In brief
- The SI joint is a common but frequently misdiagnosed source of chronic lower back pain.
- The injection both reduces inflammation and helps confirm whether the joint is the true source of your discomfort.
- You may feel immediate relief from the anesthetic; the steroid begins to provide more lasting relief within 3 to 7 days.
- A medication hold is typically not required for this injection unless our office directs it.
Understanding your diagnosis
The sacroiliac (SI) joint connects the base of your spine (sacrum) to your hip bones (ilium). When this joint becomes inflamed or misaligned, often due to arthritis, injury, or pregnancy, it can cause significant pain in the lower back, buttocks, and radiating down the back of the leg. This is a common but frequently misdiagnosed source of chronic lower back pain.
The treatment
An SI joint injection is a targeted procedure designed to reduce inflammation and provide diagnostic clarity. Using a precise blend of local anesthetic and a powerful anti-inflammatory (steroid), we deliver medication directly into the joint space. This calms the irritated joint, reducing pain and allowing you to move more freely.
Our approach
Dr. Pugh performs SI injections using live X-ray (fluoroscopy) to ensure the medication is placed exactly within the narrow joint space. This ensures an accurate diagnosis of your hip and back pain, helping us build an evidence-based plan for your long-term recovery.
Before your procedure
Medication holds
A medication hold is typically not required for medial branch blocks, sacroiliac joint injections, or ultrasound-guided peripheral joint or bursa injections unless specifically directed by our office.
Fasting, sedation, and your ride home
- If you are receiving sedation, nothing to eat or drink for six hours before your appointment. Essential morning medications may be taken with a small sip of water only.
- We offer light or deep sedation. The level is decided by the physician and anesthesia team based on the procedure and clinical need.
- Any patient receiving sedation must be accompanied by a responsible adult driver to take them home.
Where to go
Procedures are performed at one of three facilities: our clinic at 1925 Hospital Place, ACOM at 6449 Central Park Blvd, or Hendrick South at 6399 Directors Pkwy, Suite 100. Your appointment paperwork tells you which one. Please arrive early for registration and pre-procedure preparation.
Procedure day
- Performed under live X-ray (fluoroscopy) for maximum precision.
- We use sedation and local numbing medication to ensure a comfortable experience.
- The entire procedure typically lasts about 10 minutes.
- You will be able to walk out and go home immediately following the visit.
Benefits
- Direct inflammation control: delivers medication exactly where it is needed most.
- Diagnostic clarity: helps confirm whether the SI joint is the true source of your discomfort.
- Functional recovery: reduces pain so you can participate more effectively in physical therapy.
Recovery
- Immediate feedback: you may feel significant relief shortly after the injection due to the local anesthetic.
- Long-term timeline: the steroid typically begins to provide more lasting relief within 3 to 7 days.
- Follow-up: we will monitor your progress to determine whether further treatments or regenerative options are right for you.
Afterward: what to expect
- The window. You may feel immediate relief for several hours due to the local anesthetic.
- The flare. It is normal to experience a temporary increase in localized soreness or a bruised sensation for 2 to 5 days as the steroid begins to work. Use ice packs (20 minutes on, 20 off) and continue baseline medications.
- Results. Peak relief typically occurs between 6 weeks and 3 months.
- Blood glucose. If a steroid was included, expect a temporary rise in blood glucose that usually resolves within a few days. Diabetic patients should monitor their sugar levels closely for 48 to 72 hours after the procedure.
Activity
Wound care
Your procedure in one paragraph
You have undergone a sacroiliac (SI) joint injection, a targeted procedure designed to reduce inflammation and pain originating from the joint that connects your spine to your pelvis. We have delivered a concentrated blend of local anesthetic and an anti-inflammatory steroid directly into the joint to improve your mobility and decrease localized discomfort.
Follow-up schedule
- 1
1 month
Formal functional assessment of how well the injection worked.
Call us right away if you notice
- New or worsening leg weakness, numbness, or foot drop
- Sudden loss of bowel or bladder control
- Fever above 101.5°F, chills, or drainage at the site
- A severe headache that worsens when sitting or standing
This guide is the same information as the printed handout from Abilene Pain. It is general information and does not replace the instructions your care team gives you at your visit. Your care team: Nicolas Pugh, MD · Adrianne Anders, NP · Ted Chaka, PA.