Which Helps More With Leg Pain: Sacroiliac Joint Injection or Epidural Injection?
Sacroiliac joint injection is typically beneficial for leg pain that stems from the SI joint, whereas an epidural injection is recommended if the pain travels down the leg due to nerve compression. Since each injection treats a different condition, identifying the actual source of the pain is essential.
At Total Orthopedics & Sports Medicine, our team conducts a thorough assessment to determine the most effective treatment for your specific leg pain. We clearly explain your imaging findings, symptom patterns, and the treatment options available to you. Using these findings, we create a targeted treatment plan that may include facet joint injections, anti-inflammatory medications, and a structured rehabilitation program. Call us at 855-321-6784 to get an appointment.
What’s the Difference Between Sacroiliac Joint Injection and Epidural Injection?
An epidural injection targets the irritated nerve roots inside your spinal canal, while an SI joint injection targets the inflamed joint between your spine and pelvis that causes localized pain. Other than that, an epidural injection targets the compressed nerve, reducing the irritation that leads to radiating leg symptoms. However, an SI joint injection reduces pain caused by an inflamed joint, which creates localized lower-back or pelvic discomfort.
Can Both SI Joint and Epidural Injections Be Used at the Same Time?
No, SI joint and epidural injections are not administered during the same appointment. This is because delivering two steroid doses at the same time can increase the risk of tissue weakening, infection, or elevated blood sugar. Therefore, your doctor performs these procedures separately and monitors your response for each injection. Your doctor may include both injections in your overall treatment plan if your leg pain originates from overlapping spinal disorders.
Are SI Joint Injections Effective for Leg Pain After Lumbar Fusion Surgery?
Yes, SI joint injections can be effective for leg pain after lumbar fusion surgery. In fact, according to Science Direct, researchers studied 94 patients with severe SI joint pain after lumbosacral fusion. They found that 90% patients experienced temporary pain relief after diagnostic injections (pain scores dropped from 8.6/10 to 1.7/10). The researchers also reported that 41% of 2D-guided injections were effective, while 3D-guided injections showed 73% effectiveness with 100% intra-articular accuracy.
Can Repeated Epidural Steroid Injections Cause Side Effects?
Yes, repeated epidural steroid injections can cause side effects because frequent steroid exposure may weaken nearby spinal or hip bones and soft tissues. Springer’s study reports that many patients experience infection, bleeding, endocrine effects, neurotoxicity, and nerve injury after repeated steroid injections. In some cases, patients experience nerve root irritation when the epidural space surrounding tissues become sensitive after multiple procedures.
Here are some other side effects of repeated epidural steroid injections:
- Temporary increase in pain
- Elevated blood sugar in diabetes
- Increased eye pressure in glaucoma
- Tenderness or bruising at the injection site
Our doctors at Total Orthopedics & Sports Medicine follow strict guidelines for the safe use of epidural steroid injections. We also assess your response after each injection to prevent the complications of repeated steroid exposure. Contact us today for chronic pain treatment.
When Should You Avoid SI Joint or Epidural Injections?
If you have an active infection, uncontrolled diabetes, or a bleeding disorder, you should avoid spinal injections. You should also avoid these injections if you have a fever, as it can increase the risk of poor healing. Other than that, you should not receive a back pain injection if you have an allergic reaction to contrast dye, local anesthetic agents, or steroid medication.
Doctors do not recommend spinal injections in the following situations:
- Pregnancy, when fluoroscopic imaging is required
- Significant spinal cord instability affecting safe needle placement
- Recent use of blood-thinning medications
- Poorly controlled high blood pressure
Are There Any Activity Restrictions After SI Joint or Epidural Injections?
Yes, there are activity restrictions after SI joint or epidural injections, as your body needs time to recover and allow the medication to settle. You should avoid driving on the day of the procedure because temporary numbness or leg weakness may affect your ability to drive safely. Similarly, avoid prolonged sitting or walking to reduce pressure on the injection site.
Additionally, you should avoid these activities after an SI joint or epidural injection:
- Avoid bending, twisting, or lifting over 5–10 pounds.
- Delay high-impact exercise for several days.
- Avoid pools, hot tubs, or baths for 24 hours.
- Use ice packs rather than heat to ease soreness.
When to See a Doctor: Contact your doctor if you develop increasing weakness, severe headache, or new numbness after the injection.
What Is the Sacroiliac Joint Injection Success Rate?
The success rate of sacroiliac joint injections is 50% if performed with fluoroscopic guidance, as reported by the Oxford academic. This study found that ultrasound-guided injections reached the joint in only 5% of cases, while fluoroscopy achieved accurate intra-articular placement in half of all injections, which shows a significantly high accuracy and reliability.
How Long Does Relief From an Epidural Injection Usually Last?
An epidural injection generally offers pain relief for three months or longer. The exact duration of relief depends on the extent of nerve pressure, disc injury, or joint irritation that persists after treatment. Once the steroid’s effect fades, your symptoms return, and the nerve gets irritated again from ongoing mechanical compression. You may also experience short-term pain relief if the underlying disc bulge persistently compresses the nerve despite the medication.
Find the Right Treatment for Persistent Leg Pain at Total Orthopedics & Sports Medicine — Visit Us Now!
Leg pain can limit your mobility and make daily movement difficult, especially when you experience pain despite medication. As symptoms progress, you may experience muscle fatigue, gait imbalance, and increased nerve reactivity that require targeted orthopedic treatment.
At Total Orthopedics & Sports Medicine, you receive guided rehabilitation, a surgical procedure, or corticosteroid medication to treat an inflamed nerve and improve daily movement. Moreover, for your convenience, we also provide a secure online portal where you can manage bills, referral coordination, and access to your medical records, and clear procedural instructions. Call us at 855-321-6784 or visit our clinic at 925 Clifton Ave, Suite 203, Clifton, NJ 07013 to treat your persistent pain.
FAQs
What is the Alternative to SI joint Injections?
You can use oral medications and massage therapy as alternatives to reduce chronic low back pain. You may also receive facet injections or chiropractic care when facet joints in the lumbar region contribute to your pain. If you need long-term relief, you should use radiofrequency ablation or adopt lifestyle modifications that support spinal health.
Are Sacroiliac Joint Injections Painful?
No, sacroiliac joint injections are not usually painful because your doctor uses a local anesthesia to numb the injection site. You may feel mild pressure as the needle reaches the joint between the sacrum and pelvic bones. After the injection, you may experience slight soreness that lasts for a short time as the medication takes effect.
What Happens if SI Joint Injections Don’t Work?
If SI joint injections do not provide relief, it indicates that your pain originates from another source within your spinal column. To identify the exact source of your pain, your doctor may assess the spinal nerves that transmit the pain signals. Moreover, doctors also use selective nerve root block injections to determine the source of chronic back pain and prescribe anti-inflammatory drugs.
Can SI Joint Problems Mimic Sciatica in the Leg?
Yes, SI joint problems can mimic sciatica in the leg. The SI joint can irritate nearby nerves, causing pain that radiates into the buttock, thigh, or even down the leg, similar to sciatic nerve compression. This overlap makes diagnosis challenging, so doctors often use physical exams, imaging, and diagnostic injections to confirm the exact source of leg pain.
Are Epidural Injections Better for Leg Pain Caused by Disc Bulges?
Yes, epidural injections are effective for leg pain caused by disc bulges as they reduce inflammation around compressed nerve roots. This treatment helps alleviate symptoms caused by disc pressure or degenerative disc disease that irritate your nerves. In addition, you may also experience improved mobility as the injection calms the nerve pathway.
How Many Injections Are Usually Needed Before Leg Pain Improves?
You usually notice leg-pain improvement after one injection, but many patients need two or three injections for complete persistent back pain relief. This minimally invasive procedure will calm your irritated nerves and help reduce swelling around sensitive tissues and nearby blood vessels. Additionally, your recovery progress also depends on how the irritated nerve responds after each session.
Are SI Joint Injections Safe for Patients With Autoimmune Conditions?
Yes, SI joint injections are generally safe for patients with autoimmune conditions if an experienced specialist performs the procedure. In this case, healthcare providers often use imaging guidance and adjust the dosage of steroids to reduce immune-related complications. This is because autoimmune disorders can increase sensitivity to steroids and the risk of infection.
