Treatment information
Understanding your pathway
What is the treatment?
The sacroiliac joints connect the sacrum at the base of the spine to the pelvis. An injection places local anaesthetic, sometimes with corticosteroid, into or around a selected joint. It may be used to explore a suspected contribution to pain or to seek temporary symptom relief. [1]
Who may be considered?
This may be considered when the history and examination suggest a sacroiliac contribution to lower back or buttock pain. Similar symptoms can come from the lumbar spine, hip or other structures. A painful location, scan finding or one examination manoeuvre alone does not settle the diagnosis. [1]
Assessment, preparation and consent
Before deciding, discuss your diagnosis, previous treatment, medicines and relevant health conditions. Tell the clinician about allergies, infection, blood-thinning medicines, diabetes and possible pregnancy. Do not stop prescribed medicines yourself. Ask what alternatives are available, including not having a procedure, and allow time to consider the benefits, uncertainty and risks that matter to you. [2]
What happens during treatment?
The treatment plan identifies the side, target and purpose. Imaging guidance may be used to position the needle, with contrast where appropriate. The distinction between an injection into the joint and one around it should be explained. Your response is reviewed in relation to the activities that normally provoke symptoms. [1]
Risks and safety considerations
Possible adverse effects include soreness, bruising, infection, bleeding, allergy and temporary numbness or weakness if medication affects nearby nerves. Steroid-related effects may include elevated blood glucose. Relevant medication, pregnancy and infection precautions are reviewed before the procedure, with a plan for safe mobilisation afterwards. [1]
Recovery and when to seek help
Follow the written instructions for transport, supervision, medicines, activity and driving. Recovery depends on the treatment and your health, so a fixed return-to-work date cannot be promised. Ask who to contact outside clinic hours. Seek urgent assessment for fever with worsening pain, new weakness or other unexpected neurological symptoms. Call 000 for breathing difficulty, collapse or another medical emergency. [3][2]
Expected benefit and limitations
An injection may provide no benefit or only a temporary change. A response is one piece of clinical information and does not automatically justify denervation or repeated procedures. Rehabilitation may still be needed. Agree how the result would alter care and when the proposed benefit would be reassessed. [1]
Follow-up and rehabilitation
Before treatment, choose a practical goal such as walking, sleep or a daily task. Record changes in that activity, pain and any adverse effects, then discuss them at follow-up. Ask what degree of change would justify further treatment and what would lead to stopping or changing the plan. Rehabilitation and self-management may remain part of care even if symptoms improve. [2][4]
Questions to bring to your appointment
Ask which structure is being targeted, why this approach is being considered and how strong the evidence is for your diagnosis. Clarify costs, the planned review date and any practical help you may need at home. Bring previous reports and your medicine list so the discussion can address your circumstances rather than a generic treatment pathway.
Sources and further reading
Sources support the statements cited above. Overseas guidance may describe different services or eligibility rules. A procedure leaflet explains a technique and its risks; it does not establish that the treatment is effective for every condition.
- Sacroiliac joint injections — The Dudley Group NHS Foundation Trust
- Procedures in pain medicine clinical care standard — Faculty of Pain Medicine, ANZCA
- Dorsal root ganglion / nerve root block / transforaminal injection — Hull University Teaching Hospitals NHS Trust
- Options for chronic pain management — Healthdirect Australia