SI joint pain. Precisely targeted.
The sacroiliac (SI) joint is the paired articulation between the sacrum and the ilium — effectively where the spine meets the pelvis. It is a common source of chronic low back and buttock pain, and one that is frequently misdiagnosed as either lumbar radicular pain or hip pathology because the presentation overlaps with both.
An SI joint injection serves two purposes simultaneously: it is diagnostic (if the injection produces meaningful pain relief, the SI joint is confirmed as the pain source) and therapeutic (the corticosteroid component can produce weeks-to-months of relief). For patients whose pain source has been unclear after imaging and prior treatments, the SI injection often provides both an answer and relief in one procedure.
At NCSS, SI joint injections are performed by Dr. Scott under ultrasound guidance in our AAAHC-accredited operating rooms — no fluoroscopy radiation to you or the physician.
Who this procedure is designed for.
SI joint injections address a specific pain pattern. The consultation determines whether your presentation is a fit.
Pain in the low back, buttock, or posterior hip
Often unilateral and worse with prolonged sitting, standing, or transitions between positions.
Post-partum SI pain
Pregnancy-related ligamentous laxity commonly leaves patients with persistent SI dysfunction after delivery.
SI arthritis
Degenerative changes at the SI joint on imaging.
Post-lumbar-fusion SI pain
Lumbar fusion increases mechanical stress at the SI joint, sometimes producing new SI-mediated pain after otherwise successful spine surgery.
Failed workup for other pain sources
Patients whose imaging does not clearly explain their pain often turn out to have an SI-joint component.
Positive provocative maneuvers on exam
SI compression and distraction tests reproduce the patient's pain.
Every pain-management patient at NCSS is seen personally by Dr. Rand Scott for the consultation — not delegated to a mid-level provider.
Three stages, one procedure.
An SI joint injection is a same-day procedure performed in one of our operating rooms with sedation available if needed. The steps:
Ultrasound-guided approach
Real-time ultrasound imaging identifies the SI joint from posterior, allowing precise needle placement without X-ray radiation.
Confirmation of intra-articular placement
Ultrasound confirms the needle is within the SI joint before injection.
Local anesthetic + corticosteroid
A combined solution provides both immediate diagnostic feedback (local anesthetic effect) and delayed therapeutic benefit (steroid effect over subsequent days).
Unilateral or bilateral
Most patients have unilateral SI dysfunction; occasional patients present with bilateral involvement and require injection at both joints.
The procedure itself typically takes 5–10 minutes. Total time in the facility, including preparation and recovery, is usually 45–75 minutes.
Two sites. One recovery.
Discharged after brief post-procedure observation. If sedation was used, someone must drive you home.
The local anesthetic component provides immediate but temporary relief. If your usual pain substantially improves in these first hours, the SI joint is confirmed as your pain source — important diagnostic information.
The steroid gradually takes effect. Some patients notice pain returning as the local anesthetic wears off, then improving again over subsequent days as the steroid engages.
Therapeutic duration varies. When SI injections provide substantial relief, they can often be repeated at intervals for ongoing management.
Most patients return to normal activity the following day. Physical therapy focused on SI stabilization is often recommended alongside injections.
If the injection does not provide meaningful relief, this is also useful information — it argues against the SI joint as the primary pain source and prompts reconsideration of the diagnosis.
Follow-up with Dr. Scott occurs at Newport Pain Management for ongoing pain management coordination.
The medical director. Personally.
All interventional pain procedures at NCSS are performed by Dr. Rand Scott himself.
H. Rand Scott, MD
BOARD-CERTIFIED ANESTHESIOLOGIST · PAIN MANAGEMENT SUBSPECIALTYFounder of Newport Pain Management (1996) and Medical Director of NCSS. Ultrasound-guided technique, no fluoroscopy radiation.
Meet the medical director →The right starting point is a conversation.
Every SI joint injection consultation at NCSS begins with Dr. Scott personally — a careful review of your history, your exam findings, and whether this procedure is the right fit.
Call (949) 644-8182Monday–Thursday, 8am–3pm · Friday by appointment only.
Related procedures.
Epidural Steroid Injections
For radicular pain from spine pathology — often the first-line consideration for lower back pain with leg symptoms.
Learn more →Facet Joint Injections
Another common source of low back pain — facet and SI pain can present similarly and sometimes coexist.
Learn more →Newport Pain Management
Dr. Scott's comprehensive pain practice adjacent to NCSS — for the broader diagnostic and treatment relationship.
Visit newportpain.com →