SI Joint Pain: Causes, Diagnosis & Injection Treatment Explained
Sacroiliac (SI) joint dysfunction is a common but often misunderstood source of lower back and hip pain. In this video, Dr. Rainier Guiang of University Pain Consultants explains how SI joint pain is diagnosed, when conservative care is enough, and exactly how an SI joint injection is performed under fluoroscopic guidance.
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WHAT IS SI JOINT DYSFUNCTION? Your sacroiliac joints connect your spine to your pelvis and act as shock absorbers. When they become inflamed, or move too much or too little, the result is significant lower back, buttock, and hip pain — pain that's frequently mistaken for sciatica or a disc problem.
HOW IT'S DIAGNOSED Diagnosis starts with a thorough evaluation: a careful medical history plus specific provocative tests that apply pressure to the joint to see whether they reproduce your symptoms. Standard X-rays can show arthritis, but they often don't tell the whole story — which is why advanced imaging like fluoroscopy is used for precision.
WHO IS AT RISK?
Aging and degenerative change
Prior spinal surgery
Repeated stress from heavy lifting or high-impact sports
Pregnancy — hormonal changes relax the ligaments, leading to joint instability and pain
TREATMENT STARTS CONSERVATIVELY Specialized physical therapy and anti-inflammatory medication to manage the swelling come first. When those steps don't provide enough relief, the next step is a targeted intervention: an SI joint injection.
THE INJECTION, STEP BY STEP At University Pain Consultants, SI joint injections are performed under fluoroscopic guidance — real-time X-ray that ensures precise needle placement. The procedure is minimally invasive:
The skin over the SI joint is numbed so you stay comfortable throughout.
Using the fluoroscope, Dr. Guiang guides a small needle directly into the joint space.
A tiny amount of contrast dye confirms exact placement before any medication is injected.
The injection is delivered — a local anesthetic for immediate relief, plus a corticosteroid for longer-term reduction in inflammation.
WHAT TO EXPECT AFTERWARD Typical outcomes include significant pain reduction and improved mobility, with most patients feeling the full effect within a few days to a week. The most common side effect is temporary soreness at the injection site or a brief increase in pain. Rare risks include infection, bleeding, or nerve irritation — fluoroscopic guidance and sterile technique make these very unlikely.
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⏱ CHAPTERS 0:00 SI joint dysfunction: a misunderstood cause of back & hip pain 0:26 How we diagnose it — history and provocative testing 0:48 Why X-rays aren't enough: fluoroscopy and precision imaging 1:00 Who's at risk: aging, prior surgery, sports, pregnancy 1:16 Conservative treatment first: physical therapy & anti-inflammatories 1:34 SI joint injections under fluoroscopic guidance 1:47 Step by step: numbing, needle placement, contrast dye 2:05 What's in the injection: anesthetic + corticosteroid 2:15 Typical outcomes and how quickly relief comes 2:24 Possible side effects and rare risks 2:47 Serving the Inland Empire — how to schedule
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ABOUT DR. RAINIER GUIANG, MD Dr. Rainier Guiang is an interventional pain management physician with University Pain Consultants, caring for patients throughout the Inland Empire and Southern California. He performs fluoroscopically guided spine and joint injections, radiofrequency ablation, spinal cord stimulation, and regenerative medicine procedures.
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UNIVERSITY PAIN CONSULTANTS — 6 SOUTHERN CALIFORNIA LOCATIONS 📞 (951) 784-7111 | 🌐 unipain.com
📍 Riverside — 6900 Brockton Ave. #203, Riverside, CA 92506 📍 Corona — 2083 Compton Ave. #104, Corona, CA 92881 📍 Menifee — 27990 Sherman Road, Menifee, CA 92585 📍 Temecula — 27450 Ynez Road #202, Temecula, CA 92591 📍 Hemet — 3989 West Stetson Ave. #102, Hemet, CA 92545 📍 San Bernardino — 164 West Hospitality Lane #5, San Bernardino, CA 92408
Serving Riverside County, San Bernardino County, and the greater Inland Empire — including Moreno Valley, Perris, Murrieta, Lake Elsinore, Wildomar, Norco, Eastvale, Redlands, Rialto, Colton, Fontana, and Yucaipa.
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⚕️ MEDICAL DISCLAIMER This information is for educational purposes only. It is not medical advice and does not create a physician-patient relationship. Individual results vary, not every patient is a candidate, and all procedures carry risks. Please consult a qualified healthcare professional for personalized medical advice. For emergencies, call 911.
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Regenerative medicine: https://www.upcregenmed.com