SI joint injection is a common procedure used to both diagnose and treat lower back, hip, or buttock pain originating from the joint where the sacrum meets the ilium. The injection typically contains a local anesthetic for immediate relief and a corticosteroid to reduce inflammation and provide longer-term pain reduction. Following specific post-procedure instructions helps minimize discomfort and allows the medication to work effectively.
Immediate Post-Procedure Care
The first 12 to 24 hours following your SI joint injection require strict adherence to safety and rest protocols. Due to the temporary effects of the anesthetic, you must not drive or operate any heavy machinery for a full day after the procedure, and a responsible adult must take you home.
Upon returning home, plan to rest and relax, avoiding strenuous physical activity for the remainder of the day. You should limit periods of sitting or walking to short durations, typically 10 to 20 minutes at a time, to reduce stress on the injected area. You must keep the area dry, avoiding soaking in a tub, pool, or hot tub for 24 hours, though a shower may typically be permitted the morning following the procedure.
Managing Expected Pain and Side Effects
You will likely experience two distinct phases of pain response in the days immediately following the injection. The initial, short-lived relief comes from the local anesthetic component, which usually wears off within a few hours, causing your original pain to return.
The corticosteroid medication requires time to become fully effective, often taking two to seven days to begin reducing inflammation within the joint. During this waiting period, some people experience a temporary increase in pain, known as a “steroid flare.” This reaction is caused by the body’s localized response to the injected steroid crystals and is typically self-limiting, resolving within one to three days.
To manage this localized soreness or the steroid flare, you may apply an ice or cold pack to the injection site for 15 to 20 minutes at a time, several times a day. You may also take approved over-the-counter pain relievers, such as acetaminophen, for discomfort. Confirm with your physician before taking any nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen.
Activity Resumption Timeline
The return to your normal routine should be a gradual process over the course of one to two weeks. For the first 24 to 48 hours, focus on low-impact movement, such as walking for short periods, to prevent stiffness without stressing the joint. You can generally resume desk work and other light daily tasks the day after the injection.
As you move into the first week, you can slowly introduce moderate activities, such as gentle stretching and low-impact exercise. Listen closely to your body and discontinue any movement that reproduces the original SI joint pain. Formal physical therapy, if prescribed, can usually be resumed or started one week after the procedure, focusing initially on gentle exercises to capitalize on any early pain relief.
You should maintain restrictions on heavy lifting, which means limiting yourself to no more than five to ten pounds for the first week. Avoid strenuous core work, excessive bending, twisting, or high-impact activities like running for at least 7 to 14 days. These restrictions are designed to protect the joint while the anti-inflammatory medication takes effect.
Monitoring for Complications and Tracking Results
Monitor for signs of rare but serious complications in the days following the injection. You must contact your physician immediately if you develop a fever or chills, which could indicate an infection. Other warning signs include severe or unrelenting pain that worsens instead of improves, or new neurological symptoms, such as numbness or weakness in the leg that persists for more than a few hours.
Evaluating the injection’s success is just as important as monitoring for safety. Because the full therapeutic effect of the corticosteroid can take one to two weeks to manifest, you should keep a pain diary or log. This record should track your pain levels, the location of any discomfort, and your functional ability over the two weeks following the procedure. This detailed tracking provides crucial data for your follow-up appointment, allowing your physician to objectively determine if the sacroiliac joint was the source of your pain and if the injection provided meaningful relief. A positive response is typically defined as a significant reduction in pain.