Injections for pain in lower back and buttocks

The sacroiliac joint (SIJ) is the joint between the sacrum and the ilium bones. Due to wear and tear (arthrosis), inflammation, surgery or an accident, the SI joint area may undergo change. This may result in pain in the lower back and buttocks. The pain may also manifest on one side only.

An SIJ infiltration involves injecting a local painkiller and an anti-inflammatory agent (cortisone) in the area near the painful joint. Cortisone reduces the inflammatory response and this will eventually cause the pain to decrease.

If you experience a clear reduction in pain but only for a brief period, denervation (radiofrequency treatment) of the sacroilial joint may be considered. This treatment involves ‘facet joint denervation‘.

Preparation

On the day of the treatment, you will come to the hospital.
The physician will inform you beforehand whether or not you need to be fasting for the procedure.

Medication	Stop	Comments
Asaflow®, Aspegic® Cardioaspirin®, Aspirin® Dispirl®, Sedergin®	Stop if >500 mg/day
Marcoumar®, Sintrom® Marevan®	Seven days before the procedure	Replace with injections (see Clexane, for example) Anticoagulation before the procedure
Ticlid®	ten days before the procedure
Plavix®, Clopidogrel Brilique®, Efient®	Seven days before the procedure
Xarelto®, Eliquis® Lixiana®, Pradaxa®	48 hours before the procedure
Fraxiparin®, Clexane® Fraxodi®	24 hours before the procedure	Restart 6 hours after the treatment 3 days afterwards, take together with regular blood thinners After a week, anticoagulation follow-up with your GP

By law, you may not drive any vehicles or operate machinery the morning after the treatment. Therefore, make sure that somebody can take you to and from the hospital. The physician or nurses can provide you with certificates, if required. If you wish, the nurses of the Pain Centre can order a taxi for you.

Always inform the physician if:

• you have diabetes or a heart condition
• you are (or could be) pregnant
• you are allergic to certain medications, contrast agents or iodine (disinfectant), latex, etcetera
• you take a blood thinner (the table shows when to stop your medication).

If you have reduced kidney function, have recently experienced thrombosis or a heart attack or have had a stent implanted, you must contact your attending physician first.

Latest publication date: 16/03/2022