Pain from sacroiliac (SI) joint dysfunction makes it tough to move around, get comfortable, or do the things you do every day. When rest, ice, and heat aren’t enough to help, the right treatment can ease your pain and get your joint back in motion again.
Your doctor will want to try simple treatments first. If those don’t work, you can talk about other options that might help.
There are two reasons to use medication for sacroiliac joint dysfunction. The first is to bring down the swelling and irritation, called inflammation, in your joint. The second is to control pain.
Take your medication the way your doctor tells you to, even if you start to feel better. If you stop taking it too soon, the inflammation might stick around and keep your joint from healing. That means the pain may come back.
To start, your doctor might suggest that you try over-the-counter drugs called nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen.
If these don’t work, you might move on to prescription drugs, like stronger NSAIDs or other meds, including:
- Celecoxib (Celebrex)
- Ketorolac (Toradol)
- Naproxen (Anaprox, Naprelan, Naprosyn)
If you take NSAIDs for a long time, they can upset your stomach, raise your blood pressure, and be hard on your kidneys. If you can’t take them, your doctor might tell you to try acetaminophen.
Prescription muscle relaxers can ease pain by loosening up your muscles. These include carisoprodol (Soma), cyclobenzaprine (Flexeril), and metaxalone (Skelaxin). They can make you feel sleepy or sick to your stomach, though.
As medication eases pain and calms an inflamed SI joint, physical therapy can help the area become more flexible. A therapist can teach you exercises that will build strength and make your SI joint more mobile. You’ll also learn ways to move that will hurt less. You’ll probably have sessions two to three times a week, but you can continue the moves on your own at home.
Your doctor or physical therapist may suggest using a special belt temporarily to stabilize your back and SI joint during your daily activities. If your SI joint problems are because one of your legs is longer than the other, you might also get special inserts or lifts for your shoes.
If pills and physical therapy alone don’t get rid of your pain in a few weeks, your doctor might try a shot inside your joint with a drug to numb the pain and a steroid to bring down the inflammation.
You have to go to the hospital or an outpatient clinic to get the injection. It takes about 15 to 30 minutes. First, the doctor will give you a different shot to numb the area where the needle will go. Then he’ll use an X-ray or ultrasound to guide the needle to the right place in your joint to give you the steroid.
Afterward, you might feel some numbness or weakness in your legs and feet. It should go away within 6 hours. You’ll need to rest for 24 hours.
Steroid shots in the SI joint usually start working in 3 to 7 days. Most people feel a lot better and can move around much easier after they get one. You might have some side effects, such as:
- High blood sugar if you have diabetes
- For women, changes in your period
- Warm, red skin, called flushing
- Trouble sleeping
Side effects usually go away in a few days.
Many people get relief after the injection, but the pain often comes back. Your doctor will likely wait 2 to 4 months before she gives you another one.
If the pain keeps coming back for a few years, you might need surgery to fix it.