Pain Management
Sacroiliac Joint Injections
Targeted Relief for Lower Back and Pelvic Pain
The sacroiliac (SI) joints connect the spine to the pelvis. When these joints become inflamed or degenerated, they can cause low back, buttock, hip, or leg pain that often mimics sciatica. Sacroiliac joint injections deliver anti-inflammatory medication directly into the joint, reducing pain and confirming whether the SI joint is the true source of symptoms. At Desert Spine and Pain, neurosurgeon Dr. David L. Greenwald, M.D., FAANS, FACS performs SI joint injections with fluoroscopic (X-ray) guidance, ensuring safe, accurate placement for maximum benefit.
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What Are Sacroiliac Joint Injections?
In simple terms: Medication (usually steroid and anesthetic) is injected into the SI joint to calm inflammation and relieve pain.
Scientifically: SI joint injections involve percutaneous placement of a spinal needle into the intra-articular space under fluoroscopy or CT guidance, followed by injection of corticosteroid and anesthetic to reduce nociceptive signaling and confirm pain origin.
Conditions Treated
Sacroiliac joint degeneration
Pain after lumbar fusion (SI joint stress)
Low back, hip, or buttock pain suspected to originate from the SI joint
Diagnostic evaluation before Sacroiliac Joint Fusion
Chronic pelvic or posterior hip pain
The Sacroiliac Joint Injection Procedure: Step by Step
Plain-English Overview
Anesthesia: Local anesthesia with mild sedation if needed.
Needle placement: Small needle guided into SI joint using live X-ray.
Contrast dye: Confirms correct needle location inside the joint.
Medication injection: Steroid and anesthetic delivered into the joint.
Observation: Short recovery; patients usually go home same day.
Surgeon-Level Detail
Positioning: Patient prone; sterile prep and draping.
Needle placement: 22–25G spinal needle advanced via posteroinferior approach under AP and oblique fluoroscopy.
Contrast injection: Confirms intra-articular spread, not vascular uptake.
Medication delivery: Corticosteroid + anesthetic injected in controlled volume.
Closure: Needle withdrawn; bandage applied.
Benefits of SI Joint Injections
Rapid relief of low back and pelvic pain
Confirms if SI joint is the true pain source
Outpatient procedure with minimal downtime
Helps patients avoid unnecessary surgery
Provides diagnostic guidance before fusion consideration
Risks & Limitations
Temporary soreness at injection site
Infection, bleeding, or nerve irritation (rare)
Pain relief may be temporary (weeks to months)
Not a cure for joint degeneration—may require repeat injections or SI fusion if pain persists
Recovery Timeline
Day 0: Resume light activity same day; mild soreness possible
Days 1–3: Relief begins as steroid effect builds
Weeks 1–2: Significant improvement in pain and function
Months: Relief may last weeks to months; repeat injections possible if symptoms return
Why Choose Desert Spine and Pain?
Expert neurosurgeon: Dr. Greenwald ensures precise, image-guided placement for reliable results
Diagnostic clarity: Injections confirm if the SI joint is the pain generator before surgery is considered
Minimally invasive: Quick outpatient procedure with little downtime
Comprehensive care: From injections to fusion if needed, all care is tailored to each patient
Frequently Asked Questions
How do I know if my SI joint is the problem?
SI joint pain is suspected if pain is low in the back or buttock, worsens with standing or stairs, and multiple exam tests are positive. Injection confirms the diagnosis.
How long does relief last?
Relief may last weeks to months. Repeat injections may be recommended if pain recurs.
Are SI injections painful?
Most patients feel only mild pressure; discomfort is brief and well-tolerated.
Do SI joint injections replace surgery?
Sometimes. In many patients, injections provide lasting relief, but in severe degeneration, fusion may be necessary.
How does Desert Spine and Pain perform SI injections differently?
We use fluoroscopy-guided, neurosurgical precision to ensure injections are safe, accurate, and effective.
Dr. David L. Greenwald, MD
Neuro-Spine Surgeon
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If you’re experiencing persistent lower back or pelvic pain, sacroiliac joint injections may provide the relief you’ve been searching for. Dr. Greenwald and his caring team will conduct a thorough evaluation to determine if your discomfort originates from the SI joint and whether this targeted treatment is right for you. Every step you take toward managing your pain brings you closer to comfort and improved function. Schedule your consultation today and discover how Dr. Greenwald’s expertise in precision-guided SI joint care can help you move and feel better.
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Over 30 Years Experience in Orthopedic & Neuro Spine Surgeries.
Dr. David L. Greenwald, M.D., F.A.C.S.
Neurosurgeon | Spine Surgeon | Regenerative Medicine
Dr. David L. Greenwald, MD, FACS, is a board-certified spine surgeon specializing in sacroiliac (SI) joint injections, a minimally invasive treatment used to relieve pain and inflammation in the joints connecting the spine to the pelvis. SI joint dysfunction or degeneration can cause lower back, hip, and buttock pain that may worsen with sitting, standing, or walking. Using fluoroscopic (X-ray) or ultrasound guidance, Dr. Greenwald precisely delivers a combination of anesthetic and anti-inflammatory medication into the affected joint to reduce pain, confirm the diagnosis, and improve mobility. His careful, image-guided technique ensures accuracy and safety, helping patients throughout South Florida achieve meaningful, lasting relief from SI joint–related pain.
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