University of Maryland Rehabilitation & Orthopaedic Institute
410-448-2500 or 1-888-453-7626

Programs and Services

Pain Management Center

Frequently Asked Questions

Sacroiliac Joint Injection

What is a sacroiliac joint injection?

A sacroiliac joint injection is an injection of local anesthetic and a steroid medication into the sacroiliac joint. Due to the numbing medicine used during this procedure, you may experience temporary pain relief afterwards that may last several hours. Once the numbing medicine wears off, however, your pain will most likely return. The steroid medication may give longer lasting pain relief and usually begins working after 24-48 hours.

Note: The procedure cannot be performed if you have an active infection, flu, cold, fever, very high blood pressure or if you are on blood thinners. Please make your doctor aware of any of these conditions. This is for your safety!

What are the risks of the procedure?

As with most procedures, there is a remote risk of bleeding, infection, or allergic reaction to the medications used. Additional short-term effects may occur. You may have some temporary numbness or weakness in your legs caused by the local anesthetic (numbing medicine). If this interferes with your ability to walk safely, you will have to remain in the Pain Management Center until it resolves, usually several hours. You may have increased pain for a few days after the injection, including localized pain at the injection site. Diabetics may have short-term elevation of blood sugars as a result of the steroid medication.

Will the injection hurt a lot?

Most people say the stinging/burning of the numbing medicine is the most uncomfortable part of the procedure (this lasts only a few seconds); however, every person’s response to any procedure will differ.

How do I prepare for my procedure?

No solid food or fluids after midnight prior to the procedure unless directed otherwise. You may take your medications with a small amount of water. Diabetics should not take their medication for diabetes until after the procedure is complete. Please check your blood sugar at home before coming in. If you are taking any blood thinners such as Coumadin, Warfarin, Plavix, or any others, these medications must be discontinued well before the procedure. You will be directed by our staff as to when you should stop this medication. Please make your Pain Management doctor aware that you are taking a blood thinner, and contact your primary care physician or prescribing physician before stopping this medication.

What happens during the actual procedure?

After the doctor examines you and goes over the risks and benefits of the procedure, he or she will ask you to sign a consent form. Then, you will be assisted to the X-ray table and made as comfortable as possible lying on your stomach. Your injection site is cleansed with an antiseptic soap and alcohol, and then covered by sterile drapes. The skin is numbed with local anesthetic (numbing medicine). Using X-ray guidance, a needle is advanced into the sacroiliac joint. X-ray dye will be injected to confirm proper placement (Please let your doctor know if you have ever had an allergic reaction to X-ray dye or shellfish!). Local anesthetic (numbing medicine) and steroid are then injected into the joint, and the needle is removed. The injection site will be washed and a Band-Aid will be applied. You will be monitored for an appropriate time in the recovery area (usually 20-30 minutes) where you may be offered juice/soda and graham crackers. You will be given verbal and written discharge instructions, and may go home with your driver after your doctor authorizes discharge.

How will I feel after the injection?

Your pain may be improved immediately after the injection from the local anesthetic. Once the numbing medicine wears off, your pain may return. It is possible that you will have some soreness at the injection site and your pain may worsen for a day or two after the procedure. The steroid medication takes 2-3 days to start having an effect in most people. Using an ice pack applied three or four times a day can help alleviate the discomfort at the injection site. You may take your usual pain medication after the injection.

Will I have restrictions on the day of the procedure?

You may not drive for the remainder of the day after your procedure. A responsible adult (over 18 years old) must be present to drive you home or to accompany you in a taxi. The procedure will be cancelled if you don't have a responsible adult with you! This is for your safety. No heat is to be used in the injected area for the remainder of the day. No tub bath, shower or soaking in water (i.e., pool, hot tub, etc.) for the remainder of the day. You may resume normal diet and medications after the procedure unless told otherwise by your doctor.

When should I call the Pain Management Center?

We would like speak to you the day after your procedure regarding your response. Specifically, we would like to know if you experienced pain relief (if so, how long did it last), your current pain score, and if you are experiencing any problems. If you experience severe pain, new numbness or weakness of your legs, a temperature of 100.5 or greater, or signs of infection in the area of the injection (redness, swelling, heat, discharge), you should call the Pain Management Center immediately at 410-448-6824 during business hours, and 410-448-2500 after hours to have the pain management physician on call paged to your number.

For more information or to make an appointment, call the University of Maryland Pain Management Center at 410-448-6824 or email us at paininfo@anes.umm.edu