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SI Joint Injection/Radiofrequency Denervation

Sacroiliitis can cause low-back and buttock pain that may radiate down the leg and into the hip.  At times, it is difficult to distinguish sacroiliac (SI) joint pain from other causes of low-back pain.  SI injections help us diagnose the cause of your pain. 

There are two procedures that may benefit the patient suffering from sacroiliac joint pain:

  • One is the injection of an anti-inflammatory medication into the SI joint.
  • The second procedure is the radiofrequency denervation (“ burning/stunning”) of small lateral branches of the fifth lumbar nerve as well as the first, second, and third sacral nerves. These nerve branches only receive pain signals from the SI joint and are not involved in the movement of your legs. Therefore, they can be safely “burned” without any loss of function. Radiofrequency denervation of the lateral branch nerves to the SI joint can provide therapeutic relief for 6-12 months.

How It Works

A sacroiliac joint injection is performed under live fluoroscopic guidance to ensure the accuracy and safety of this procedure. 

  • You will be asked to lay on your stomach. 
  • Your lower back will be cleaned with an antiseptic, and a sterile drape will be placed.
  • Your physician will anesthetize your skin with a numbing medication.
  • Next, a fine needle will be guided into the SI joint. 
  • An anti-inflammatory medication (cortisone) will be injected into the SI joint to decrease inflammation and pain. 
  • The needle will be removed and a sterile dressing will be placed.

Lateral branch radiofrequency denervation is also performed under live fluoroscopic guidance to ensure the accuracy and safety of this procedure.

  • You will be asked to lay on your stomach. 
  • Your lower back will be cleaned with an antiseptic, and a sterile drape will be placed.
  • After numbing your skin with numbing medicine, your physician will direct radiofrequency needles to the lateral branch nerves, using x-ray guidance.
  • A probe will be inserted into the needle which can then create a controlled heat lesion, using radiofrequency energy. This allows “burning” or “cauterizing” of the nerve and disruption of these nerves’ ability to send pain signals to the brain.
  • Finally, the needles will be removed, and a sterile dressing will be applied.  

Risks

Similar to any other procedure or medication, there are potential risks of infection, bleeding, allergic reaction, and prolonged increases in pain. Your JLR Center for Pain Medicine physician will use x-ray guidance and sterile techniques to significantly reduce these risks.