Health Organization for Pudendal Education

Has anyone who also has SIJD tried SI joint injections to "diagnose" if their PN pain was a result of SIJD?

Hi Faith,
To the best of my (limited) knowledge, SIJ injections are not used as a diagnostic tool for PN(E).
Unfortunately, people with our condition have to do a lot of travelling and jump through a lot of hoops to get accurate diagnosis and treatment.
Warm regards and best wishes,
Karyn

Thanks Karyn,

I know SIJ injections aren't used to diagnose PNE, but if someone is having PN caused by compression of the PN due to pelvic misalignment (SIJD) and they had an SIJ injection that took away their sitting pain then I guess they would know it was not a true entrapment of the nerve. I don't know, just trying to think through this since it is mentioned on this site that PN can be caused my a compression/tension issue r/t the SIJ. Just thought I would through it out there.

To the best of my understanding this is not a sufficient tool to diagnose SIJD. You need a hands-on assessment by a PT experienced in pelvic misalignment, to test for pelvic joint dysfunction. Also, pain in the region of the S-I joint is often NOT due to the SIJ itself, as that general area is enervated by nerves from the Lumbar area - if I am recalling correctly, L3, L4, and L5.
Also if there is pelvic misalignment pushing on a nerve, injecting the SIJ would not give any relief as the injection only numbs the joint itself, whereas a misalignment in the joint can cause the pudendal nerve to be pressed on at any point lower down...the nerve does not run through the S-I itself.

Hi Faith,

My pain management doctor found that I was hypomobile on my left side (where I have PN) and hypermobile on the right. Whether that is what started my PN or is a result of tight muscles due to the PN is unknown. However, I was having some tenderness in the area of my left SI joint and he suggested I undergo an injection there to see if he could reduce inflammation.

I decided it was worth a shot, because at least the tenderness might be resolved. Oddly, I had a flare up of my PN after receiving the injection--and I acquired a new, but only temporary symptom--neuropathic itch!


My doctor said he couldn't understand why this happened, and said I quote "there is no correlation between the area I injected and the pudendal nerve." Mostly the branch of the dorsal nerve to the clitoris. So who knows, I'm a freak of nature I guess

Best wishes,

Krista

HerMajesty wrote:To the best of my understanding this is not a sufficient tool to diagnose SIJD.

From what I have read HerMajesty, SI joint injections are used primarily for diagnostic purposes to see if the joint is a source of pain. If the anesthetic that is used takes away the pain even for a little bit then you know the SI joint is the culprit of pain. This helps the therapist and doctor to know they are treating the pain correctly.

HerMajesty wrote:Also if there is pelvic misalignment pushing on a nerve, injecting the SIJ would not give any relief as the injection only numbs the joint itself, whereas a misalignment in the joint can cause the pudendal nerve to be pressed on at any point lower down...the nerve does not run through the S-I itself.

I agree with this. I am not saying for sure that an SI joint would help for PN pain, but I was wanting to see if anyone had tried it. I also have low back/sacral pain that I wonder is maybe coming from the SI joint only so maybe an injection would help that part of my pain. Just wondering.

KC17 wrote:I decided it was worth a shot, because at least the tenderness might be resolved. Oddly, I had a flare up of my PN after receiving the injection--and I acquired a new, but only temporary symptom--neuropathic itch!

Thanks for sharing your experinece Krista. I think people with PN most often react badly to steriods (that's been my experiene anyway). I'm assuming you had steriod in your injection. Apparently steriods and neuropathic pain don't mix well. I think this is because the CNS is involved and when a new source of pain is elicited (like an injection) the CNS goes crazy because it is already "wound up" from the constant pain signals we have every day. I guess this is the simplified definition of central sensitization which I know not all PN sufferers have, but it seems the longer the pain goes on the more likely it is to involve the CNS as a whole.

Faith wrote:I agree with this. I am not saying for sure that an SI joint would help for PN pain, but I was wanting to see if anyone had tried it. I also have low back/sacral pain that I wonder is maybe coming from the SI joint only so maybe an injection would help that part of my pain. Just wondering.

Faith,
Low back/sacral pain is a fairly common symptom of PN(E). It was explained to me by Dr. Conway that the PN originates in your genital area and wraps around the bottom of the sacrum. I have very intense sacral pain, but no back pain.
Warm regards,
Karyn