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Management of Sacroiliac Back Pain with Steroid Injections

By May 11, 2020 No Comments

When you are experiencing debilitating back pain, this pain can bring your busy life to a screeching halt. People who have never had such pain have absolutely no idea how it can keep you from everything that is important to both you and them. You may even consider back surgery to attempt to return to, well, living your life as you previously had.

Pain you feel in your lower back that tends to radiate deep into your buttocks suggests an injury or inflammation of the sacroiliac joint, or the surrounding ligaments. With a lot of inflammation, you could even have pain that travels down into the leg. When the pain is due to an injured sacroiliac joint or one of the surrounding ligaments, talk to your doctor about trying a sacroiliac joint injection before any surgery. This injection can perhaps help to relieve the pain and, it can help diagnosis exactly which joint is causing your pain. It is a “win, win” choice!

Before the injection, a local anesthetic is administered to reduce the pain. You may also choose to have “conscious sedation”, also known as “twilight sleep”. This is an intravenous injection of medication given by an anesthesiologist. The anesthesiologist will be in the procedure room and will monitor your condition throughout the procedure.

A needle will be inserted into one or both of your sacroiliac joint spaces; the insertion of the needle is guided by use of radiology. Once in the correct position, the doctor will administer a corticosteroid mixed with a local anesthesia into these spaces. When the procedure is complete, the anesthesiologist will administer medication, which will reverse the effect of the anesthesia and you will wake up.

When you awaken, you may notice that your back is numb and your pain is gone. This is because of the medication used. The relief can last for about 4-5 hours. However, do not celebrate just yet. After 4-5 hours, the pain might return and it may be a little worse than before you had the injection. For some individuals the steroid can take 2 days to a week before you notice the effects.

The length of time that the injection will relieve the pain can vary from person to person. For long-term relief usually a series of injections will be given with a focus on rehabilitation of the joints and ligaments and strengthening of the supporting muscles between injections. This alternative does take a person who is willing to put in the work to achieve long-term relief. During the periods of time that the inflammation and pain are relieved, your doctor might order physical therapy to teach you exercises you can do at home to strengthen the muscles to better support your sacroiliac joint. When the muscles correctly support the disc and preserve the space, this can produce lasting pain relief.

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