Sacroiliitis

[Ron Scott]

Has anyone experienced the "pain" or treatment of this? Inflamation of the area between the hip and spine.

[Texas Ranger]

Yep, been living with it.  Adjustments used to help, sometimes still, anti inflammatory drugs still help.  Other than that, Bayer Back and Body.  Oh, and steroids, on occasion, when it gets real bad.  Some times I think the Doc is still just practicing on me.

One of the things old fellers need to put up with.

[Tom]

Yep, been living with it too.  It's one of those ailments that gets a doctor's response of "take two aspirin and call me in the morning."

I've hurt so bad in my left leg that I can't get out of bed or a chair.  My hair even hurt. 

Then, one day, for no reason what-so-ever, the pain will disappear.  I never know when it will return, nor how long it will stay.

I'm told that stretching exercises help to alleviate the pain, but that is from people who have not felt the pain.   I've done the stretching exercises and  have not noticed improvement.  My final assumption was that I should just grit my teeth and pray a lot. 

One note is that I think that constipation can bring it on.  I have gotten some temporary relief, on occasion, by taking a laxative.  Perhaps it is just relieving the pressures on a pinched nerve.

[Ron Scott]

This came on about 3 weeks ago right out of the blue with severe pain in the right leg from the buttocks down to the shin and then settles mostly in the thigh. Haven't been able to do much walking since. It also messed up the turkey hunting.

VA doctor has me on Ipuprofen 800 mg and pain pills,Vicoden but nothing has relieved it so far. They're suppose to be sending me something stronger, so hope it comes soon. Also putting moist heat on it.

I'm going to an orthepedic doctor next Tuesday for another opinion. 

[Chuck White]

I've been putting up with pain kinda in-between the belt-line and the hip.

Went to the chiropractor for adjustments and it helped, but it didn't completely go away.

Then I got to thinking that as I hold onto the control console of my mill while the saw runs through the log, I waddle!
So, I am teaching myself to "not" hold onto the console and the pain/discomfort has greatly subsided!

[Reddog]

Ron, you might try alternating ice and heat on your lower back/butt area.
I found that even thought the pain is in your leg, the problem area is up higher where the nerve is irritated. Might also ask about pysical therapy and a muscal relaxer.

[Tom]

Mine was diagnosed as Sciatica, but I've learned that many  doctors use it as a catch-all.  I studied it a bunch, because I didn't want it to happen again, if I could get rid of it. 

I was walking on a slope (sawdust pile) lifting heavy weights, pulling and pushing on a cant-hook, climbing into and out of a tall truck, overweight, worn shoe soles, arthritic joints ....   It seems that I did everything that would cause sciatica or sacroilitis.  The scariest thing was when they began to check me for prostate cancer.  It seems that is a cause of the pain too.

Thankfully, it went away one day.  I've suffered from it twice and the last time was for almost two years.  Yes, they fed me copius amounts of aspirin, Tylenol and ibuprofen, but the best thing was when I found a position to sit where it didn't hurt.  It would take Hannibal's Elephants to get me to move. 

[pineywoods]

Sitting on a thick wallet in your hip pocket (too much money?) can cause t...

[Chuck White]

Sitting on a thick wallet in your hip pocket (too much money?) can cause t...

You have that right.
About a year ago, I started carrying my wallet in my front pocket.  It really does help!
If you're ever in a congested area, like a fair, carnival, etc. carrying the wallet in the front pocket eliminates the chance of being picked!

[Ron Scott]

I don't have to worry about a thick wallet being the cause, don't carry one that much and it's in the left or a front pocket when I do. ;) Maybe too much wood's walking and carriyng too much marking paint.

[DanG]

Sounds like a pain in the butt, Ron.  I self-diagnosed myself with Sciatica once, and eventually concluded that it was the worn out old chair I was watching tv in, making me sit a little bit lop-sided.  A fresh new recliner solved the problem for me.

My Wife suffered terribly for a couple of years with hip pain that sounds similar to yours.  The Orthopedic Surgeon spotted a "stress fracture" of her pelvis on the x-rays, and recommended no treatment as it was about healed up on its own by then.  Sure enough, it cleared up soon after that.

[Left Coast Chris]

I have had sacroilitis for several years with pain down the leg.  It started by just having high miles on the body and doing high school and college sports.  The doc said there were thining discs and that hypermobility was the issue causing the very lower back to go in and out.   Getting bucked off of a horse several years ago was the real bad episode.  In the hospital for three days on morphine not being able to walk.  I could feel the legs but could not move them without pain that induced shock.  I did not know the tear ducts held so many tears.  It was diagnosed as severe sacroilitis (bruised nerve).   Physical therapy really helped.   They give you back excercises and stretching that get the muscles to hold the spine in line again.   I am pretty good now with one episode every 5 or 6 years that can last 6 months or a year.   The latest thing that seems to help is the wife's excercise DVD that is low impact arobics and yoga.  The yoga stretches and movements are especially helpful.  If you try some stretching on your own you have to feel what is best for your condition and work up to getting movement back.  For me, laying belly down and pushing up with the arms while leaving the hips on the ground is good along with standing up and putting the hands on the counter in a slightly bent forward position and bring the knee to the chest then extending the leg/pushing the foot out in back of you repeatedly.   If that is too much try laying on the back and pulling the knee to the chest slowly.  Or using a belt around the bottom the foot while lying on the back pulling the foot in the air while the leg is straight is good also.

When you are injured and have pain though, the physical theripist will only have you flex the muscles without moving the back to cause more pain.  He will also use ice and heat and massage.    That will slowly get you going unless you have a blown disc needing surgery.   I would suggest getting the doc to perscribe a phycial theripist as soon as possible and ask around for the best one in the area.   Hope you get to feeling better soon.

[Ron Scott]

Went to the Orthopedic doctor this morning, the same young doctor that did my rotator cuff surgery 4 years ago. He took x-rays of the hip and back, etc. It appears that I may have a pinched nerve in the sciatic area. He Rx'd Prednisone, a steriod and Flexeril, a muscle relaxer on top of the increased pain pills of the VA doctor.

He's starting me on phsical therapy treatment Friday morning and if pain doesn't let up in a week or so he will have an MRI done for a better look at the nerves and go from there. I have quite a battery of pills to keep track of. ;)

[Tom]

Ron, I hope you have the luck I had, only sooner.  Perhaps it will go away so suddenly that you won't remember that it used to hurt.

[Kas]

Ron, that sounds just like mine, pain locations and all.  By mapping the pain locations down your leg, the can tell which of the five nerves is irritated, and from that tell you which disc joint has the problem. My problem was a bulging disc at L5-S1. Flexeral and Vicodin helped, but only in taking the severity away, not all the pain. Tried the shots, helped but always came back. finally had an operation, helped a lot, but in the healing process lost a lot of muscle strength. Took a long time to get that back. This all happeded in 2002. Still have the pains occasionally, tho not as severe, usually 800mg IB will kick it now.  Still have a few Vicoden for really bad bouts, haven't had one in two years now. Learned a whole new way of walking, standing, sitting, and sleeping since then.  And like Tom said, when it acts up you'd play heck getting me to move from a relieving position.

Hope the meds get you through it quickly, after that just take care of the stresses you put on the back. I call it managing my movements, becomes second nature after a while.

[Ron Scott]

Thanks! It sounds like I'm on the right meds.

[Warbird]

Prednisone can be serious when taken for a long period, and when on high doses.  I hope they spoke with you about that.

[Ron Scott]

Yes, doctor mentioned some possible effects. Dosage is small for 7 days. He also mentioned a shot if need be, but that was more critical and a special need. I'd take anything though to get rid of the pain at this point. ;)

The pain seems to be letting up some from what it has been, though I feel like a druggy with all the pills RX'd so far. 3 weeks has been too  long to deal with this. He also said no walking on uneven ground or woods walking. >:(

[Bro. Noble]

I had that problem several years ago in my right leg.  The Dr. I went to wasn't much help and basically told me it would just take time to heal.  It did,  a couple of years >:(

Last year I hung my chainsaw while felling a tree and had to walk a long way over rough ground to get my spare.  The next day I recognized the familiar pain in my left leg.  It wasn't getting better so went to the Dr.  He gave me some pain killer and told me to take it easy for a couple of days.  He also gave me a prescription for prednisone  and told me a little about it.  He said it was up to me if I wanted to fill it but I should consider it if the pain didn't let up in a couple of days.  The biggest concern was that I'm diabetic and one of the side effects of prednisone is that it raises blood sugar.  I ended up filling the prescription and was completely back to normal after a couple of weeks.

I'm glad I had the option to take it.

[Kas]

Ron, I can also speak about the shots.  My back was so bad that from a sitting position, everytime I stood up I'd get the lightning bold feeling across my lower back and fall to the floor. Didn't matter what I did or how I tried to stand, when getting up from a chair I would collapse within 10 seconds, I had no control of my legs. So after several ortho visits, I tried the shots.  First shot worked for about four months. Second shot only worked for about two months. Never did a third shot, was advised that three shots is the lifetime limit for any one specific location, so thought I would save the final shot for the future if ever needed. It was at that point that I elected to do the surgury. If I had to do it over again, I would still do the shots: it gave me plenty of pain free time to figure out what my best options were.

[Ron Wenrich]

Mine is sciatica.  The first time I went to a doctor who gave me pain pills.  It took care of the pain, but when the pills were gone, the pain was back.  He was treating symptoms and not the problem.

So, I went to a chiropractor.  He helped me several times, but it always took a long time.  I often wondered if he helped or if time was the factor and it healed on its own.

The last time was the worst.  I couldn't hardly walk.  I felt older than Tom.   :D  The chiropractor wasn't doing a whole lot, so I went on the net and started to look at other things. 

I tried an inversion table, but it really didn't do a whole lot of good. 

Then I ran across a site that was run by a physical therapist in Canada.  He says that back problems, particularly sciatica was quite often a deep muscle spasm that has pinched the sciatic nerve.  The cost for his ebook was $20.  So, I figured it was worth a try. 

He gave a lot of background information and cited sources.  Its well written and pretty easy to understand.  His feeling was that 90% of the back pains are muscular in nature.  His remedy is to find the trigger spots, and lay on a tennis ball.  Sounds a lot like quackery.

But, guess what.  It worked.  After suffering with sciatica for over 3 months where I couldn't get out and walk, it cured me in a couple of days.  The first day gave me relief.  I haven't had any problems since. 

I don't know if this is the same type of pain Ron has or if it will work for others.

Here's the site:

http://saveyourself.ca/articles/perfect-spots/spot-06-gluteus-medius.php

[Ron Scott]

Ron,
Some good info. there. Pessure point #6 is easy to find as a trouble spot. Hopefully the physical therpists will work on them starting tomorrow. Between the doctors, they say I have both sacroiliitis and sciatica at present, so treating for both I guess.

Noble,
I'm diabetic also and the ortho. doctor said that the Prednisone would drive my sugar crazy and I need to take a sugar reading at least twice /week to watch it. I did a test today and my sugar was down, so go figure. ;)

[Ron Scott]

Started physical therapy this morning. After being in some traction and the heat pulsating machine, I feel much better tonight, less pain. They will start me on some excercises next week with treatments 3 times a week. PT says that the pain is from the sciatic nerve and they will get me back walking in the woods.

I guess technology is everywhere. When I signed in to PT, they handed me a notebook computer and mouse. I had to enter answers to several pages of questions referring to my condition at present. I asked what that was all for since they already had a paper record that I had to complete before I went. They said that the computer questions were to keep the doctor informed.

[Reddog]

Glad to hear you are getting some relief. I hope yours heals much quicker than mine has.

[Ron Scott]

It must have put a crimp in your trail riding. I know that I sure couldn't.

[Reddog]

Haven't done any riding yet this year.
Up until this week it was all I could do to drive to PT.
Seemed better the last few days, hoping it is now on the mend.

[Reddog]

How are you holding up Ron?

[Ron Scott]

Getting a little better with a little less pain. Saw my VA doctor yesterday. He said that this could go on for up to 6 months. Doing PT 3 times a week and  still taking the meds. Will see the othopedic doctor June 8th. Not doing much woods walking.

How about you?

[Reddog]

Well I am walking five plus miles a day, but still cannot sit and drive for more than a halfhour.
Getting better but it sure is a slow go.

[Reddog]

How are you progressing Ron?


I am doing a little better, seem to be able to do 18 minute miles for five miles. But sitting is still limited to less than an hour. The walking does help me a lot to loosen up. Tried walking on some grass the other day and found some hip muscles that did not like that.

[Ron Scott]

I've been to the orthopedic doctor, had x-rays and MRI, now referred to a Dr. Zimmerman, a popular neurosurgon in Traverse City, who I saw last Wednesday. I need more X-rays this coming week and another visit to neurosurgon next Friday. The diagnosis is Lumbar Spinal Stenosis where the spinal canal is closing up and pinching nerves causing the pain. Also bulged discs in lower lumbar.

They want to schedule surgery ASAP, but I need to think about that. I just don't have the time for that present and want to learn a little more it there are any possibilities without surgery. Pain isn't as bad as it was, so trying to put things off until winter or spring "break up" if I can.   

[Tom]

Ron, I know it sounds dumb, but a podiatrists told me that many painful structural ailments can be relieved with simple shoe inserts.  He said it doesn't always have to be an expensive, personally designed thing either.  Just something that will shift your normal stance and allow you to retrain muscles. 

He recommended that I buy a cheap insert from the pharmacy for an in-grown toenail.  It worked.  He said, "Just pick one". 

[SwampDonkey]

Sometimes I feel like the Tin man. All seized up until I get moving some. Sometimes it feels like my hands have swelled and the knuckles ache when bent. This goes away after a short time when I get moving. Weird bit of business. Sitting for a long time can really make things stiff'n up, almost like walking on two stubs sometimes. Maybe that just happens after 40. :D :D ;)

[Ron Scott]

Yes, that does happen after 40, its called arthritis I believe. Have had that for some time also and it does feel better if you keep moving.

Tom, I've worn molded inserts for some time and yes they do help. The VA has provided me with two pair and they really help when timber marking over woods terrain.

[Ron Scott]

I had a spinal injection by a pain management doctor in Traverse City today that the VA doctor referred me to, so will see how that does. Have to go back in 3 weeks for a possible second one in another area of the back.

[Magicman]

I've had an ongoing and progressively worsening condition with the bottoms of my feet.  The "Foot Doctor" prescribed MBT shoes and a special insole.

On my own, I decided to try Reebok DMXMAX shoes.  They have an air pocket in the heel and another in the sole with a tube connecting the two pockets.  The air transfers between the two as you walk.  So far, so very good.

[beenthere]

MM
Put a little whistle or tuned tweeter in those tubes, and play a tune as you walk.  : :
;D

[Magicman]

I did have a pair a few years ago that farted as I walked.  I foolishly drilled a hole in them to stop the air from squishing.  It stopped the noise, but ruined the shoes.

I won't be drilling holes in these.  I like the whistle idea, but I guess that I will have to do the whistling.   ;)

[trim4u2nv]

Found these shoes great for heel + arch pain and back pain.
$55-$139 on amazon.  Had heel pain for almost 2 years went away in about 2-3 weeks.  The back felt better also.  On my 3rd pair.  Have to order 1 size larger than my american size shoe.  The insole is removable and adjusts your heel lower and lower to correct your posture.

http://www.amazon.com/Springboost-Mens-B-Walk-Essential-Walking/dp/B000S5TOPO/ref=pd_sbs_shoe_2

[Magicman]

There is no question in my mind that the other half of our feet is the shoes and boots that we wear.

[Roxie]

Ron, I sure hope that pain injection does it's job.  Keep us posted.   

[doctorb]

I somehow missed this thread last year.  It exemplifies a huge problem in medicine - low back pain and its many causes.  Reading through the thread, some of you have degenerative disc disease, some have spinal stenosis, some have accompanying sciatica, some have posterior facet syndrome, some have sacroiliac disease, and some of you just don't know.  Pain in the low-back paraspinal area can have many causes, and can be very difficult to diagnose and treat.  Unless you are having neurologic symptoms, especially if they are worsening, let anti-inflamatories and time, with PT, weight loss, and good shoe wear, be the mainstay of your treatment.  These things often take protracted periods of time to improve, and can be life-style changing and frustrating.

[Ron Scott]

doctorb,

What are the neurologic symptoms to watch for?

[doctorb]

Pain can be 1) localized. That means there's a spot or area that hurts, and the rest is OK.  That pain is usually notneurologic in origin.  2). Pain can be reffered.  Arthritis pain of the hip is often reffered to the knee.  Pain from the SI joint is often reffered to the lateral thigh.  These pains do not follow the standard anatomical distributions of nerves, and are not neurological in origin.  3). Radicular pain.  These pains are the results ofnerve irritation, and follow the known pathways of the nerve.  A herniated disc in the low back can cause "sciatica"' and this pain follows the sciatic nerve down the back of the thigh and often results in numbness and/or weakness in the leg or foot.

So, Ron,in general you want to be on the lookout for a change in neurological function, usually evident by numbness or weakness in the lower extremities.  This can be subtle, and often is only found by someone who knows the spinal anatomy and looks specifically in all to the distributions of the lumbar nerve roots in the lower leg.  Sorry to sound so doctorish.  Example.  If you have a herniation of the 5th lumbar disc, you can get numbness in between the great and second toe.  This specific patch of skin is innervated by the L5 nerve root.  So, if you have back pain and numbness in that area, your doc should be looking for something that is irritating that nerve along its anatomical
course.  You do not have to have neurological symptoms to be having a problem with your spine.  Most people don't.  If you do, they may get better with treatment.  If they don't improve, then the dreaded back surgery looms on the horizon. 

[Ron Scott]

I had the second pain shot today to the facet joint. Feels pretty good right now.

[doctorb]

Ron

If you got relief from a facet injection, not a sacroiliac injection, then you certainly have a back problem and not sacroiliitis.

[Ron Scott]

I agree. VA doctor said that it was sacroiliitis a year ago, but further testing, MRI etc. says otherwise.

[Ron Scott]

The MRI Summary results were:

1. The lower four lumber discs are degenerated wuth disc bulge at all four lumbar levels.

2. Right foraminal/lateral disc protrusion is present which impinges upon the exited right L4 nerve root.

3. Left foraminal/lateral disc protrusion is present at the L2-3 level.

4. Moderate to marked stenosis of the canal is preasent at L4-5 with moderate stenosis at 2-3 and mild stenosis at L3-4. Multilevel mild to moderate formainal narrowing is also present as listed above with no sever foraminal stenosis identified.

5. Minimal grade I degenerative spondylolisthesis L4 on L5.

With this I was referred to a popular neuro-surgeon who wanted to schedule surgery soon. That sounded too soon for me, and I didn't want to put up with another long surgery recovery time, so trying some alternatives. Now the pain shots.

[doctorb]

Looks like you've got plenty of degeneration and disc protrusion and stenosis for a group of guys.  All that stuff on the MRI doesn't mean a hill of beans if it's not the source of your pain or neurological findings.  Before you think about heading to the OR, you need a second and maybe a third opinion.  Remember, we operate on patients, not their MRI's.  So a radiologic test should be confirmative of a clinical diagnosis and should not be used as the sole indication to cut.