What Happens If SI Joint Injections Don't Work?

July 4, 2024

Explore what happens if SI joint injections don't work and learn about alternative treatments and strategies.

SI Joint Injections Overview

Understanding the purpose, effectiveness, risks, and side effects of SI joint injections is crucial when considering this procedure as a potential solution for lower back pain.

Purpose and Effectiveness

SI joint injections serve to alleviate lower back pain associated with the sacroiliac (SI) joint. The injections are estimated to benefit as many as 90% of people who undergo the procedure, indicating a high success rate for pain relief Healthline. The injections, which contain a combination of a corticosteroid and anesthetic mixture, provide short-term (up to 8 weeks) and intermediate-term (6 months) pain relief in patients with sacroiliac joint pain PubMed Central.

At four weeks and eight weeks after the procedure, patients reported a decrease in the visual analogue scale (VAS) score for pain from an average of 5.85 at the baseline to 3.30 PubMed Central. Improvement in terms of clinical assessment using provocative tests was seen at four weeks, eight weeks, and six months.

The Roland-Morris Disability (RMD) questionnaire scores also showed significant improvement at each follow-up interval (four weeks, eight weeks, and six months) compared to baseline PubMed Central. On average, the effects of sacroiliac joint injections last for 2 to 3 months, with some individuals experiencing relief for longer periods Healthline.

Risks and Side Effects

Like any medical procedure, SI joint injections come with potential risks and side effects. The most common side effect is increased pain or soreness at the injection site. There's also a small chance of experiencing a vasovagal response, which can lead to fainting. Other rare risks are also associated with the procedure Healthline.

The long-term outcomes of SI joint injections can vary depending on factors such as the underlying cause of pain, the patient's health, response to the injection, and the type of injection used Spine-health. As such, the success of SI joint injections heavily depends on accurately identifying the SI joint as the primary cause of the patient's pain, as well as considering the duration of symptoms, severity of pain, and the patient's overall health Spine-health.

As with any medical intervention, it's important to discuss potential risks, benefits, and alternatives with a healthcare provider before proceeding with SI joint injections.

Post-Injection Considerations

After undergoing an SI joint injection, there are several important factors to consider. These include monitoring the response to pain and determining the necessary follow-up procedures.

Monitoring Pain Response

SI joint injections with a combination of corticosteroid and anesthetic mixture have been found to provide short-term (up to 8 weeks) and intermediate-term (6 months) pain relief in patients with sacroiliac joint pain [1]. On average, the effects of these injections last 2 to 3 months, with some individuals experiencing relief for longer periods [2].

The response to pain following the injection is typically monitored through the visual analogue scale (VAS) score for pain and the Roland-Morris Disability (RMD) questionnaire scores. For instance, at four weeks and eight weeks follow-up evaluations, the mean VAS score for pain decreased from 5.85 at baseline to 3.30. Additionally, the RMD questionnaire scores showed significant improvement at each follow-up interval compared to baseline.

Time Interval	Mean VAS Score
Baseline	5.85
4 weeks	3.30
8 weeks	3.30

However, the most common side effect of sacroiliac joint injections is increased pain or soreness, with a small possibility of experiencing a vasovagal response that may lead to fainting [2].

Follow-Up Procedures

If the initial sacroiliac joint injections do not provide long-term pain relief, other options for managing discomfort include follow-up injections and alternative treatment approaches [2].

In some cases, if SI joint injections provided temporary relief but eventually wore off, it may be an indicator of sacroiliitis. Patients may qualify for more advanced treatment options if they experienced 75% or more pain relief from the injections [3].

Monitoring the patient's pain response and determining the necessary follow-up procedures are crucial steps in addressing the question of "what happens if si joint injections don't work". These considerations help guide the next steps for treatment and long-term management strategies for SI joint pain.

Alternatives to SI Joint Injections

If SI joint injections don't work or provide only temporary relief, it's crucial to know that there are other options available for managing sacroiliac joint pain. These alternatives can be pursued individually or in combination, depending on the patient's specific needs and the healthcare provider's recommendations. Two of the most common alternative approaches are physical therapy and medication treatments.

Physical Therapy Options

Physical therapy can offer significant benefits as an alternative or adjunct to SI joint injections. This non-invasive approach involves exercises and stretches designed to strengthen the muscles supporting the SI joint, improve flexibility, and promote better joint function.

Physical therapy can also help manage pain and inflammation, improve posture, and teach patients proper body mechanics to prevent further injury or discomfort. With regular sessions and diligent home practice, many patients can achieve significant improvements in pain and function.

The specific exercises and stretches used in physical therapy will vary depending on the patient's individual needs and abilities. Therefore, it's crucial to work with a physical therapist who has experience in treating SI joint dysfunction.

Medication Treatments

Medications are another alternative to SI joint injections. These can be used to manage pain and inflammation associated with SI joint dysfunction. Medication options can include over-the-counter pain relievers, non-steroidal anti-inflammatory drugs (NSAIDs), and in some cases, stronger prescription pain medications.

Another type of medication treatment involves the use of corticosteroids. Like the corticosteroid used in SI joint injections, these drugs can be taken orally or injected into the muscle to reduce inflammation and relieve pain. However, because of potential side effects, corticosteroids are usually only used for short periods.

It's important to note that while medication treatments can help manage pain and inflammation, they do not address the underlying cause of SI joint dysfunction. Therefore, they are typically used in conjunction with other treatments, such as physical therapy or surgical interventions.

In conclusion, if SI joint injections do not yield the desired results, patients should not despair. There are multiple alternative treatment options available, and a comprehensive treatment plan can often lead to significant improvements in pain and function. As always, patients should work closely with their healthcare provider to determine the best course of action based on their individual needs and circumstances.

When SI Joint Injections Fail

Dealing with the reality of sacroiliac (SI) joint injections not providing the expected relief can be challenging. Understanding the potential causes and the next steps for treatment is crucial in this situation.

Potential Causes

If SI joint injections don't work, it could be due to a variety of reasons. One possible explanation is an overuse inflammation leading to joint changes and painful symptoms.

In some cases, if the injections never provide relief, it does not necessarily confirm or deny an SI joint dysfunction diagnosis. There might be other underlying causes of the pain, and additional tests and evaluations are likely required to ascertain the root cause [3].

Next Steps for Treatment

If initial sacroiliac joint injections do not provide long-term pain relief, there are other options for managing discomfort. These include follow-up injections, alternative treatment approaches, physical therapy, and medicines [5].

In instances where SI joint injections provided temporary relief but eventually wore off, it may be an indicator of sacroiliitis. In such cases, patients may qualify for PainTEQ's minimally invasive LinQ SI Joint Stabilization System, particularly if they experienced 75% or more pain relief from the injections [3].

The key takeaway when SI joint injections fail is not to lose hope. There are various other treatment options available to manage pain and improve quality of life. It's important to consult with a healthcare provider to discuss the best course of action based on individual circumstances.

Advanced Treatment Options

If SI joint injections fail to provide lasting relief, there are advanced treatment options available. These options aim to provide long-term pain relief and improved functionality. Two such methods include sacroiliac joint fusion and the LinQ SI Joint Stabilization System.

Sacroiliac Joint Fusion

Sacroiliac joint fusion is a surgical procedure that aims to eliminate pain by eliminating the motion at the sacroiliac joint. This procedure can be performed using various techniques, but all aim to fuse the iliac bone to the spine for better stability.

One such device used for this procedure is the iFuse Implant. According to SI-BONE, it is the only device for treating SI joint dysfunction supported by significant published clinical evidence.

However, it is important to note that while this procedure may provide substantial pain relief, it is typically considered only after conservative treatments, including SI joint injections and physical therapy, have been unsuccessful.

LinQ SI Joint Stabilization System

Another advanced treatment option is the LinQ SI Joint Stabilization System by PainTEQ. This procedure aims to stabilize dysfunctional SI joints by inserting a non-metal implant into the joint. This minimally invasive procedure allows patients to go home the same day of surgery and resume daily activities within a few weeks.

This treatment option is particularly relevant for patients who experienced significant (75% or more) pain relief from SI joint injections but found the relief was only temporary. It's an indicator that the root cause of the pain may be sacroiliitis, an inflammation of the SI joint.

However, if SI joint injections never provide relief, additional tests and evaluations are likely required to determine the root cause of the pain [3].

These advanced treatment options offer hope for individuals seeking answers to the question, "what happens if si joint injections don't work?" It is important to have open and thorough discussions with healthcare providers about potential risks, benefits, and expectations associated with these procedures.

Long-Term Management Strategies

When dealing with chronic pain from the sacroiliac (SI) joint, particularly if SI joint injections have not provided the desired relief, long-term management strategies become crucial. These strategies typically involve a combination of proactive pain management techniques and lifestyle adjustments to help mitigate the impact of SI joint pain on daily life.

Proactive Pain Management

Proactive pain management involves actively seeking out and implementing strategies to manage and reduce pain over the long term. This can include a variety of treatments such as physical therapy, medications, and in some cases, alternative therapies such as acupuncture or massage.

One of the most effective proactive pain management strategies is regular physical therapy. This can help to strengthen the muscles around the SI joint, improving stability and reducing strain on the joint itself.

Medications can also play a role in proactive pain management. Over-the-counter pain relievers, prescription medications, and topical treatments can all be used to manage SI joint pain. However, these should always be used under the guidance of a healthcare professional to ensure safe and effective use.

If SI joint injections are not effective at easing back pain, a sacroiliac joint fusion may be an option to prevent bones from grinding against each other and help reduce pain caused by the SI joint [6].

Lifestyle Adjustments

In addition to proactive pain management strategies, making certain lifestyle adjustments can also help to manage SI joint pain over the long term. These can include modifications to physical activity, diet, and stress management techniques.

Physical activity is an important part of managing SI joint pain. Regular exercise can help to strengthen the muscles around the SI joint, reducing strain and improving stability. However, it's important to choose low-impact activities that do not put excessive strain on the joint, such as swimming, cycling, or walking.

Diet can also play a role in managing SI joint pain. Eating a balanced diet rich in anti-inflammatory foods can help to reduce inflammation in the body, potentially reducing pain.

Stress management techniques such as mindfulness, meditation, and yoga can also be beneficial for managing SI joint pain. Stress can exacerbate pain, so finding effective ways to manage stress can help to reduce pain levels.

In conclusion, when facing the reality of what happens if SI joint injections don't work, it's important to remember that there are still many options available for managing SI joint pain. With a combination of proactive pain management strategies and lifestyle adjustments, it's possible to effectively manage SI joint pain and maintain a high quality of life.