Sacroiliac Joint Injections and Radio-Frequency Ablation
Sacroiliac Joint Injections are primarily used either to diagnose or treat low back pain and/or sciatica symptoms associated with sacroiliac joint dysfunction. The sacroiliac joints lie next to the spine and connect the sacrum with the hip on both sides. There are two sacroiliac joints, one on the right and one on the left. Joint inflammation and/or dysfunction in this area can cause significant pain.
A diagnostic Sacroiliac Joint Injection is used to confirm a suspected diagnosis of sacroiliac joint dysfunction. This is done by numbing the sacroiliac joint with a local anesthetic like lidocaine. The injection is performed under X-ray guidance for accuracy. Once the needle has entered the sacroiliac joint, contrast is injected into the joint to ensure proper needle placement and proper spread of medication. The numbing medication is then injected into the joint.
After the numbing medication is injected, we’ll ask you to try and reproduce the pain by performing normally painful activities. If you experiencs 75-80% pain relief for the normal duration of the anesthetic, a tentative diagnosis of Sacroiliac Joint Dysfunction is made. We may perform a second diagnostic sacroiliac injection in order to confirm the diagnosis. If this second diagnostic injection also provides 75-80% pain relief for the duration of the anesthetic, there is a reasonable degree of medical certainty the sacroiliac joint is the source of your pain.
Therapeutic Sacroiliac Joint Injection
A therapeutic Sacroiliac Joint Injection is done to provide relief of the pain associated with sacroiliac joint dysfunction. The injection is performed using the same technique as a diagnostic SI joint injection, except that anti-inflammatory medication (cortical steroid) is included in the injection to provide pain relief by reducing inflammation within the joint.
If you experience prolonged pain relief after a therapeutic Sacroiliac Joint Injections, you can begin a physical therapy and rehabilitation program to further reduce pain and enable you to return to normal activity levels. If the therapeutic Sacroiliac Joint Injection is successful in reducing or eliminating your pain for a longer duration, it may be repeated up to three times per year, in conjunction with physical therapy and rehabilitation program, to help you maintain normal daily function.
Radio-frequency ablation is a minimally invasive procedure that is usually performed with local anesthetic and mild sedation. As with many spinal injections, radio-frequency neurotomy is best performed under fluoroscopy (live x-ray) for guidance in properly targeting and placing the needle (and for avoiding nerve or other injury). A small amount of electrical current is often carefully passed through the needle to assure it is next to the target nerve and a safe distance from other nerves. This current should briefly recreate the usual pain and cause a muscle twitch in the neck or back.
The targeted nerves will then be numbed to minimize pain while the lesion is being created. The radio-frequency waves are introduced to heat the tip of the needle and a heat lesion is created on the nerve to disrupt the nerve’s ability to send pain signals. This process will be repeated for additional nerves.
