Leon E. Popovitz, MD
Top-Rated Orthopedic Surgeon
Specializing in Arthroscopic Surgery of the Shoulder & Knee.
For appointments 212.759.4553

Fluoroscopic Guided Sacroiliac Joint Injections

A Sacroiliac Joint Injection is intended to diagnose and treat pain in the lower back and buttocks, originating from the sacroiliac joint or sciatica. This joint connects the bottom of the spine with the outer part of the hip. There is one sacroiliac joint on each side of the hip, responsible for controlling the pelvis. They transfer force from the lower body to the upper body with the help of surrounding ligaments.

Causes for Sacroiliac Joint Pain

  • Muscle tightness
  • Sciatica
  • Pregnancy; as the pelvis widens it stretches the surrounding ligaments
  • Arthritis
  • Difference in leg lengths
  • Wearing away of the cartilage between the bones
  • Trauma


If conservative methods like ice, heat, rest, medical massage, or physical therapy, do not relieve pain symptoms, then a Sacroiliac Joint Injection will be recommended. The first injection will serve as a diagnostic test. If the Sacroiliac Joint Injection provides considerable pain relief, it may be used as a regular therapy.

Preparing for the Procedure

  • Arrange to have someone else drive after the procedure.
  • Plan to rest for the day.
  • Notify the doctor about any medications you are taking.

The Procedure

IV medications may be administered beforehand to help the muscles relax. The doctor will then sterilize the hip area and insert a long, thin needle. The doctor will guide the needle based on fluoroscopy imaging and an injected dye that will mark the area. It will either be inserted in the actual joint or the surrounding ligaments, depending on where the damage is located. A local anesthetic will be injected to numb the area to all pain along with a corticosteroid to provide long term anti-inflammatory relief.

The patient will be monitored for up to thirty minutes after the Sacroiliac Joint Injection. It is important to record all changes in pain and mobility to plan further treatment.


The injection site will be sore for approximately 2-3 days, but can be treated with over the counter ibuprofen. The corticosteroid will activate after several days, at which point the patient should experience the full pain relief. Pain relief will usually last for several months to years if there are no other underlying problems in the area. When the symptoms return, the patient can receive another Sacroiliac Joint Injection and continue doing so as regular therapy.


As with any deep tissue injection, there is a minimal risk of infection and bleeding. Very rare cases of nerve injury have occurred. The corticosteroid may raise blood pressure in some patients.

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