Pain after a sacroiliac joint injection?

Hi, I am new today.  I posted on the back forum and was recommended to try this site.  I had a l4-s1 fusion 2 years ago and still suffering from back pain and poor range of motion.  Since December I have had: 2 spinal epidurals (l4-l5), 1 facet block epidural (multiple sites) and then yesterday I had a sacroiliac joint injection with only numbing meds since I have had so many steroids.  I had it done around 4:30 was in tears while I waited my 30 minutes from the pain and pressure in my back.  Woke up this morning with MAJOR pain in the side of my upper thighs.  Feels like someone "deadlegged" me.  I have taken 20mg of percocet in the last 6 hours  and have iced my legs.  It hurts to lay down, sit down, move or walk.....when the Dr finally called me back (after 4hrs of waiting) he said its normal to have some pain and it should subside in a few days, if it's strong and unbearable (which it is) he said go to the ER.  I figured I would give it another night since it was 6pm when he called and went to bed...I tossed and turned kept waking up in pain.  My bottom hurts especially the right check along with the outer upper thighs, again worse on the right.  Any ideas clues suggestions experience would be greatly appreciated.
Thanks Karen AZ
Thank you

[Tuckamore]

Hello Karen,

I am glad that you found posted on our forum and welcome you. I am very sorry to hear about your SIJ pain. I can relate. I have severe and disabling SIJ Dysfunction. I also have had SIJ injections.

I am assuming the reason for the SIJ injection with just a numbing agent was only for diagnostic purposes. Otherwise it makes no sense. Usually they also inject a steroid in an attempt to reduce some of the inflammation. Did you have no pain for several hours while the numbing agent was active? If so that mean you have SIJ problems. If not than you do not have SIJ problems.

But back to your pain. Mind you my SIJ injections also included the steroid so after a few hours when the numbing agent wore off I had that on board to reduce the pain and inflammation.  The first injection I had went fine. Yes I had some increased pain once the numbing wore odd for about 24 hours but than it gradually decreased. The second one I had was extremely painful but subsided for a few hours and than returned with a vengeance. My pain could be best described as you are describing yours. Horrid!

Why the difference? For me it was because with the first injection my SIJ was in alignment. The second time my SIJ was "out" and I knew it going into the injection but I had hoped it wouldn't make a difference. When the severe pain continued I saw my PCP, an Internal Medicine D.O. who put the SIJ back in alignment and then... and not until then did the pain subside which was three days following the injection. I do know the kind of pain you are experiencing and my heart goes out to you.

Ice made the pain worse. I used heat. I know that heat can increase inflammation and swelling but it is the only thing that helped to any degree.

My question to you is do you see a D.O. (Doctor of Osteopathy) that practices OMT (Osteopathic Manipulation Therapy)?  It is the only thing that keeps my moving and helps in my pain control to any degree. Of course I also require pain medications but even with them the pain can be severe and OMT makes a significant difference in my ability to function. I would never have beleived that proper alignment could make such a huge difference. I had never heard of  SIJ Dysfunction before my diagnosis nor was I aware that your SIJ could be out of place. It's not a bunch of hooey.    

So that's my experience with SIJ and injections for what it's worth. I hope it has been helpful. If you don't see a DO I encourage you to find one that practices OMT. SIJ Dysfunction is often over-looked and under diagnosed. My spinal structure is fine and because every physician I saw could not find a thing wrong with my spine they dismissed my pain as all in my head. It took a DO to diagnose my condition. She saved my life! So obviously I am very partial to D.O.s.

Please let us know how you are doing. I will look forward to hearing from you again soon. Best of luck.

Take Care,
~Tuck

[sandee1818]

Hi Karen,
   Tuckamore has given excellent information. I just wanted to add that I used to get these injections and I would have a lot of pain following, more so than I had initially. I found out later when seeing a new doctor that if the nerve is hit when doing these injections blindly then it will cause the horrible pain I was experiencing, He said he always does the injections with the proper equipment or will not even attempt to at all. he used an x-ray type machine that showed him where he was precisely putting the needle/medication. I know there is a technical name for this machine but it escapes me at the moment:)
I have since stopped the injections as I have done alot of research and found they can be more harmful than they are good.
I would definatly go to the ER. What dose percocet do you normally take? Is 20mg the usual dose for you or is that dose a little more than you usally take?
The reason I ask is that if your still having this much pain with more pain medication then I would advise you to go to the ER.
I hope you will let us know how your doing.
We are very glad to have you here:)

[Tuckamore]

Karen,

SIJ Injections must be done under guided fluoroscopy. There should be no chance of hitting a nerve. At least that is the idea. I can't imagine any professional doing a SIJ injection without fluoroscopy.

But Sandee is correct. Sometimes nerves are struck with other injections that are done blindly. She is also correct that if your pain is continuing or uncontrolled you should go to the ER. Sometimes they can stop the pain cycle.

Please let us know how you are doing.    

[karenAZ]

Thank you both for all your information.  Yes, this was done for diagnostic purposes only under fluoroscope.  I had it done Wed at 4pm and it is Fri at 12:30 and the pain is the same.  I normally take 10mg percocet and 4.5 of zanaflex, I have increased both to 20 and 6 with no relief.  I see my pcp today in an hour, he is a DO.  I have never been told by films of any sort problems with my spine other than the l3-s1 fusion and never better since.  Every position hurts, even not moving...how can hat be.  My p/m Doc has a poor beside manner and says its normal to a degree to have pain, but I think this is out of the norm, especially for me.  I have not had pain like this with my epidurals or my facet injections.  I just want it to be over!  I couldn't sleep last night, I wait as long as possible before I get up to use the restroom, I cant use the stairs....on top of that emotionally its killing me.  I have 6 kids, 2 of which are young and still need "mom" they both had field trips today while I lay in bed :(

thanks for everything will update later

[Tuckamore]

If you see a DO has he checked for alignment of your SIJ? When my SIJ is "out" that's when the pain get so severe. I just had mine put back in yesterday by my DO.

Does your DO perform OMT? I know not all practice OMT but they were all taught it.

~Tuck

[karenAZ]

I am not sure if he does OMT or not.  He does not think it is my SIJ and did not want to do anything that could risk making things worse....I would have loved some trigger points.  He added morphine 2 times a day to see if we can decrease some of the percocet.  Not to much change in pain, a lot more pain with walking in my hips now.  I see a new Doc tmr (spine surgeon).  I am praying he has some answers.

Thanks for you information again

karen

[martikadragoon]

"SIJ Injections must be done under guided fluoroscopy. "

While I was in pain mgmt the dr's wanted to do the injections w/flouroscopy after I had my son and had healed from my csection BUT they didn't want to do any new imaging and my last xrays were done in Sep. 08. they were toying w/the idea of SIJ dysfunction.

[ScoobyCat]

Did your nerve pain finally go away after having the SI injection? If so, how long did it take? I had an SI injection 3 weeks ago and my pain got much and is still worse than before I got the shot.

My problem before was mostly in my periformas and sit bone area. The Doc said he thought it was coming from my SI joint and suggested the injection. I wish I NEVER got it.  

[Tuckamore]

This post is almost 2 years old. If you want to contact Karen I would try sending a PM (Personal Message). I don't think she is active. Also if you have a question or comment it is always best to begin your own thread instead of hijacking one. You'll get better responses as a general rule.

I normally will not comment on a hijacked post... but SIJD is the condition that disabled me and I am always interested in talking to others with this horrid diagnosis.

SIJD has disabled me and I can relate to your pain. It's horrid!! After my first SIJ injection my pain was worse too. It did return to normal after the second injection, indeed was a bit better for a few weeks. They use to be considered a treatment option but today they really are given  more for diagnostic purposes. Some insurance companies will only approve them as a one time Diagnostic tool.

Hang in ScoobyCat. The pain should subside or a second injection may reduce it. Be sure to talk to your treating physician! A good PT can work on the Piriformis pain which in turn can reduce the SIJ pain so you may want to discuss this with your physician.

Another thought is OMT (Osteopathic Manipulation Therapy) for the SIJ. A good D.O. (Doctor of Osteopathy) can do wonders for SIJ problems.... as I commented to Karen in my above post.

Good Luck to You,
~Tuck