Discussions that mention acetaminophen

Back Problems board

Hi - your pain sounds just like mine. I've been injured for 7 mos, but I have a great Physical Therapist who know all about Sacroiliac joint disorders - malignment of the pelvic bones. So many people don't seem to know much about this, and the ones who do always say it's underdiagnosed. Maybe it's what you have, so here's what I know if it helps.

Here's what's I've learned. Your Ilia (the two big hip/pelvic bones) can upslip, tilt forward (anterior) or back (posterior) - and they can curve in or out. It's usually due to some movement or accident that stretched or tore the ligaments that hold the ilia to the sacrum (base of spine). Mine was most likely the result of some lunges at the gym that I should have used lower weight to avoid bad form. When these pelvic bones move, even a millimeter can cause terrible pain, but cannot usually be seen by xrays, MRI, or an inexperienced examiner (inexper with SI Joint alignment). My Dr will do a phys exam & tell me I'm in alignment when I know I'm not, and then later that same day my PT will confirm I'm about a millimeter tilted forward. It's so painful because the piriformis reacts by tightening to try to hold things stable, and the sciatic nerve runs under or through the piriformis, depending on the person - so you have muscles doing the wrong thing right by the huge sciatic nerve...hence lots of pain. I even get gynecological pain at the worst times due to other nerves being affected (feels like a UTI but three tests confirm it isn't). Lots of people have types of groin pain I hear.

The piriformis tightens in attempt to hold things in, and that tightening creates pain and often extreme tenderness in a band from the center of the glutes to the hip. (uhg.) I get that pain on both sides even though my injury is on one side. Muscles work hard to try to compensate for things being off.

Get a Manual/Physical medicine doc to refer you to a PT who is familiar with Sacroiliac Joint Disorder. They know how to feel that you're are out of alignment. Further, they use Manual Physical Therapy to correct you. Immediately relief usually results, or after a few days when inflammation goes down. Strict attention to posture and movement can help prevent going out again, but it depends on how badly the ligament is stretched. I may have to try prolotherapy - they inject sugar solution or other substances into the ligament, which causes collagen to grow - it heals. (Ligaments don't heal easily on their own due to little blood supply.) I just bought a sacral wedge to lay on throughout the day - I'm trying that before anything invasive. I also tape my back and use an SI belt in addition to lots of core, glute, and lat exercises. The plank seems to get at most of these at once.

And personally, I believe any NSAIDs are bad news - why stop the inflammation that is part of the healing process? Try acetaminophen.

And in the worst of times, I take a prescribed muscle relaxant, skelaxin, which lets the muscles settle and hurt less (and I don't know, but the tightness may exacerbate the malignment as things are pulled around in there).

Have you been to PT? My doc can't tell when I'm "out" but my PT can. They have "smart" fingers.

Oh yeah - I had muscle blocks - injections of numbing med - and it never changed the pain. What I have feels like mechanical pain - like my parts are working in the wrong fashion. The nerve and piriformis pain comes afterward and are the result of maligned pelvic bones (nerves and piriformis are not the cause in my case).

I'm not better yet, but at least I have lots of tools. What all have you tried?