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Old 12-02-2012, 08:36 AM   #1
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L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

I have seen a bit about my issues on previous posts but nothing recently. I am/was an avid runner and have had a slight ache on occasion in my left lateral hip area for several years which generally gets better during a run; I've just lived with this. However about 2 weeks ago I began having much more severe pain both in that lateral hip area as well as slightly above that and a bit more medially in what I'd call the left lower back area. But most troubling of all is that I've developed severe "burning"/shooting pains along the lateral side of my left leg down my thigh and often into my calf. In addition my big toe and 2nd toe are tingling or numb. The pain is very severe at times and is the worst when I stand or walk for more than a few minutes. I also can't lie on my back which elicits the leg pain; so I've been forced to try to sleep on my side in a balled up position. Sitting is the only position which gives me any relief. Thus far I've only taken ibuprofen or tylenol with no real help. I saw a "sports medicine" family doctor specialist (in a group with a bunch of orthopedists) who did xrays and suspects I have an L5-S1 disc issue. She ordered an MRI (which I'm not sure how I'm going to do since I can't lie on my back without terrible pain) and physical therapy. I had sciatica on the other side many years ago and received spinal steroid injections which helped but this doesn't seem the same since I couldn't sit then and now I can't stand and can sit without pain.

I am hurting and very frustrated (and anxious to get running again). I am 62 years old and in otherwise in excellent health. I would greatly appeciate any comments or suggestions. Thanks

 
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Old 12-02-2012, 09:37 AM   #2
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Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

Hi p05, It seems that you do have a problem @ L5-S1. If you havent looked @ a dermatome map, there are many when you look them up. You will see the areas you describe the are served by the L5 nerve. When you had the steroid injection for sciatica where did they inject, put the needle? You may have muscle spasms that are pulling your nerve root over onto bone or a disc bulge, herniation, or just nerve root irritation. As far as the MRI! you should want to get it done asap to make sure exactly what is the problem &so it can be addressed & relieved asap also. You can request sedation to help you lay down in MRI tube, but you must request it @ time of scheduling it. They put pillows under your knees & you should try this @ home. Put 3-4 pillows under your calves/feet, pillows from under your knees down. This may help you with laying on your back & if your bed is too hard you may do better on sofa. Whether a disc or inflammation the symptoms are the same. Im very sorry that yours are so severe. The dr should give you anti- inflammatories, muscle relaxers & possibly something for pain if you call & relay the info on how badly you feel. I would not delay & i would see a practice limited to spine issues only neurosurgeon or ortho if this becomes an invasive procedure needed diagnosis or situation. I would try icing the area, protecting your skin from freezing, heating pad, hot baths, & get PT scheduled. I hope this helps some, I would call dr & express the severity of
what you have described here & get the MRI. Hope this helps you. Thank you, gmak

Last edited by gmak; 12-27-2012 at 06:20 PM. Reason: typos

 
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Old 12-02-2012, 10:53 AM   #3
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Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

Hi, sorry you are in so much pain. I have a similar problem but it is much more stable now (and I am an athlete). There are some gentle yoga poses that may help - try child's pose first. There is a type of belt that holds the sacro-iliac area stable - I find it really helpful when I have pain, it is from a company called Serola.
You may be different but I can move my SI joint when it is wrong and it usually stays right. If you lie flat on your back, you should be able to feel your hip bones are level. Sometimes one of mine is higher by an inch or so. If this happens I bend up both my knees and have my feet flat. Then relax and 'drop' the leg with the high hip out to the side and it clicks. Sounds dramatic and probably not good to do often, but it works for me.
Good luck.

 
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Old 12-02-2012, 12:02 PM   #4
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Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

SIJ problems do not cause pain to radiate down into the foot nor will they cause numbness or tinging. You are most likely having a problem with either the L5 or S1 spinal nerves, possible both of them. It may be a disc or there may be some other reason that the nerve is being compressed, possibly spinal stenosis or spondylolisthesis.

If you have the MRI, you will probably be able to determine what is causing the pain. However, the treatment recommendations will most likely be the same. Conservative treatment including a course of physical therapy to increase strength in core and back, perhaps oral medications and a round of ESI injections.

If you should suddenly develop problems with bladder and/or bowel control, or have a sudden muscle weakness such as drop foot, get help immediately.

These are signs of severe nerve compression that could become permanent if the compression is not relieved.

You may be having some issues with the SI joints too, but what you are describing sounds like classic lower lumbar nerve compression. I would suggest you switch to walking rather than running until you know what is causing your pain.

 
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Old 12-02-2012, 01:47 PM   #5
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Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

[QUOTE=teteri66;5098124]SIJ problems do not cause pain to radiate down into the foot nor will they cause numbness or tinging. You are most likely having a problem with either the L5 or S1 spinal nerves, possible both of them. It may be a disc or there may be some other reason that the nerve is being compressed, possibly spinal stenosis or spondylolisthesis.

If you have the MRI, you will probably be able to determine what is causing the pain. However, the treatment recommendations will most likely be the same. Conservative treatment including a course of physical therapy to increase strength in core and back, perhaps oral medications and a round of ESI injections.

If you should suddenly develop problems with bladder and/or bowel control, or have a sudden muscle weakness such as drop foot, get help immediately.

These are signs of severe nerve compression that could become permanent if the compression is not relieved.

You may be having some issues with the SI joints too, but what you are describing sounds like classic lower lumbar nerve compression. I would suggest you switch to walking rather than running until you know what is causing your pain.[/QUOTE]

Thanks teter. I figured it was S1 or L5; its just very frustrating and painful. I can't even walk more than about a block without the pain gettin too excruciating, so there's no way I can even consider running (althoughwhen I jog in place it hurts less than just standing there). I hope to get some answers and improvement soon and will post further updates. Thanks to you and the others who have offered advice.

 
Old 12-03-2012, 08:16 PM   #6
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Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

Well, today I saw the physical therapist for the 1st time. He evaluated me and then gave me a simple excercise (basically sway my hip away from the painful side 10 times every hour). He had me do lots of other things and seemed to think that was going to be the most helpful to start. I'm seeing him again tomorrow. The doctor perscribed some ativan and vicodin to help get me through my MRI (so I can bear lying on my back) on 12/5. I may be feeling a tiny bit better today so far...less tingling in my toes and a bit less pain...but I've pretty much stayed in my recliner most of the day. I hurt quite a bit for the 2-3 hours after PT and then walking to my car. I'm so worried that I'll never be able to run again, let alone be pain free. An additional concern I have when I get a lot of toe tingling(although I know it's a bit irrational because of my age) is that I might have Multiple Sclerosis (my Mother had it). Anyway, I'll repost after I get my MRI results and pray for good news.

 
Old 12-04-2012, 07:57 PM   #7
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Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

I would advise you to stay out of the recliner until you find out what is going on. It can bend you in the wrong places and cause more problems. The best thing would be to recline on the bed with pillows supporting the curves of your spine.

 
Old 12-04-2012, 08:22 PM   #8
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Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

Can't seem to do that. I've tried pillows in many places...under my spine, under my knees, etc. but no matter where I place them I'm still in severe pain in the supine position. The recliner helps because I'm sitting and not lying down...I don't recline it fully as I'm pretty sure that too would hurt. Even sitting in a hard chair is better than lying down. The MRI is tomorrow so hopefully I'll have some answers soon (if I can tolerate the MRI even with medication...she perscribed ativan and vicodin).

 
Old 12-04-2012, 11:38 PM   #9
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Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

You will do just fine. Relax. Let us know.

 
Old 12-06-2012, 08:02 PM   #10
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Unhappy Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

Well, the MRI was horrible (both in terms of pain and the results). It showed (among other things) under impression:
L5-S1 moderate broad-based disc bulge asymmetric to the left extending into the left foramen.Moderate bilateral facet arthrosis. Moderate to severe right and severe left neural foramenal narrowing.
L4-5 moderate bilateral facet arthrosis resulting in mild anteriolisthesis of L4 on 5.(and in the description of L4-L5:"Moderate bilateral facet arthrosis with ligamentum flavum redundancy results in mild to severe central canal narrowing."
And there was other stuff too. I only got this from the physical therapist who cancelled my appointment until I see the MD tomorrow and who also (at the MD's direction scheduled me with the pain specialist presumably for some sort of injection.

I am in severe pain whenever I stand or walk for more than a few minutes. Sitting is still okay except my big and second toe are now tingling or numb most of the time. No footdrop or incontinence. No help from any over the counter meds. And really no help from the vicodin and ativan they gave me yesterday for the MRI (except that it made me puke several hours later). I'm hoping the MD gives me something tomorrow for the pain because I really can't stand it much more. I've heard sometimes they give you oral steroids until you can get an injection.

And above all else I'm very depressed that not only can't I run now but I'm terrified that I may never be able to...I don't think I could live with that.

 
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Old 12-07-2012, 12:51 AM   #11
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Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

Hi Po5, Im truly sosorry that you are in such severe pain. I know what it is. I was a ballet dancer all my life, i loved it so i was still dancing when i sustained a severe injury at age 26. Exploded into pieces discs @ L4-L5 & L5-S1. After 4 surgeries to put me back together I married, worked in my career, had children and i never really missed ballet. After all it took to get my spinal fluid to stay in it would hurt and i had had enough of hurting. My son however had a bulging disc had one epidural steroid injection and the disc went back into place, perfectly &he finished univ on his soccer scholarship & is an avid golfer, runner and plays 3 team sports. So, i hope that all goes well with your dr appt tomorrow & if anyone mentions surgery, I would make sure that the dr is a board certified practice limited to spine only neurosurgeon or orthopedic surgeon. Thank you, p0506

 
Old 12-07-2012, 07:33 AM   #12
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Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

gmak, thanks for the encouragement.

 
Old 12-08-2012, 04:40 AM   #13
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Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

Well, I was started on prednisone yesterday (60mg x 3 days, 40mg x 3 days, then a continued taper) as well as robaxin (1000mg 4 x day) and my back/leg symptoms are a bit better. I was able to lie down on my side again and the numbness in my foot is a bit better. BUT, I had a headache all day and when I checked my blood pressure it was 198/103 (rechecked) and stayed high though slightly better most of the day despite me taking an extra dose of lisinopril which I have taken for years for BP. My blood pressure when I'm healthy and running has been in the range of 115/60 for many years. When the back symptoms started (before the prednisone) it was already a bit elevated (about 150/80) especially when I tried ibuprofen. Also I could barely sleep because I was "wired". I've decided to take only 40mg today and hope it still controls the pain because I can't risk such high BP. Anyway I'm seeing the pain specialist on 12/10 AM and hopefully will shortly thereafter receive an epidural steroid and won't need the systemic ones. This is so frustrating. A few months ago I was a very healthy, "young" 62 year old who ran 20 plus miles a week, ate well and generally took good care of myself (including crunches and other excercises regularly). Now I feel like a hopeless, broken down old man. Sorry to whine but maybe venting on here is some sort of therapy.

I'm also wondering what suggestions anyone might have for excercises/activities that I can safely do to keep some level of fittness when the pain subsides and once its gone (hopefully) what and when can I participate in. I feel so out of shape already. Thanks for any help in advance.

 
Old 12-10-2012, 05:25 PM   #14
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Unhappy Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

Well, I suffered through the weekend with my head throbbing and my blood pressure up. Also couldn't concentrate and had severe acid indigestion. I wasn't any better (blood pressure) after the 40 mg prednisone dose on 12/8 and took none on 12/9. I've increased my normal lisinopril dose to 45 mg from 30.The back and leg and foot pains did become more tolerable but I actually felt worse overall. Couldn't sleep or think straight. I saw the pain management doctor today at 9AM and at the time my blood pressure was the best it had been since I started the prednisone (163/88) and he said the epidural probably wouldn't have as many systemic effects (though he couldn'r guarentee it). He scheduled me to come back a 1:30 today for an epidural. In the meantime my pain was increasing in intensity again. I went at 1:30 but my blood pressure on repeated readings was about 190/95 and he wouldn't do the procedure. He said...see you primary care doc and get the BP under control and then come back. My primary doc said just see if it wears off. I'm not very happy, not to mention feeling lousy. I took a xanax which helped my BP pretty quickly (140/72) but after 2-3 hours that effect has worn off and it's elevated again and I'm in pain. Getting more and more frustrated and don't know what to do. Any advice will be appreciated.

 
Old 12-11-2012, 03:16 AM   #15
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Re: L5-S1 vs Sacroiliac Joint Pain and other issues in a Runner

Dear po506, I would call the primary &/or the back specialist and ask if its the pain or the prednisone making my bp go up and what is the next step. Hopefully, they can do something for the increased pain and the increased bp. Also, my husband got sick from the IV contrast dye later in the day. Have you tried the pain medicine again since the mri? And, i see you said your primary dr thought that you had to wait for the prednisone to wear off, did he give you any guidelines as far as your elevated bp? I hope that you feel better this morning.

Last edited by gmak; 12-11-2012 at 03:17 AM. Reason: typo

 
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