SI Joint Injection Side Effects: PRP vs. Steroid Shots for SI Joint Syndrome

By /


Steroid shots are the mainstay of current injection-based spine care. Why? Certainly not because steroid shots are the best therapy we have for reducing pain and helping an injured part of the spine heal. Also, while many online sources would have you believe that SI Joint injection side effects are minimal, that’s not been our experience. Hence, it’s always great to see physicians worldwide testing autologous biologics, like platelet rich plasma, against steroids for SI joint pain.

SI Joint Syndrome

The SI joint (sacroiliac joint) lives between the tailbone and the back of the hip and is critical for transferring energy between your legs and your spine. It’s not a hinge joint, like the knee, but instead works by giving in this direction or that. The joint can be injured via trauma (e.g., a car crash or a fall on the butt) or can get arthritic, like any other joint, through normal wear and tear. The joint can also be injured through overload from a low-back fusion.

When physical therapy fails, the mainstay of treatment for this problem is an X-ray–guided, anti-inflammatory steroid shot. The upside is that these injections can help some patients obtain months of relief. The downside is that SI Joint injection side effects from high-dose steroids are an issue. For example, these steroid injections can injure local ligament and cartilage cells as well as impact bone density in older women.

One way that’s been proposed to help chronic SI joint pain that won’t resolve with a steroid shot or can’t be effectively managed with conservative care is minimally invasive SI joint fusion. However, while the research for this new solution looks somewhat encouraging, the downside side effects appear to be no better than other fusions and even worse than SI Joint injection side effects. Hence, the world needs another option.

PRP SI Joint Injections

PRP means platelet rich plasma, a substance made by concentrating the patient’s platelets. We’ve injected several hundred SI Joint pain patients with one platelet-based procedure or another over the last decade. In fact, this works so well that it’s been a long time since I remember injecting an SI Joint with high-dose steroid. Hence, it’s great to see some research that backs up what we observe in the clinic every day.

The new study randomized 40 patients to get either a steroid shot or PRP injection via ultrasound guidance. The patients were then followed only short-term up to three months (which is a weakness of this study). Back pain was less with PRP at six weeks and three months. Only 25% of the patients who had a steroid injection were still experiencing significant relief at three months compared to 90% of the PRP group. Functional scores worsened at three months for the steroid group while these same scores improved gradually for the PRP group. In summary, PRP beat steroid in this small study.

The Older SI Joint Therapy Option—Prolotherapy

It’s hard to write this blog without giving a tried and true SI joint pain option a plug. While PRP is sexier, prolotherapy (prolo) is based on the idea that injecting a solution that causes a brief inflammatory reaction will facilitate healing. Also, there’s an even better study out there that shows that prolo works better than steroid injections.

The prolo study looked at a few more patients and for longer than the PRP study. One group was injected with dextrose prolotherapy solution in the SI joint and the other with high-dose steroid. The positive effects of prolo weren’t just seen for three months, but for 15 months where almost 60% of the prolo group had significant relief whereas only 10% of the steroid group reached that goal.

The upshot? While steroid injection for SI joint pain is a mainstay, it’s a not a great treatment for long-term relief when compared to simple treatments like PRP and prolo that focus on ramping up the body’s natural ability to heal versus suppressing it. So if you have SI joint pain, realize that what your insurance covers is likely a second-rate treatment. Also, SI Joint injection side effects are quite real, so based on this early research, avoiding the “roids” would likely be smart.

Get health and wellness information from a trusted source.

By submitting the form, you are agreeing that you read and consent to our Privacy Policy. We may also contact you via email, phone, and other electronic means to communicate information about our products and services. We do not sell, or share your information to third party vendors.

Leave a Reply

Your email address will not be published. Required fields are marked *

7 thoughts on “SI Joint Injection Side Effects: PRP vs. Steroid Shots for SI Joint Syndrome

  1. Maxine Dennis

    Where can get this shot? I’ve had the steroid shots that last for abut 3 months.

    1. Regenexx Team Post author


      These treatments are available at these locations:

  2. Allen Burson

    It’s also been a couple of years since your post. Have insurance companies started to support PRP more now?

  3. SJ Lee

    Is SI PRP injection covered by health insurance? If not, how much is the cost for one?

    1. Regenexx Team

      Hi SJ,
      You can reach the team that would have that type of information at 855 622 7838.

  4. douglas matthes

    How do you determine it’s the SI joint causing the pain?

    1. Regenexx Team

      Hi douglas,
      We can use a fluoro guided si joint injection block.

Is Regenexx Right For You?

Request a free Regenexx Info Packet


Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar


Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog


9035 Wadsworth Pkwy #1000
Westminster, CO 80021


Copyright © Regenexx 2020. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.