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Can SI Joint Injection Diagnose Your SI Joint Pain?

An SI joint injection is the most commonly used procedure to accurately determine if lower back pain is being caused by sacroiliac (SI) joint dysfunction or alternative conditions. An accurate diagnosis is critical to determining the proper course of treatment to relieve pain.

Understanding How SI Joint Injection Can Diagnose SI Joint Pain

In order to understand how an SI joint injection can determine if the SI joints are the focal point of lower back pain, it is useful to take a look at where the joints are and how they are designed to perform. The sacroiliac joints form at the points where the sacrum region of the spine and the two ilium (hip) bones meet, one on the left and one on the right side of the spine. The two ilium bones are the major structures of the pelvis. The SI joints play a major role in supporting the upper body and helping to transmit motion through the hips and legs. There are several components to the SI joints, each of which is subject to pressures that can cause friction, inflammation, and long term wear and tear.

The SI joints are basically opposing bony surfaces covered by cartilage and bound together by extremely strong ligaments. By design, SI joints have a narrow range of movement. But they need to be fluid enough to allow the hips and legs to move smoothly while at the same time supporting the spine and upper body. Any stressors to this balance of function can damage the joints and introduce SI joint dysfunction.

Over the course of a lifetime, people are as likely to suffer some form of back pain as they are to catch a cold. But back pain takes on many forms, and expresses itself in many ways. If a preliminary physical examination suggests that SI joint dysfunction may be the cause of the pain, an epidural injection into the SI joints can help verify the diagnosis. SI joint injections can serve both as a diagnostic tool and a therapeutic treatment. As a diagnostic tool, the clinician injects a painkiller directly into the suspected SI joint. Typically, lidocaine is used. Since the SI joints present a very narrow and specific target beneath a thick layer of ligaments, the clinician uses an X-ray fluoroscope to accurately guide the needle to its proper place. A contrast medium is injected to highlight the joint. If the injection of painkiller significantly reduces the patient’s pain, the clinician can conclude that the SI joint is the source of, or major contributor to, the patient’s low back pain. This reduction in pain is therapeutic as well. The clinician may also inject a corticosteroid into the joint to help relieve inflammation caused by arthritis.

SI joint pain typically results from hypo-mobility or hyper-mobility. Hypo-mobility simply means low movement. The ligaments that hold the SI joints together tighten and lose elasticity. Cartilage of the SI joints can erode, bone spurs can develop, and the joints can freeze or lock up. The result is limited motion and chronic pain. Hyper-mobility means high movement. The ligaments stretch out and become more elastic. This can cause undue friction within the joint, misalignment of the bones, uneven wear, and subsequent pain. There are also many nerves in proximity to the SI joints that can become irritated and inflamed. The range of pain can vary from dull to acute.

SI joint pain can express itself on either the left or right side of the lower back. SI joint dysfunction can produce pain in the buttocks, groin, and thighs as well.

SI joint injection follows a thorough physical exam in determining the SI joints as source of lower back pain. Other imaging tests, such as X-rays, CT scans, and MRIs may also be used to confirm. If you are experiencing symptoms of lower back pain, get in touch with a medical expert in spine health. Early diagnosis and treatment of SI joint dysfunction can slow progression of the disease, relieve low back pain, and help to restore healthy joint function.


Tips for Preventing and Managing SI Joint Pain at Home

  • Regular stretching and exercise can help prevent and ease low back pain.
  • When lifting heavy objects, use your legs for leverage, not your back.
  • Walk cautiously and wear shoes with good traction when walking on slippery surfaces.
  • When carrying something, be sure to distribute its weight evenly, not favoring one side.
  • Consult a spine specialist for severe low back pain that hasn’t resolved with conservative methods in a few weeks.

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