PLEASE HELP!!!!! I have been bedridden for 5 months. I am on my 17th treatment of Chinese medicine and acupuncture and i have no relief yet. They say i am a SPECIAL CASE!?! and i must be patient. Please tell me your experience with your SEVERE sacroiliac joint pain and if Acupuncture has helped. I am going to loose everything i have worked so hard for.
Have you been to see a spine specialist for an accurate diagnosis of what is causing your pain? Have you had a MRI or CT scan?
Sacroiliac pain is tricky in that it mimics that same or very similar pain that is caused by some other conditions in the lumbar spine...such as a herniated disc or spondylolisthesis.
I am skeptical that acupuncture will ever resolve your SI problems. I had acupuncture at least once a week for many years. While I think it works quite well for some things, I've never felt it was terribly effective treatment for a nerve compression.
I'm guessing since you are in bed it is because you have terrible sciatic pain probably running down your leg. I shouldn't assume things. Why don't you tell us what are your symptoms?
Being the Guy that i am, i thought this would pass. I did not seek a GP until the 2nd month of pain. I currently have no family doctor, i applied to heath care connect 3 months ago. As far as seeing an Orthopedic Specialist, the process of a referral is so much slower with a walk in doctor. Walk-in ordered MRI and here are the results.
Multilevel lumbar degeneration, including a right paracentral disc protrusion at L5-S1, which produces mild to moderate acquired central canal stenosis, and abuts and dorsally displaces the traversing right S1 nerve root in the lateral recess.
The SI joint disfunction is a self diagnosis from online research and from my own experiences with the pain. I have ruled out spinal nerve compression as the cause because i have absolutely no back pain in my spine. HOWEVER, i do have a lumosacral ligament in the upper part of my right buttock that is always inflammed, sore and it is the pathway of my sharp pain. This ligament runs on an angle from the lumbar spine to the illium crest. My sciatic pain has eased considerably to an uncomfortable burning sensation, much like the funny bone sensation. I know you can't believe everything you read online but these pains seem to be linked to the SI joint.
It has come down to making my own diagnosis and self treatments. I know this sounds ridiculous but ive been abandoned by the Walk-In GP who requested the MRI.
I can help explain a couple things to you. The reason why you are more comfortable when not standing on your feet is due to the central canal stenosis.
Before going into more detail we need to clarify a couple things about the spinal nerves. Obviously I have no formal medical training and I am not going to go into a great deal of detail, but a basic understanding of the nerves is helpful when dealing with back issues.
There are 31 pairs of spinal nerves that connect with the spinal cord through nerve roots and travel to specific parts of the body. These are broken down into the cervical, thoracic, lumbar and sacral areas. Each pair of nerves innervates a particular part of the body. The cervical nerves tend to innervate the arms and upper body while the lumbar and sacral nerves innervate the lower limbs and some of the big muscles of the "core."
For example if your big toe is numb, your doctor will know to begin looking at a problem with the L4 spinal nerve. This is because each pair of nerves is responsible for innervating a particular part of the body. This (the area that is innervated) is called a dermatome and you can look for a dermatome map online to see which spinal nerves innervate which area of the body.
It is important to note that you do not need to have a single bit of back pain to have spinal nerve compression. The nerve can be compressed, irritated or "pinched" as it exits the spine and you can feel pain at any point along the nerve. For example, sometimes people have tingling in their toes first, before they have any idea they have herniated a lower lumbar disk.
[B]Multilevel lumbar degeneration, including a right paracentral disc protrusion at L5-S1, which produces mild to moderate acquired central canal stenosis, and abuts and dorsally displaces the traversing right S1 nerve root in the lateral recess.
This indicates that there are changes of a degenerative nature at several of your lumbar segments. The one that seems to be the worst is a disc located between the L5 and S1 vertebra which is protruding, and is causing mild to moderate narrowing in the central canal. This disc bulge is taking up room that is needed by the S1 nerve, which results in the S1 nerve being pushed aside (displaced) by the disc protrusion in the lateral recess (think of the lateral recess as the exiting door for the nerve as it goes from the spine out into the body).
So, these sentences indicate that there are two potential areas where that S1 nerve is being compressed and/or irritated: in the central canal due to the stenosis (narrowing) and in the lateral recess.
Often when the S1 nerve is compressed, the pain radiates down the buttock and down the back of the leg. It can result in pain in the large muscle of the calf and can run down into the outside edge of the foot, into the little toe.
I had stenosis that affected my lower lumbar nerves, including S1. Prior to having surgery (and I put it off as long as I could), I was only able to stand for about a minute or two and I could only walk a very short distance before the pain became intolerable. I was driving down my driveway to the mailbox to get my mail. I couldn't stand to take a complete shower, etc. This is stenosis. Luckily, in my case, as soon as I sat down or lay down, the pain mostly went away...but, I was turning into a hermit.
It may be that your disc protrusion is such that it can heal on its own without surgical intervention. I hope that will be the case for you.
I have been referred to an Orthopedic surgeon. I am guessing that i am on a huge waiting list. Some people i have talked to seem to have their surgery just days after their symptoms arise. It's been 160 days and i don't even have a diagnosis.
18th treatment of Acupuncture this morning. They say and I quote " You are a SPECIAL CASE, you just need to be patient, I have 40 years experience with a very high success rate"
I personally think they are taught how to run a successful acupuncture business rather that how to treat illness. Do you think I am being taken advantage of?
I remember the burning sensation that I was experiencing during the consultation. I could not sit still. If i compare after 18 treatments, there is definitely an improvement in pain tolerability but this could be the 40 days that have passed.
Last edited by Administrator; 04-13-2012 at 09:54 PM.
Find yourself a TENS unit and a good physical therapist that understands muscle energy technique. My physical therapist has kept me working for a couple of years. Sadly, My luck may have run out.
One way I can tell if my SI joint is out of place - lie on the edge of your bed ( like you're reading a book ) take your leg and hang it over the edge and bring it back up. Mine will jolt the heck out of me when it's out.
Three things that might help.
Take a ball ( football, etc ) place it between your knees and squeeze for 10 seconds for ten reps.
Take a large gym ball and place your heels in the center while your knees are bent and your back is flat against the floor - inhale and lift your weight off the floor with your hamstings and keep your knees level. If your iliums are off this may help
Soft and easy pelvic tilts. Lie of your back and lightly breath out while you pull your belly button towards the ground. Inhale and return back. I do about twenty of these every morning. This helps me
Last edited by Administrator; 04-13-2012 at 09:54 PM.
The Following 2 Users Say Thank You to One day For This Useful Post: josh1982 (04-13-2012), Megin764 (10-02-2012)
My illiolumbar ligament is very inflamed on the right side. Pushing the abdomen as if i was having a bowel movement produces stabbing pain along the ligament upwards. Also, a burning sensation along the outside of my thigh almost to the knee. I wonder if a TENS unit would help with the ligament pain. Thanks for you response (one day)
[QUOTE=josh1982;4961187]My illiolumbar ligament is very inflamed on the right side. Pushing the abdomen as if i was having a bowel movement produces stabbing pain along the ligament upwards. Also, a burning sensation along the outside of my thigh almost to the knee. I wonder if a TENS unit would help with the ligament pain. Thanks for you response (one day)[/QUOTE]
I've had my SI joint issue for several years.
Last edited by Administrator; 04-13-2012 at 09:52 PM.
SO i took your advice and bought a Tens Machine. I made an X near the L5 S1 vertebrae and i works great for pain relief in the lower back. The leg and butt pain is still present.
It numbs the whole area for about 3-4 hours. I have NEVER had this much relief with my acupuncture. I am sure they will have something negative to say about the tens machine when i tell them how well it works.
[QUOTE=josh1982;4961599]SO i took your advice and bought a Tens Machine. I made an X near the L5 S1 vertebrae and i works great for pain relief in the lower back. The leg and butt pain is still present.
It numbs the whole area for about 3-4 hours. I have NEVER had this much relief with my acupuncture. I am sure they will have something negative to say about the tens machine when i tell them how well it works.[/QUOTE]
You very well may have some nerve issues with your L5/S1?
From everything that I understand sometimes an injury with that area can bring on the SI joint trouble. After several years I'm still having the same issues. For the past few days I've been taking the medro dose pack, Ice, and my tens unit. Everything seemed "ok" this morning until I started walking around the house. Just as soon as I place weight on my leg something pinches in the left sacro notch. The pain is kinda numb and with any twist it lights me up.
The one issue I see cropping up from 'alternative' medicine practitioners is many of them believe they can fix any issue, and that a person should not need surgery of any type. That is not the case. I have dealt with PT people, chiropractors, and others that think they can fix me completely. Those conservative methods have not fixed anything except for temporarily. In my case, it's time for surgical intervention.
One day - I think you are right about my L5-S1 disc and nerve root (not my S.I joint)
When i palpate near/around the facet joint at L5-S1 on the right side. I can increase the intensity of my burning butt/leg pain on the right side. I get the best effect when i am standing.
Be cautious when trying to diagnose on your own. My symptoms have constantly changed from one week to another. From a lumbar disc protrusion with S1 nerve compression to an iliolumbar ligament tear to piriformis syndrome to S.I joint pain and now back to a lumbar disc protrusion with S1 nerve compression. My MRI seems to be true.
I will assume your doctor had requested an MRI of the SI joints
One reason it is difficult to diagnose a SI joint problem to the exclusion of anything else is that it often is a weight-bearing problem. The person can be OK and then when standing or walking, the joint moves.
The SI joint, the way it is structured, has a very limited range of movement -- so when the ligaments are lax and the joint moves more than customary, percentage-wise, it is a great amount of movement. What often happens when a SI joint moves is that other surrounding tissue is effected -- often the piriformis will be pulled taut, or will be irritated enough that it swells a little bit. The sciatic nerve runs directly beneath the piriformis (and in some people, it actually runs through the muscle), so any irritation of the piriformis can also irritate the sciatic nerve.
Sometimes on a forum, I notice that there is confusion between the sacrum and the SI joints. The sacrum, which is located below the L5-S1 vertebral segment, is separated from the ilium by the SI joints. They are synovial joints, just like the knee, hip, etc. and are subject to the same types of arthritis, cartilage breakdown, etc.
Some women develop SI joint problems while pregnant, but the dysfunction does not develop until years later.
If there is a problem with the joint popping out of position, a physical therapist can teach a patient a quick exercise that will put it back. There aren't any muscles that hold the SI joints in position so while exercising the back and core does not specifically impact them, it does help to keep the entire spinal structure in alignment. Ideally, it is tightening up the ligaments that would stabilize the SI joints, but the only treatment that claims to do that is prolotherapy.
Often lower lumbar issues and SI issues go hand in hand. Any time the lower lumbar area is injured, the body tends to compensate for the injury. This results in muscle imbalances, and other soft tissue issues which can pull the spine out of structural alignment. This has a direct effect on the SI joints.
Or it can go the other way. If someone walks with a bad pronation, and has done so for his/her entire life, it takes its toll on the blocks of joints that stack above the feet -- namely, the knee, and hips. Often the pelvis is slightly rotated or one hip is carried higher than the other. (Did you know that the majority of people who think they have one leg shorter than the other in reality have hips that are not "level?") These things often result in SI joint discomfort or pain. So, as you can see, it can be caused by a whole slew of things and these issues are almost always interrelated.