Self-Reported Female Orgasm Following Serial Sacroiliac Joint Injections

Sacroiliac joint (SIJ) dysfunction has been increasingly recognized as the underlying pathology responsible for a significant percentage of cases of chronic lower back pain and radiculopathy. Diagnosis of SIJ dysfunction involves multiple provocation tests followed by serial injections of anesthetic, with significant alleviation of pain indicating that the SIJ is the pain generator. One documented complication of SIJ injections is extravasation of injected material from the SIJ capsule, resulting in unintended symptoms. We report the case of a patient who reported experiencing an orgasm following each of her three diagnostic SIJ injections. We hypothesize that this unusual symptom was caused by extravasation of injected material ventrally to the nearby pudendal nerve, a nerve responsible for sensory innervation of the perineum and a mediator of sexual arousal and orgasm.