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Sacroiliac Joint InjectionImage-guided sacroiliac joint injections to diagnose and treat SI joint pain — a frequently missed cause of one-sided low back and buttock pain, performed by board-certified pain management physicians at Remix Medical in Houston, TX.

Specialty
Pain Management
Type
Procedure
Body location
Sacroiliac joint, sacrum, ilium, posterior sacroiliac ligaments, lateral branch nerves
CPT code
27096 (sacroiliac joint injection with image guidance, arthrography); G0260 (HCPCS: SI joint injection, facility setting); 64451 (nerves innervating the SI joint, with image guidance); 77003 (fluoroscopic guidance, when reported separately)

Also known as: SI Joint Injection, Sacroiliac Block, SI Joint Block, Sacroiliac Arthrography

Sacroiliac Joint Injection in Houston, Texas

The sacroiliac joint is the most consistently overlooked source of low back pain. It sits below the level most spine imaging focuses on, it refers pain in a pattern that mimics sciatica, and no physical exam test identifies it reliably on its own. The reference standard for diagnosis is an injection.

What is a Sacroiliac Joint Injection?

An SI joint injection places local anesthetic — and usually corticosteroid — directly into the joint space under fluoroscopic or ultrasound guidance.

Because the joint is deep, irregular, and surrounded by dense ligament, image guidance is not optional. Blind injections miss the joint a substantial fraction of the time, which is precisely why unguided injections produce unreliable diagnostic information.

Diagnosis and Treatment in One

Diagnostic: if local anesthetic in the joint substantially relieves your familiar pain, the SI joint is confirmed as the pain generator.

Therapeutic: the corticosteroid reduces inflammation within the joint, often producing relief that outlasts the anesthetic by weeks or months.

A positive diagnostic response also identifies patients who may benefit from radiofrequency ablation of the lateral branch nerves, which supply sensation to the joint and can be interrupted for longer-lasting relief.

Who It Helps

  • Pain below the belt line, usually on one side, that the patient can point to with one finger
  • Buttock and groin pain
  • Referred pain down the back of the thigh, typically stopping above the knee
  • Pain after lumbar fusion, where the SI joint absorbs transferred load
  • Post-partum pelvic girdle pain
  • Pain after a fall onto the buttock or a motor vehicle collision
  • Sacroiliitis from inflammatory arthritis

Finding the Real Source at Remix Medical

If months of sciatica treatment have not touched your pain, it may be that the joint responsible was never examined. Contact Remix Medical to schedule a consultation with a board-certified pain management physician in Houston.

How it's performed

With the patient prone, the sacroiliac joint is visualized under fluoroscopy or ultrasound. After skin anesthesia, a needle is advanced into the inferior aspect of the joint space and intra-articular position is confirmed with contrast arthrography. Local anesthetic, usually combined with corticosteroid, is then injected into the joint.

How to prepare

Avoid taking pain medication immediately beforehand, as it can obscure the diagnostic result. Arrange a driver. Hold anticoagulants only as directed by the prescribing physician. Be prepared to record pain scores for several hours after the injection.

What to expect after

Record your pain level hourly for 6 to 8 hours after the injection, since the anesthetic phase carries the diagnostic information. Ice the site 20 minutes every 2 to 3 hours on the first day. Avoid heavy lifting for 24 hours. Monitor blood glucose if diabetic. Report fever, spreading redness, or new leg weakness.

Outcome

Substantial relief of familiar pain during the anesthetic phase confirms the SI joint as the pain source. The corticosteroid component commonly extends relief for weeks to months, and a positive result identifies candidates for lateral branch radiofrequency ablation.

Your physician

Your pain management at Remix Medical.

Every clinician at Remix Medical is board-certified and owns the practice — so the physician in your exam room is the one making decisions about your care.

  • Raju Mantena, DO

    Pain Medicine Physician

    Medical Center — South Freeway · Montrose — Upper Kirby · Pearland

    Board certifiedAccepting newBook

This page is for general education and is not a substitute for medical advice. Whether a given procedure is appropriate depends on your individual evaluation. Contact a Remix Medical clinician to discuss your care.

Updated July 9, 2026.

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