What is Sacroiliac Joint Block?

A Sacroiliac Joint Block is an injection procedure used to diagnose and treat low back pain associated with injury or disease to the sacroiliac joint. The sacroiliac joints are located in the area of the low back and buttocks where the pelvis joins with the spine. Injury and disease to these joints will cause pain in the low back, buttocks, abdomen, groin, and legs. The medicine injected reduces inflammation and swelling inside the joint space. This may in turn reduce the pain.

Procedure Overview

The Sacroiliac Joint Block is an outpatient procedure, usually done in the Operating Room or a Special Procedure Room. For your safety and comfort, you will be connected to monitoring equipment (EKG monitor, blood pressure cuff, and a blood-oxygen monitoring device), and positioned on your stomach. The doctor or nurse may start an intravenous line and give somemedicine to help you relax. Your back is cleansed with an antiseptic soap after which the doctor injects numbing medicine deep into your skin and tissue. This will cause a burning sensation for a few seconds. After the numbing medicine takes effect, the doctor will insert another needle and, with the assistance of a special X-ray machine called a fluoroscope, inject a radiopaque dye (contrast solution) to ensure the needle is in proper position. With the needle in position, a small mixture of numbing medicine (anesthetic) and anti-inflammatory medicine (steroid) is injected. Immediately after the procedure, you will get up, walk around, and try to imitate something that would normally bring about your usual pain. We ask that you to remain at the Clinic until the doctor feels you are ready to leave.

Procedure Details

Will you be asleep for the procedure? It is not necessary for you to go to sleep for this procedure; however, you will receive enough medication to keep you comfortable.

How long will the procedure take? Normally, a sacroiliac joint block procedure takes no more than 30 minutes.

Before the Procedure

Since you will be receiving medication it is recommended that you do not eat within eight hours before the procedure. If you are a diabetic, be sure to discuss your eating and medication schedule with the doctor. You may need to stop taking certain medications several days before the procedure. Please remind the doctor of all
prescription and over-the-counter medications you take, including herbal and vitamin supplements. The doctor will tell you if and when you need to discontinue the medications.

Before the Procedure

Since you will be receiving medication, it is recommended that you do not eat within eight hours before the procedure. If you are a diabetic, be sure to discuss your eating and medication schedule with the doctor. You may need to stop taking certain medications several days before the procedure. Please remind the doctor of all prescription and over-the-counter medications you take, including herbal and vitamin supplements. The doctor will tell you if and when you need to discontinue the medications.

It is very important to tell the doctor if you have asthma, had an allergic reaction (i.e. hives, itchiness, difficulty breathing, any treatment which required hospitalization) to the injected dye for a previous radiology exam (CT scan, angiogram, etc) or if you have had an allergic reaction to shellfish (shrimp, scallops, lobster, crab). The doctor may prescribe some medications for you to take before having the procedure. Tell the doctor if you develop a cold, fever, or flu symptoms before your scheduled appointment.

After the Procedure

You need to be aware of several potential side effects. These side effects, which usually disappear four to eight hours after the block may include: A droopy eyelid on the side of the block; Redness and blurred vision in the eye on the side of the block; A feeling like a lump in your throat; Difficulty swallowing; Hoarseness of your voice; Warmth and weakness of the arm on the side of the block. Drink plenty of clear liquids after the procedure to help remove the dye from the kidneys and do not eat solid food until you are comfortable swallowing. Do not drive for the remainder of the day. Please have an adult drive you home or accompany you in a taxi or other public transportation.

Depending on how you feel, you may resume normal activities and return to work the following day. If the doctor prescribes physical therapy, it is very important that you continue with the physical therapy program. Although you may feel much better immediately after the injection (due to the numbing medicine), there is a possibility your pain may return within a few hours. It may take a few days for the steroid medication to start working.

Procedure Risks

The risks, although infrequent, include:

• Collapsed lung
• Numbness of an arm that may last for hours
• Temporary weakness or numbness from the neck down
• Allergic reaction to the medication
• Nerve damage
• Bruising at the injection site
• Infection at the injection site
• Injection of medication into a blood vessel.

If you experience new shortness of breath 24 – 48 hours after the injection or any signs of infection in the area of the injection you should call the doctor right away.