Sacroiliac Blocks
At The Brain and Spine Centre, we specialize in the diagnosis and surgical treatment of neurological and spinal disorders. Dr. Muhammad Aqeel Natt, a leading neurosurgeon in Lahore, provides advanced, safe, and compassionate care for patients.
Sacroiliac Blocks
Sacroiliac (SI) joint blocks are diagnostic and therapeutic injections of local anesthetic and corticosteroid into the sacroiliac joint to confirm and relieve pain originating from SI joint dysfunction, which accounts for 15-30% of chronic low back pain. At The Brain and Spine Centre, Dr. Muhammad Aqeel Natt performs fluoroscopy-guided SI joint injections at Farooq Hospital, West Wood Branch, Lahore, for patients with buttock/pelvic pain unresponsive to conservative therapy.
Our goal is simple: accurately diagnose SI joint pain, provide immediate and prolonged relief, and guide definitive treatment like radiofrequency ablation or physical therapy.
What Are Sacroiliac Blocks?
SI joint blocks deliver medication directly into the sacroiliac joint—the large, L-shaped articulation between the sacrum and ilium—using fluoroscopic guidance to target the posterior joint space precisely. Diagnostic blocks use anesthetic alone to confirm >75% pain relief; therapeutic blocks add steroid for inflammation reduction.
Symptoms and Indications
SI joint pain mimics disc or facet pain but localizes to buttocks/posterior pelvis.
Common features and indications:
Unilateral buttock/pelvic pain, worse with prolonged sitting/standing, transitioning positions.
Positive SI joint provocation tests (FABER, thigh thrust, compression/distraction, Gaenslen’s).
Pain below L5 dermatome without leg radiation.
Normal lumbar MRI but positive SI maneuvers.
Diagnosis
Clinical: ≥3/5 positive SI provocation tests.
MRI/CT: joint effusion, sclerosis, capsulitis.
The Procedure
Outpatient, 10-15 minutes under fluoroscopy.
Steps:
Prone positioning; fluoroscopy AP view identifies joint lines.
Oblique tilt aligns posterior joint space; needle entry at distal/caudal third.
22G spinal needle advanced to “safe zone”; contrast confirms intra-articular spread (1-2 ml capacity).
Anesthetic (lidocaine 1-2 ml) ± steroid (triamcinolone 20-40 mg or depomedrol 80 mg).
Observe 30 minutes for response.
Recovery & Aftercare
Immediate anesthetic relief; steroid peaks 2-5 days.
Resume normal activities; PT focuses on pelvic stabilization.
Repeat 2-3x if >50% relief; proceed to RFA if confirmed.
Results You Can Expect
Diagnostic accuracy: >75% relief confirms SI origin.
Therapeutic: 60-80% achieve significant relief 1-6 months.
50% long-term benefit with series.
Why Choose The Brain and Spine Centre
Neurosurgeon-guided fluoroscopy ensuring intra-articular precision. Dual diagnostic/therapeutic; pathway to RFA/fusion if positive. Integrated spine/pelvic pain program.
Cost of Sacroiliac Blocks
Per-injection outpatient; series of 2-3 diagnostic. Cost-effective vs surgery.
