Selective Nerve Root Blocks & SI Joint Pain

The sacroiliac joints are small joints that mark the connection between the sacrum (bottom of the spine) and the upper rim of the pelvis. In many people, one or both of these joints can become irritated and painful, either through injury or disease. When this happens, selective nerve root blocks can be administered to reduce pain and promote healing.

History

Like other joints in the body, the sacroiliac joint can become painful due to disease or injury. If the pain becomes severe, basic movements, including walking, sitting and even standing, can cause pain. When this happens, injection therapy, typically in the form of a selective nerve root block, is often used to control pain and reduce inflammation within the joint. Selective nerve root blocks are generally quite effective at reducing pain and carry few side effects.

Function

To treat sacroiliac joint pain, selective nerve root blocks are generally administered into the joint under fluoroscopy, which is a special X-ray that allows for accurate injection placement. The goal of a selective nerve root block is to block the pain signals along certain nerve roots, or branches, believed to be responsible for sacroiliac joint pain. Thus, careful placement of the injected medication, which generally consists of a steroid-based agent along with a local anesthetic, is crucial for optimizing results.

Benefits

The main benefit of a selective nerve root block for sacroiliac joint pain is pain relief. Once the injected medication has a chance to absorb into the targeted nerve fibers, pain relief is generally swift. In addition, nerve root blocks are generally effective at reducing or eliminating any tingling or numbness that may radiate down into the legs as a result of nerve root irritation or entrapment near the sacroiliac joint. One nerve block may be sufficient to remedy a sacroiliac joint flareup. If symptoms persist, additional injections can be given several weeks apart.

Effects

Selective nerve root block injections are generally well-tolerated and produce few side effects. The most common side effects, which are generally short-lived, are redness and swelling at the injection site. This generally clears up within a few days. Occasionally, tingling or numbness can occur in the pelvis region, sometimes extending down one or both legs, immediately following a nerve root injection. This is generally caused by irritation of the nerve roots during the injection and usually subsides within a few days.

Considerations

Generally, the use of selective nerve root blocks are used to treat cases of sacroiliac joint pain that fail to respond to less-invasive treatment options, including rest, activity modification and over-the-counter pain medication. Not all sacroiliac joint problems require injection therapy to treat. Many times, simple rest or a short course of pain medication is all that is needed to settle a sacroiliac joint flareup. However, in cases of persistent or chronic sacroiliac joint flareups, selective nerve root blocks are generally used as an effective management therapy.

References

• Advanced Spine Care