly into the sacroiliac joint, often targeting the lowermost portion for maximum effectiveness. This injection aims to reduce inflammation and provide more immediate relief from pain associated with conditions such as sacroiliitis or sacroiliac joint dysfunction.

For long-term pain relief, Dr Mittal and her team often use sacroiliac joint radiofrequency neurotomy, also known as radiofrequency ablation (RFA). This technique involves incapacitating a small portion of nerve tissue to interrupt pain signals.