Over the years, there’s been a lot of debate about the source of pain felt in the sacroiliac joint (SIJ). Is it coming from the joint itself? From outside the joint? Or both? Injecting a numbing and antiinflammatory (steroid) agent
into the SI joint has convinced scientists that pain can come from the joint. Relief of pain after injection is proof of that.
But what about the many patients whose pain isn’t relieved by an injection into the SIJ? Would injecting this same pain reliever and steroid outside (but near) the joint help? In a recent study, surgeons split the total usual dose of medication in half. They injected half into the SIJ and the other half under the posterior sacroiliac ligaments at the
S1-3 level.
They found that injecting a numbing agent and steroid into the SI joint and also around the posterior interosseous ligament was a successful treatment for patients with chronic SI pain. The results support and confirm the findings of several other studies that reported sacroiliac joint pain can come from outside the joint. The number of patients who experienced pain relief with the dual blocks increased by 47 per cent over just the single injection.
If you got any amount of pain relief with the first injection, it’s a good indication that a second injection will help. Some studies have also shown that maximum pain relief doesn’t always occur right away. Some patients continue to improve over time. The positive results they experienced at the end of three weeks after the injection are even better three months later. This may be in keeping with the saying that time heals all. The exact neural mechanism isn’t known yet but research continues to help define what treatment works best for each type of patient.