Lumbar spine
Sacroiliac joint injection
The joint that connects the base of the spine to the pelvis is a well-established site for ultrasound-guided treatment, with good visibility even in patients with a larger build.
How it is performed
The sacroiliac joint joins the sacrum to the pelvis and is a frequent, and often unrecognised, cause of low back and buttock pain. With the patient lying face down, ultrasound identifies the lower portion of the joint: the needle is inserted under direct visualisation and the anti-inflammatory medication is deposited inside or around the joint. The procedure is outpatient and takes only a few minutes.
Who it is for
- Low back pain that is lateralised, gluteal or groin-related
- Pain that worsens when standing up from a chair or climbing stairs
- Inflammatory or post-traumatic sacroiliitis
Recovery
No particular restrictions: you can walk immediately. It may be helpful to avoid strenuous effort for 24-48 hours.
Conditions treated in this area: chronic low back pain, disc herniation and sciatica, sacroiliac joint pain, muscle tension and pain (paraspinal, piriformis).
Scientific evidence
Randomised studies confirm the analgesic effectiveness of sacroiliac injection performed under image guidance and show that ultrasound guidance allows reliable access to the joint; comparisons with injections performed using anatomical landmarks alone highlight the importance of image guidance.
References on PubMed
- Fluoroscopically Guided vs Landmark-Guided Sacroiliac Joint Injections: A Randomized Controlled Study
Cohen SP, Bicket MC, et al. — Mayo Clin Proc, 2019 · PMID 30853260
- Steroid vs. Platelet-Rich Plasma in Ultrasound-Guided Sacroiliac Joint Injection for Chronic Low Back Pain
Singla V, Batra YK, et al. — Pain Pract, 2016 · PMID 27677100
Published data describe average results in groups of patients and are not a prediction of an individual outcome. The indication for treatment must always be assessed during a consultation.
Risks, costs and opinions
The three questions patients ask most often before deciding, with clear answers.
What are the risks of sacroiliac joint injection?
It is an outpatient procedure performed with a thin needle under local anaesthesia and continuous ultrasound guidance, which makes it possible to see the needle, the target and the structures to avoid in real time. The most common issues are transient: pain or swelling for 24-48 hours, a small bruise. Joint infection is a rare event, prevented by sterile technique. In treatments with cortisone, facial flushing or a temporary rise in blood sugar may occur in diabetic patients. Personal risks and contraindications are assessed during the consultation.
How much does the sacroiliac joint injection cost?
The cost depends on the setting in which the procedure is performed: some treatments are available through the National Health Service or under agreement, others privately or through insurance. The quote is given clearly before scheduling the treatment, and includes the assessment, the procedure and the planned follow-up. During the consultation I tell you which pathway is available in your case: you do not have to decide before knowing the cost.
Does it really work? What patients and the literature say
The most frequent questions are "how long does the benefit last?" and "can I repeat it?". The answer depends on the diagnosis and the stage: some injections resolve the painful episode, others serve to open a window in which rehabilitation becomes effective. Experiences read in forums concern cases different from yours. During the consultation we review your imaging and I tell you frankly what to expect, how many sessions may be needed and when another approach is better.
Want to know if it is right for you?
At the first consultation we review your clinical history and previous imaging together.