An SI joint injection is a therapeutic procedure that delivers a combination of local anesthetic and a corticosteroid directly into the sacroiliac (SI) joint. This joint connects the spine to the pelvis and is a common source of lower back or buttock pain. Post-procedure restrictions prevent complications, ensure proper medication absorption, and allow the anesthetic effects to safely wear off. Adhering to these limitations helps maximize the potential pain-relieving effect of the injection.
Immediate Restrictions Following the Procedure
You must not drive a vehicle or operate heavy machinery for a minimum of 12 to 24 hours, or as advised by your physician. The local anesthetic injected alongside the steroid can cause temporary numbness or weakness in the leg on the side of the injection. This temporary loss of sensation makes it unsafe to control a car and increases the risk of falling or causing an accident.
Avoid strenuous physical activities for the remainder of the day of the procedure. This includes refraining from heavy lifting, typically defined as anything over 5 to 10 pounds. Excessive strain on the SI joint immediately after injection can potentially push the medication out of the joint space or increase local tenderness.
Do not sign important legal documents or make significant business decisions during the immediate post-procedure period. This caution is due to the potential effects of mild sedation or temporary alteration in comfort from the local anesthetic. If you received sedation, a responsible adult must drive you home and stay with you for the first 24 hours.
Activity and Hygiene Precautions
You should not soak the injection site for 24 to 48 hours after the procedure. Avoid taking a bath, swimming, or using a hot tub or sauna, as submerging the puncture site significantly increases the risk of infection. You may take a shower the day after the procedure, but keep the injection site clean and dry.
Do not immediately resume intensive physical therapy, chiropractic adjustments, or aggressive stretching involving the lower back and pelvis. Wait for a few days, or until your physician gives clearance, to allow the anti-inflammatory steroid medication to begin working and avoid irritating the injection site. For the first 7 to 10 days, limit activity to mild movements and gradually increase your activity level.
The small bandage over the injection site can usually be removed the following morning, or within 24 hours. If the area feels sore, do not apply direct heat. Instead, apply an ice pack wrapped in a towel for 15 to 20 minutes at a time, two or three times a day, to help reduce swelling and discomfort.
Recognizing and Managing Side Effects
You may experience expected, minor side effects that do not require emergency attention but should be monitored. These can include temporary soreness or bruising at the site, a feeling of “hot flashes,” or a temporary increase in blood sugar levels if you have diabetes. These symptoms typically resolve within a few days as the anesthetic wears off and the steroid begins to take effect.
Seek immediate medical care if you notice signs of a potential infection or other severe complication. Warning signs include a fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, significantly increased redness, swelling, or warmth at the injection site, or drainage or pus coming from the puncture site.
Other serious symptoms include severe, escalating pain worse than before the injection, sudden and persistent weakness or numbness in the leg that lasts beyond a few hours, or signs of an allergic reaction. If you experience any of these red flags, contact your healthcare provider immediately or go to the nearest emergency department.