A sacroiliac joint injection may help evaluate or temporarily reduce selected SI joint pain involving the lower back, buttock, hip, or pelvic region.
Learn how Dr. Siefferman performs sacroiliac (SI) joint injections to diagnose and treat lower back and pelvic pain, helping reduce discomfort and improve mobility.
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Hi, I’m Dr. Jason Siefferman, medical director at Manhattan Pain Medicine. If we suspect that pain is coming from within the sacroiliac joint, we will often offer a diagnostic sacroiliac joint injection. This is where we will use local anesthetic to turn pain from the joint off and confirm whether or not it is the source of pain.
Many things can mimic sacroiliac joint pain, and sacroiliac joint pain can actually be downstream from other mechanical processes. Part of the process of understanding everything that’s going on with the patient may involve a diagnostic injection to selectively turn off one structure to confirm its role in the pain cascade.
To perform the sacroiliac joint injection, this can be done in office with ultrasound guidance or at a surgical center with X-ray guidance. Generally, the patient is lying on their stomach. There’s cold solution to clean the skin. We fill the joint with fluid. It’s numb for several hours and we see what result comes. Generally, complications are rare but can include infection.
A sacroiliac joint injection is a targeted procedure used to evaluate or temporarily reduce selected pain coming from the sacroiliac joint, also called the SI joint. This joint connects the sacrum at the base of the spine to the pelvis and can contribute to lower back, buttock, hip, groin, or pelvic-region pain.
At Manhattan Pain Medicine, sacroiliac joint injection NYC care begins with diagnosis-first evaluation. The goal is to determine whether symptoms are coming from the SI joint itself, inflammatory sacroiliitis, lumbar disc disease, facet pain, hip pathology, pelvic floor dysfunction, hypermobility-related instability, cluneal neuralgia, or another pain generator.
MPM specialists evaluate whether a sacroiliac joint injection may be appropriate by reviewing the pain pattern, physical exam findings, provocative SI joint testing, imaging, inflammatory history, hypermobility features, pelvic mechanics, prior treatments, and related spine, hip, pelvic, or nerve symptoms.SI joint pain can overlap with sciatica, disc herniation, facet-mediated back pain, sacroiliitis, hip pathology, pelvic floor dysfunction, pudendal neuralgia, cluneal neuralgia, autoimmune-related pain, and joint instability.
This evaluation helps determine whether an SI joint injection, spine injection, rheumatology coordination, regenerative medicine, prolotherapy, PRP, rehabilitation, pelvic pain care, or SI joint fixation and fusion evaluation may be appropriate.
Patients often search for sacroiliac joint injection in Manhattan when lower back, buttock, hip, groin, or pelvic pain has not improved with physical therapy, stretching, medication, bracing, imaging, spine care, pelvic pain care, or rheumatology treatment. SI joint pain can be difficult to identify because it may mimic sciatica, lumbar disc pain, facet pain, hip pain, cluneal nerve pain, or pelvic floor dysfunction.
MPM approaches SI joint injections as a diagnostic and therapeutic tool, not a standalone cure. A local anesthetic injection may help clarify whether the SI joint is contributing to pain. When corticosteroid is used, the injection may also help reduce inflammation and pain for selected patients. Relief may be temporary, but the response can guide next steps, including rehabilitation, rheumatology care, regenerative medicine, prolotherapy, PRP, spine procedures, pelvic pain treatment, or SI joint fixation and fusion evaluation when clinically appropriate.
Sacroiliac joint injections fit within MPM’s Hypermobility, Musculoskeletal issues, and Autoimmune and Inflammatory expertise because SI joint pain often involves overlapping mechanical, inflammatory, pelvic, and stability-related factors. Some patients have sacroiliac joint dysfunction related to joint instability, anterior pelvic tilt, scoliosis, hip mechanics, or hypermobility. Others have inflammatory sacroiliitis related to autoimmune or rheumatologic conditions.
MPM evaluates SI joint pain within the full clinical picture. Treatment planning may include physical therapy, pelvic floor therapy, rheumatology coordination, medication management, steroid injection, spine injections, regenerative medicine, PRP, prolotherapy, or SI joint fixation and fusion evaluation when appropriate. The goal is to match treatment to the actual pain generator rather than assuming all low back, buttock, or pelvic pain comes from the SI joint.
Before a sacroiliac joint injection, MPM reviews the suspected diagnosis, pain pattern, exam findings, imaging, medications, allergies, bleeding risk, diabetes considerations, pregnancy considerations, and post-procedure instructions. SI joint injections are typically performed with image guidance when appropriate to help confirm placement and support procedural accuracy.
During the procedure, medication is directed toward the SI joint or related target area. The injection may include local anesthetic, corticosteroid, or another option depending on the treatment plan. Patients may feel pressure, brief discomfort, temporary numbness, soreness, or a short pain flare afterward. Relief may be temporary and varies by diagnosis, inflammation, joint mechanics, and overall pain pattern. MPM uses the response to determine whether the SI joint appears to be the primary source of pain and what next steps should be considered.
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
The best care I've received as a chronic pain patient. I traveled from out of state to visit Manhattan Pain Medicine because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
I was injured in a bicycle accident over 8 years ago. I’ve suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I’m feeling an improvement in my life. I no longer stay up all night in pain, a...
One of the best experiences, if not the best, I have ever had at the doctor’s office. From the front desk to the nurses to the PA assisting the doctor this was a great experience. Dr.Nino actually listened to me and came up with a game plan. Would recommend this practice to as many people as I could...
I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!
After two years of searching and feeling lost and let down, I finally found real help at Manhattan Pain Medicine. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I’m finally getting answers with m...
Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...
The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
A sacroiliac joint injection is a targeted injection used to evaluate or temporarily reduce pain from the sacroiliac joint, also called the SI joint. The injection may include local anesthetic, corticosteroid, or another medication depending on the treatment goal. It may be diagnostic, therapeutic, or both. At MPM, an SI joint injection is considered only after evaluating whether the SI joint is likely contributing to lower back, buttock, hip, groin, or pelvic-region pain.
The SI joint connects the sacrum at the base of the spine to the ilium of the pelvis. It helps transfer load between the spine and lower body. Because it sits between the lower back, pelvis, and hips, SI joint pain can overlap with spine pain, hip pain, pelvic pain, or sciatica-like symptoms. MPM evaluates the SI joint in the context of the patient’s full musculoskeletal, inflammatory, and pelvic pain pattern.
SI joint pain may feel like lower back pain, buttock pain, hip pain, groin pain, pelvic-region pain, or pain that travels into the thigh. Some patients feel worse with standing, walking, stairs, rolling in bed, prolonged sitting, or transitioning from sitting to standing. Similar symptoms can occur with disc herniation, sciatica, facet pain, hip pathology, cluneal neuralgia, pelvic floor dysfunction, or inflammatory arthritis, so careful evaluation is important.
An SI joint injection may help selected patients when the SI joint is a meaningful pain generator. It may provide temporary relief and can help clarify whether symptoms are truly coming from the SI joint. It does not cure all lower back, buttock, hip, or pelvic pain. MPM evaluates whether symptoms may instead be related to lumbar spine disease, hip pathology, pelvic floor dysfunction, nerve pain, inflammation, or hypermobility-related instability.
An SI joint injection can be diagnostic, therapeutic, or both. A diagnostic injection uses numbing medication to help determine whether the SI joint is contributing to pain. A therapeutic injection may include corticosteroid to reduce inflammation and pain for a period of time. Relief may be temporary, but the pattern of response can guide next steps, including rehabilitation, rheumatology care, regenerative medicine, spine procedures, or SI joint fixation and fusion evaluation.
SI joint pain often starts around the lower back, buttock, or pelvic region and may refer into the hip, groin, or thigh. Sciatica usually involves irritation of a nerve root, often causing pain that travels down the leg with numbness, tingling, or weakness. The two can overlap or mimic each other. MPM evaluates the spine, SI joint, hips, nerves, and pelvic mechanics before deciding whether an SI joint injection is appropriate.
Facet pain, disc pain, and SI joint pain can all cause lower back or buttock symptoms. Facet pain often comes from small spinal joints, while disc-related pain may involve disc injury, inflammation, or nerve root irritation. SI joint pain comes from the joint between the sacrum and pelvis. MPM uses history, exam findings, provocative testing, imaging review, and sometimes diagnostic injections to help distinguish these pain generators.
SI joint injections may help selected patients with sacroiliitis when inflammation in or around the SI joint is contributing to pain. Inflammatory sacroiliitis may be related to autoimmune or rheumatologic conditions such as seronegative spondyloarthropathy or psoriatic arthritis. An injection may reduce local inflammation temporarily, but it does not replace rheumatology evaluation, disease-directed medication, physical therapy, or broader inflammatory pain management when needed.
SI joint injections may be considered for selected autoimmune or inflammatory SI joint pain when local inflammation appears to be contributing to symptoms. However, autoimmune-related pain often requires coordinated care, which may include rheumatology evaluation, lab review, imaging, medication management, DMARDs, biologics, physical therapy, or other treatment. MPM evaluates whether the SI joint is the correct target and whether inflammation, mechanics, or both are involved.
SI joint injections may help selected patients with hypermobility or EDS-related SI region pain when the SI joint is contributing to symptoms. However, injections do not cure hypermobility, EDS, or joint instability. MPM evaluates joint mechanics, pelvic alignment, muscle compensation, ligamentous laxity, spine and hip contributors, and functional goals before deciding whether injection, bracing, physical therapy, prolotherapy, PRP, or another pathway may be appropriate.
Image guidance is commonly used for SI joint injections when clinically appropriate because the SI joint can be difficult to access accurately by landmarks alone. Depending on the clinical setting, guidance may include fluoroscopy, CT, or ultrasound in selected circumstances. MPM determines the appropriate approach based on anatomy, diagnosis, safety factors, and treatment goals. Image guidance supports accuracy but does not guarantee relief.
Relief varies by patient, diagnosis, medication used, inflammation level, joint mechanics, and whether other pain generators are present. Some patients feel short-term relief from numbing medication, while steroid-related improvement may take longer and may last days, weeks, or longer in selected cases. Some patients do not respond. MPM reviews the timing, location, and duration of relief to guide next steps.
Temporary relief can still be useful because it may suggest that the SI joint is contributing to pain. Depending on the response, MPM may consider physical therapy, pelvic floor therapy, rheumatology coordination, steroid injection planning, PRP, prolotherapy, regenerative medicine, spine treatment, cluneal nerve evaluation, or SI joint fixation and fusion evaluation when appropriate. If relief is limited or does not match the expected pattern, the diagnosis may need to be refined.
An SI joint injection often refers to local anesthetic or corticosteroid injection used for diagnosis or inflammation-related pain relief. PRP and prolotherapy are regenerative medicine approaches that may be considered for selected musculoskeletal or instability-related pain patterns. These treatments have different goals, evidence considerations, recovery expectations, and risks. MPM determines which approach, if any, best fits the patient’s diagnosis, anatomy, prior response, and care goals.
SI joint fixation or fusion may be considered only for selected patients with persistent SI joint-mediated pain after careful diagnosis and when less invasive treatments have not provided enough benefit. An SI joint injection may sometimes help confirm whether the SI joint is a meaningful pain generator before more advanced options are considered. MPM evaluates the full clinical picture, including spine, hip, pelvic, inflammatory, and hypermobility-related factors, before referral or escalation.
Risks may include pain flare, bruising, bleeding, infection, allergic reaction, temporary numbness or weakness, vasovagal reaction, steroid-related side effects, elevated blood sugar, tissue effects with repeated steroid exposure, incomplete relief, temporary relief only, or no relief. MPM reviews risks before treatment. Fever, spreading redness, severe swelling, new weakness, new numbness, bowel or bladder dysfunction, saddle anesthesia, severe trauma-related pain, chest pain, shortness of breath, or rapidly worsening symptoms require urgent evaluation.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
If you are considering a sacroiliac joint injection in NYC for lower back pain, buttock pain, pelvic-region pain, sacroiliitis, SI joint dysfunction, inflammatory pain, or hypermobility-related SI pain, MPM can help determine whether this treatment may be appropriate. Your evaluation will consider your symptoms, exam findings, imaging, diagnosis, prior care, safety factors, and treatment goals before any recommendation is made.
A sacroiliac joint injection is a targeted procedure used to evaluate or temporarily reduce selected pain involving the sacroiliac joint, also called the SI joint. The SI joint connects the sacrum at the base of the spine to the pelvis. Because it sits between the spine, hips, and pelvic region, SI joint pain can be difficult to distinguish from other causes of lower back, buttock, hip, groin, or pelvic pain.
At Manhattan Pain Medicine (MPM), sacroiliac joint injection NYC care begins with diagnosis-first evaluation. The goal is to determine whether the SI joint is truly contributing to symptoms and how an injection may fit within a broader care plan.
The sacroiliac joint helps transfer force between the upper body, spine, pelvis, and legs. It has limited motion, but it can still become painful when irritated, inflamed, stressed, unstable, or overloaded. SI joint pain may be mechanical, inflammatory, hypermobility-related, post-traumatic, pelvic-mechanics-related, or related to overlapping spine, hip, or nerve conditions.
Patients may feel pain in the lower back, buttock, posterior hip, groin, pelvis, or upper thigh. Symptoms may worsen with stairs, standing, walking, rolling in bed, prolonged sitting, or moving from sitting to standing.
SI joint pain can mimic sciatica, disc herniation, facet pain, hip pathology, cluneal neuralgia, pelvic floor dysfunction, and inflammatory arthritis. Some patients are told they have low back pain, hip pain, pelvic pain, or sciatica without a clear explanation of the true pain generator.
MPM evaluates the pain pattern, provocative SI joint testing, imaging, gait and pelvic mechanics, hypermobility, inflammatory symptoms, autoimmune history, prior physical therapy, prior injections, and related neurologic or pelvic symptoms. Imaging can be helpful, but it does not always confirm whether the SI joint is the active pain source. In selected cases, a diagnostic SI joint injection may provide important clinical information.
An SI joint injection may be diagnostic, therapeutic, or both. A diagnostic injection uses local anesthetic to determine whether numbing the SI joint reduces the patient’s typical pain. If relief occurs in the expected area, the SI joint may be a meaningful contributor.
A therapeutic injection may include corticosteroid when inflammation is suspected or when reducing pain and swelling is clinically appropriate. Relief may be temporary. Some patients improve for days or weeks, while others have limited or no response. MPM uses the response to guide the next step rather than assuming the injection is the final treatment.
Sacroiliitis refers to inflammation of one or both SI joints. It may occur in autoimmune or inflammatory conditions, including seronegative spondyloarthropathy, psoriatic arthritis, rheumatoid arthritis overlap, lupus, Sjogren’s, vasculitis, or undifferentiated connective tissue disease. Inflammatory SI joint pain may include stiffness, deep buttock pain, night pain, morning stiffness, or improvement with movement.
For selected patients, an SI joint injection may help reduce local inflammation and pain. However, inflammatory sacroiliitis often requires coordinated care with rheumatology, medication management, lab review, imaging, and disease-directed treatment when appropriate.
Some SI joint pain patterns are related to hypermobility, EDS, joint instability, anterior pelvic tilt, scoliosis, hip mechanics, or pelvic floor compensation. In these cases, the SI joint may be irritated because surrounding muscles, ligaments, and joints are working harder to stabilize the pelvis.
An injection may provide temporary relief or diagnostic information, but it does not correct instability or hypermobility. Treatment may also include targeted rehabilitation, bracing, pelvic floor therapy, prolotherapy, PRP, regenerative medicine, or other stabilization-focused strategies when clinically appropriate.
SI joint injections are different from epidural injections, facet injections, PRP, prolotherapy, and SI joint fixation or fusion. Epidural injections target nerve root or spine-related inflammation. Facet injections target spinal joints. PRP and prolotherapy are regenerative medicine approaches that may be considered for selected musculoskeletal or instability-related pain patterns. SI joint fusion is a more advanced option reserved for carefully selected patients.
MPM helps determine which option best matches the patient’s diagnosis, anatomy, symptoms, prior response, and goals.
Risks may include pain flare, bruising, bleeding, infection, allergic reaction, temporary numbness or weakness, vasovagal reaction, steroid-related side effects, elevated blood sugar, tissue effects with repeated steroid exposure, incomplete relief, temporary relief only, or no relief.
Patients should seek urgent evaluation for fever, spreading redness, severe swelling, new weakness, new numbness, bowel or bladder dysfunction, saddle anesthesia, severe back pain after trauma, sudden inability to walk, severe pelvic or abdominal pain, pregnancy-related pelvic pain, unexplained weight loss, cancer-related red flags, suspected infection, chest pain, shortness of breath, or rapidly worsening symptoms.
For selected patients, a sacroiliac joint injection may be an important step in identifying and treating SI joint-mediated pain. MPM’s role is to determine whether the SI joint is the right target and how the injection fits into a coordinated, diagnosis-first plan.
