Sacroiliac Joint Injections Vs Epidural Injections – What’s The Difference

With steroid injections or facet injections, various orthopedic disorders, including spinal ailments that cause chronic pain, can be addressed without surgery. When drugs and physiotherapy are unable to improve a patient’s spinal health or when a patient has significant debilitating pain, spinal injections can be a very effective therapeutic alternative. The most frequently utilized injections for treating neck and back pain are sacroiliac joint, epidural steroid, and facet joint injections. If you are unfamiliar with the injections for your spinal illnesses, let us first educate you on the types of injections before getting into the intricacies and differences.

What are Sacroiliac joint injections?

Lower back pain that originates in the sacroiliac joint is diagnosed or treated with a sacroiliac joint injection. The connection between your spine and pelvis is made at this joint. To relieve pain during the treatment, your healthcare professional will inject medication right into the joint. The sacroiliac joints may be the source of the certain hip, buttock, or lower back pain. To determine if your discomfort is coming from a sacroiliac joint issue, you should get a sacroiliac joint injection. The treatment can also be used to relieve localized pain.

What are facet joint injections?

Facet joint injections are frequently used to treat pain and diagnose facet joint discomfort (also referred to as lumbar spondylosis or zygapophyseal joint pain). Injecting a long-lasting steroid into the facet joints of the spine is known as facet joint injection. To relieve pain and inflammation, local anesthesia and steroids can be injected into the facet joints, which are present on both sides of the vertebra. 

A diagnostic procedure involves injecting an anesthetic and cortisone into the joint. These injections are administered to confirm that the source of your pain is a joint.

What are Epidural steroid injections?

The epidural steroid injections (ESIs) can treat lower back and leg pain.

Usually, an epidural steroid injection is paired with a comprehensive rehabilitation program to maximize benefits, but rarely, the injection alone can reduce discomfort. Pain in the neck (cervical area), the midback (thoracic region), and the low back (lumbar region) can also be treated with epidural steroid injections (lumbar region).

How do Sacroiliac joint injection and Epidural steroid Injection help in pain management?

Lower back pain is frequently brought on by swelling in the SI joint. Sacroiliac (SI) joint dysfunction causes pain that makes it difficult to walk around, get comfortable, or do daily activities. The appropriate treatment can help you feel better and restore motion to your joint when rest and other forms of physiotherapy are ineffective. 

You can determine whether your pain is caused by a problem in the sacroiliac joint with the aid of a sacroiliac joint injection. An injection into the SI joint will relieve your lower back pain. Similar to Sacroiliac joint injection that helps relieve localized pain in and around the SI joint, epidural steroid injections (ESI) can reduce pain brought on by irritated spinal nerves as a result of ruptured disk or spinal stenosis. 

Epidural steroid injections can be used to alleviate shoulder, calf, cervical, lumbar, and other types of pain. 

When more conservative treatments have not worked, epidural steroid injections are frequently advised. Epidural injections may also be used to help pinpoint the exact source of your excruciating disease. Your pain management doctor can identify the precise site of damage, inflammation, or impingement by administering an injection to one particular neuron or sensory root and observing the consequences.

A closer look: sacroiliac joint injection vs epidural injection

Adult Americans experience persistent back pain that interferes with their regular activities. Additionally, the most common reason why workers take time off work is due to persistent back aches. Patients who experience persistent back pain typically seek out a variety of therapies, including pain management through manual therapy and medication.

Sacroiliac joint injections and epidural steroid injections are further treatments for persistent back pain. Both therapies strive to manage and alleviate pain, but they focus on different bodily regions and different root causes of severe back pain. 

Epidural steroid injections have anti-inflammatory properties that relieve nerve damage or spinal stenosis-related pinched nerves. They weren’t initially designed to cure backaches; instead, they were made to ease the pain brought on by inflamed nerves in the glutes or legs. 

As opposed to that, a sacroiliac joint injection targets lower back discomfort by injecting specifically into the joint between the sacrum and pelvic bones. Intense, localized pain in the hip, legs, thigh, pelvis, or belly is a common description of the symptom of an impacted sacroiliac joint. Let us take a look at the top 4 differences between these two injections.

  1. Origin: 

Sacroiliac joint injections are a treatment for chronic lower back pain, hip discomfort, pelvic pain, and sacroiliitis brought on by an injury, a traumatic event, pregnancy, or illnesses like osteoarthritis. In contrast, an epidural steroid injection is used to treat scoliosis (distress felt from the lower spine down to the limbs) brought on by progressive degeneration or injury.

  1. Place of injection: 

A sacroiliac joint injection is injected into the sacroiliac joint using fluoroscopy, local anesthetic, and steroid medicine. To put it simply, your doctor will inject drugs right into the joint to relieve pain. If pain is reduced, the joint may be the source of the discomfort. 

The epidural steroid injection, on the other hand, is a minimally intrusive treatment. A steroid or cortisol drug is injected by a medical professional into the epidural space surrounding your vertebrae in your low back.

  1. Pain Relief

Epidural steroid injections are a safe and effective treatment for back and leg or neck and arm discomfort brought on by a variety of disorders when carried out by a qualified medical professional. It is critical to understand that epidural steroid injections aren’t necessarily intended to treat neck or back pain; rather, they’re meant to offer short-term respite so that the patient can resume regular activities and/or keep up with their physical therapy schedule. 

Patients may need a single injection or a series of injections to experience the greatest amount of pain relief with epidural steroid injections, which may take anywhere from one week to a year. 

Conversely, SI joint blocks are used to identify and treat SI joint discomfort when there is a suspicion of SI joint pain. More than 75% of discomfort is relieved with diagnostic sacroiliac joint injections. 

The use of SI joint injection in chronic low back pain and/or lower extremities discomfort below the L5 vertebra is moderately supported by systematic review data. Patients with SI joint dysfunction may have long-lasting pain alleviation through therapeutic SI joint injections.

  1. Post Procedure: 

An injection into the sacroiliac joint (SI) reduces discomfort right away. For a day or two following the procedure, you might anticipate pain and tenderness at the injection site. 

The effects of the steroid drugs may not become apparent for two to three days. The anesthesia may temporarily cause numbness or weakness in your legs. However, in most circumstances, your pain can come back as the anesthesia’s numbing effect wears off. 

On the contrary, in the case of epidural steroid injection, following the procedure, you might go back home. On a subsequent day, you should be able to resume your regular activities. Within one to four days, the steroids typically start to act. Sometimes it can take up to a week to start feeling the advantages. The injections help many people experience pain relief and functional improvement for several months. If the injection is successful, it may be given again.

Risks associated with sacroiliac joint injection

Injections into the sacroiliac joint are often secure. However, there are a few of the procedure’s potential risks:

  • contamination of the injection site
  • bleeding following an injection
  • nerve injury
  • a weakened leg
  • severe pain
  • an allergic response to the medication

You can experience certain negative effects if you receive steroid medication through your shot. These include allergic reactions, facial flushing, and brief elevations in blood sugar for one to two days.

Based on your unique situation and other health issues, you might also be at risk for other things. Be cautious to first address any worries with your healthcare professional.

Risks associated with epidural steroid injections:

In most cases, an epidural steroid injection is trouble-free. If you do experience adverse effects, they could consist of:

  • “steroid flushes,” or prolonged redness of the face and chest accompanied by warmth and a rise in temperature
  • sleeping issues
  • distress
  • menstrual abnormalities
  • fluid retention

Rarely, the discomfort may even get worse for a few days after the treatment.

Conclusion

Today, the fifth most frequent issue that prompts patients to seek medical care is chronic back pain. Sacroiliac joint injection and epidural steroid injection are widely used to deliver medication directly to the physical site that causes pain. 

Research has proven that these injections are more effective than oral medications for relieving neck or back pain. 

Additionally, these injections have been extensively used to identify the structural component of the spine that may be the cause of the discomfort, such as a compressed nerve or a herniated disc. Much like any other injection technique, these two might have dangers and adverse effects. However, most of the time, the side effects are mild and transitory. Serious adverse outcomes could occasionally happen.

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