Serenity

What is a diagnostic SI injection?
A diagnostic SI joint injection is the injection of a local anesthetic medication into the SI joint.
 

What is the purpose of a diagnostic SI injection?
A diagnostic SI joint injection is an important diagnostic procedure to confirm that pathologic changes (i.e. arthritis) and inflammation within the SI joint in the underlying cause of your plan. If this injection works, it will give you relief for several hours. After that, the pain is expected to return to normal.
This test is always performed twice (usually a week or two apart) because two successful tests are required to move onto treatment. If both diagnostic tests are positive, then we schedule a treatment.
The treatment may involve a steroid injection to decrease the inflammation within the joint.
Alternately, your doctor may choose to treat the problem with radiofrequency (RF) ablation. In this
procedure, nerves that feed the SI joint are cauterized, which typically leads to pain relief for 6-18 months.
If this process works well on one side, it can be performed on the other side if needed.pain.

How is the procedure performed?
You will be placed on the procedure table. The injection site is sterilized with either iodine or
chlorhexidine. The site to be injected is numbed with a local anesthetic and a needle is directed to the target area. X-ray guidance is used to ensure proper placement and positioning of the needle.
Contrast (x-ray dye) may be injected to be sure the needle is in the proper position. Once proper
needle placement is confirmed, the anesthetic solution is slowly injected.

Will the procedure be painful?
The injection can be uncomfortable but is tolerated well by the majority of patients.  Most of the discomfort can be minimized with local anesthetic.

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What are the discharge instructions?
You may return to work the next day following your procedure. You may resume your
normal diet immediately. Do not engage in any strenuous activity for 24 hours. Do not take a bath,
swim, or use a hot tub for 24 hours (you may take a shower). Use ice at the injection site for 2 hours, on and off every 10 minutes.  Call the office if you have any of the following: severe pain afterwards (different than your usual symptoms), redness/swelling/discharge at the injection site(s), or fevers/chills.
 

What are the risks and side effects?
The complication rate for this procedure is very low. Whenever a needle enters the skin, bleeding or infection can occur. Some other serious but extremely rare risks include paralysis and death.
You may have an allergic reaction to any of the medications used. If you have a known allergy to any medications, especially x-ray contrast dye or local anesthetics, notify our staff before the procedure takes place.

You may experience any of the following side effects up to 4 hours after the procedure:
● Dizziness may occur due to a decrease in your blood pressure. If this occurs, remain in a seated
or lying position. Gradually sit up, and then stand after at least 10 minutes of sitting.
● Mild discomfort at the injection site can occur. This typically lasts for a few hours but can persist
for a couple days. If this occurs, take anti-inflammatories or pain medications, apply ice to the area the day of the procedure. If it persists, apply moist heat in the day(s) following.

The side effects listed above can be normal. They are not dangerous and will resolve on their own. If, however, you experience any of the following, a complication may have occurred and you should either contact your doctor. If he is not readily available, then you should proceed to the closest urgent care center for evaluation:
● Severe or progressive pain at the injection site(s)

● Arm or leg weakness that progressively worsens or persists for longer than 8 hours
● Severe or progressive redness, swelling, or discharge from the injections site(s)
● Fevers, chills, nausea, or vomiting
● Bowel or bladder dysfunction (i.e. inability to urinate or pass stool or difficulty controlling either)

How long does it take for the procedure to work?
The anesthetic medication begins to take effect in 5-15 minutes.  Typically, the pain relief experienced from this anesthetic used during the procedure lasts 1-3 hours, but this can be lengthened with use of corticosteroids.