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911DOC
911DOC, Board Certified Dr.
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Experience:  Emergency Medicine Physician
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How effective are Si joint injection for pain and inflammation?

Customer Question

How effective are Si joint injection for pain and inflammation? My sacrum seems to have too much mobility as well and causes my SI joint to lock up.. will the injections reduce the inflammation and help keep the sacrum from moving too much?
Submitted: 1 year ago.
Category: Medical
Expert:  911DOC replied 1 year ago.

911DOC :

just to clarify, you have the diagnosis of SI joint inflammation and, perhaps, instability and are scheduled for injections?

911DOC :

to respond place your cursor in the box below, type, and click 'reply'

Customer:

Yes.. I strained them at work.. I am a firefighter.. for some reason.. my sacrum shifts out and jams my si joint as well. They thought the numbness down my leg was from a bulge in my bag.. spine dr said it was all coming from the si joint inflammation..

911DOC :

okay

Customer:

oops.in my spine

911DOC :

so the injections are both diagnostic and therapeutic

911DOC :

meaning

911DOC :

when they do the injection if you get good relief they know the diagnosis is correct and a second injection of longer acting anti-inflammatory and numbing medicine will be given

911DOC :

however,

911DOC :

if there is instability the injections do not treat this.

911DOC :

standing by

Customer:

yes.. I am very athletic.. cyclist.. no problems before.. just miserable with all the si joint inflammation

911DOC :

okay

Customer:

what helps the instability? that is my biggest fear. the pain will return if I don't fix the instability..or what is causing what..cant seem to answer that.. strain caused the instability or vice versa

911DOC :

well, can you tell me the imaging studies that have been done? CT / MRI/ plain Xrays?

Customer:

I guess what I am asking is.. can all this inflammation or can trauma cause the instability to occur?

Customer:

are you still ther?

911DOC :

yes

911DOC :

instability can develop over time but usually a trauma is needed for significant instability to occur

911DOC :

did you have a fall or did this occur without trauma?

Customer:

no fall... we were testing very heavy hose for several hours..bent over.. twisting... throwin.. 60 pounds... found a labral tear in hip.. L5 S1 4 mm bulge..on left side.. all my problems are pretty much on right side.. I really strained everything from all the hours of heavy use

Customer:

mri , xray etc

911DOC :

i see

911DOC :

so nothing definitive on the imaging

911DOC :

now they are doing the injections to help isolate the cause

Customer:

nope

911DOC :

and to answer

911DOC :

about the instability

Customer:

just a lot of strain pain

911DOC :

the progression would be

Customer:

no

911DOC :

injections

911DOC :

physical therapy

911DOC :

and as a last resort they could do an SI joint fusion surgery

911DOC :

but with good rehab this will likely be unnecessary

Customer:

how effective is that? and quality of life after? I am a firefighter.. avid cyclist..

911DOC :

it's a few pages that you have to click through but it's good information

911DOC :

again

911DOC :

it's the rare patient that needs an SI fusion

911DOC :

how long ago were you injured?

911DOC :

and have you started physical therapy yet?

Customer:

I am sorry.. your opinion on fusion for my activity and career if I need to do it?

911DOC :

maybe the chat is dropping some of my responses

911DOC :

there's no way for me to know if you will need the fusion but you are young and healthy and motivated to get better, so i would say that your chances of needing a surgery are very small indeed

911DOC :

they are rarely done and usually only after major trauma like falling from height

911DOC :

standing by

Customer:

they just now figured out it was si joint strain.. 6 months.. my pain is not crazy bad.. just irritating.. I can ride my bike.. walk.. etc.. it just burns.. can compare it to shin splints..lol.

911DOC :

i see

911DOC :

so this is very hard for me to guess about

Customer:

it is my computer.. sorry

911DOC :

but it confirms my suspicion that the injections are going to be done to try to get this diagnosis or rule it out

911DOC :

if the injections relieve the pain

911DOC :

then they can focus therapy on stabilizing the SI joint

911DOC :

it is only after months of physical therapy that fails that fusion is considered

911DOC :

as to what it would mean for you it's hard to say

911DOC :

i have had a lumbar fusion and am not supposed to run anymore

911DOC :

but with the SI joint, since there is less moblity in the joint to begin with

911DOC :

people usually do well with the surgery if they are young and healthy

911DOC :

so I do not think it would end your career

Customer:

I just want to ride my bike..lol.. I am a 44 year old woman... single mom.. 24 years as a firefighter

911DOC :

there's every reason to expect you to be able to get back on your bike, but there may be some time inbetween where they want you to do something less stressful to the SI joint

911DOC :

standing by

Customer:

Okay... hopefully the injection will help..you have been very informative.. thank you very much! I just wanted some peace of mind.. several months of relief would be a great welcome

911DOC :

i sure hope you get it. thank you for your service as a firefighter. you guys have the best food!

911DOC :

any final questions?

Customer:

lol..yes.. my guys are missing my cooking... I want my life back.. been far too long..

911DOC :

you will get there though it has been a long road!

911DOC :

if you have nothing further I will sign off and wish you well.

Customer:

Thank you sir! Blessings!

911DOC :

and God bless you as well.

911DOC :

good night

911DOC :

and if this has been helpful please consider leaving positive feedback.

911DOC :

best

Customer:

I will.. God Bless.. He is soooo good!

911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5094
Experience: Emergency Medicine Physician
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