Rheumatological conditions like Ankylosing Spondylitis (HLA B27 positive), Psoriatic Arthritis, Rheumatoid Arthritis, Sexually Acquired Reactive Arthritis (SARA) associated with pelvic inflammatory disease (PID) and chlamydia infections
To investigate in the pain relief clinic the cause of sciatica in the leg, and low back pain in the SIJ area.
Under local anaesthesia and (sometimes) light intravenous sedation , a small diameter needle is placed into the joint in question using X-ray Guidance .
X-ray contrast medium is sometimes injected to confirm correct needle placement
Local Anaesthetic and steroid mixture is injected (usually 5 - 10 ml of 0.5% marcain plus triamcinolone 20 - 40 mg)
After the injection, some patients may obtain further relief by wearing a specifically designed SIJ support belt.
Commonly used steroids include:-
Triamcinolone (Kenalog )
Methylprednisolone (Depo-medrone )
- Information Leaflet.
No pain relief - if the cause of the pain was not the SIJ itself then injecting it will make no difference. Trying to inject an SIJ without X-ray guidance is very difficult, and increase the chance of no pain relief.
Temporary leg weakness - the sciatic nerve runs just in front of the SIJ. In some patients the local anaesthetic mixture spreads from the joint onto the nerve causing temporary weakness and inability to stand. The magnitude and duration of the complication depends on the type and strength of local anaesthetic used.
Infection - procedure performed under aseptic conditions to reduce infection.
Worse Pain - like any pain procedure, the pain can appear to be worse afterwards. The cause of this can not always be explained.