Injecting an anesthetic and anti-inflammatory into the SI
joint has been a treatment option for decades. The purpose is to calm down
infalmmation and reduce pain. About 1/3 of patients state they get some
long lasting relief, about 1/3 get good temprorary relief for days to
weeks, and about 1/3 get little or no relief.
Two medications are commonly injected either in the office or under
fluoroscopy (real time x-ray). Depomedrol or another depot steroid is
commonly used. This medication shuts off the local inflammatory (swelling)
response. Used a few times a year, there are no significant side effects.
The other medication is usually Marcaine, a long acting anesthetic. Again,
there are no significant side effects with this medication. Patients who
have had a reaction to the anesthetic used in dental offices should tell
their doctor.
The risks with this procedure are all the same things that one would
expect with any injection. There is a very small chance of causing an
infection, hitting a blood vessel with associated bleeding, hitting a
nerve, etc... These complications happen less than 1 in 100 times in
skilled hands.
The injection can be placed into the joint or around some of the
ligaments. After the procedure, the joint should go numb for 3-12 hours.
You may experience some transient numbness in the leg that will go away
when the feeling in the joint returns. If your pain isn't decreased by
this type of injection, it's unlikely that your SI joint is the culprit in
your pain syndrome. Ask your doctor about what's next.
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