Diagnosing SI Joint Dysfunction: SI Joint Injections
Definitively diagnosing Sacroiliac (SI) joint dysfunction can be difficult. One powerful diagnostic tool available to doctors to not only diagnose but potentially treat SI joint pain is called an SI joint injection.Abnormal movement in the sacroiliac joint may contribute to a condition called Sacroiliac Joint Dysfunction, the most common symptom of which is pain in the affected SI joint. But SI pain symptoms are often similar to other lower lumbar back pain causes, a lumbar disc herniation, sciatica, or even hip pain. For this reason, diagnosing the source of the pain is critical in deciding which treatment methods will give the best potential for ultimately resolving symptoms.
The SI joint injection has two purposes:
- Diagnostic SI Joint Injection:To confirm or diagnose that the pain you are experiencing is in fact coming from the SI joint and;
- Therapeutic SI Joint Injection:To potentially provide an effective therapy for relieving pain originating from the sacroiliac joint
Both diagnostic and therapeutic SI joint injections are performed in a similar fashion. The procedure is done in either a doctor’s office or in a medical facility in an outpatient fashion. At the physician’s and patient’s discretion, an SI injection may be performed with or without the use of anesthesia.
An SI joint injection begins with the patient laying face-down on the treatment table – medically referred to as the prone position. Both a cleaning and sterilizing agent are used to prepare the area prior to the injection. Using an X-ray machine typically called a fluoroscope or C-Arm, the sacroiliac joint is visualized and a needle is inserted into it.
After the needle is visualized in the joint, a small amount of dye may be injected into the joint to confirm that the needle is in its correct position. Once this position is confirmed, medication is injected into the joint.
In a diagnostic SI joint injection a local anesthetic such as lidocaine or bupivacaine is injected for pain relief. These drugs temporarily block the nerve signals from parts of the affected area, which can help determine if the pain is originating from a problem with the SI joint. If more than a 75 percent reduction in pain symptoms is experienced after the SI joint injection, this helps confirm diagnosis. Often, the physician will repeat this same SI joint injection to obtain even further confirmation of the SI joint as the source of the pain.
Other SI Joint Diagnostic Examinations
In addition to the SI joint injection as a means to achieving a definitive SI Joint Dysfunction diagnosis, other tests your physician will likely perform include:
- History – During an initial discussion with you, your physician will ask detailed questions regarding your health history, pain symptoms and other risk factors that may be associated with your concerns.
- Physical – An initial back pain exam will be performed to rule out diagnoses that do not include SI Joint Dysfunction. One aspect of this exam may include the Fortin Finger Test
- SI Joint Provocative Tests – Some simple provocative exams have shown good diagnostic validity for sacroiliac pain if three or more of them are positive. These tests are considered positive if they reproduce the patient’s pain.
At the root of an accurate SI joint dysfunction diagnosis is a complete diagnostic checklist that physicians use to make sure that the SI joint is the true cause of the pain. Among the most important items on this checklist is the diagnostic SI joint injection.