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SI joint dysfunction after L5 S1 fusion

AnonymousUserAAnonymousUser Posts: 51,464
edited 06/11/2012 - 8:23 AM in Back Surgery and Neck Surgery
Hi,
I am 28 year old and have undergone L5 S1 fusion operation for disc prolapse and spondylolisthesis.Its been 1 year 6 months now.As per doctor I am fused a month back.Now I suffer from pain in and around my left SI joint.My lumbosacral Xrays and MRI looks fine as per the doctors.But I still have lot of pain in my buttocks and SI joints.Also the operated area feel very stiff and heavy most of the times.Does anybody has any such experience after this operation.Any suggestion to alleviate the pain will be helpful.
Thanks!
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Comments

  • Hi,

    I have had a laminectomey at L4/5, 2 fusions, first L4/L5 and then 6 months later L1/L5. I am almost a year out from the last fusion but have been getting SI joint pain lately. I understand it is quite common as it is the first articulating joint below the fusion. I have tried accupuncture without much success and am having a steroid injection in about a week. I cannot sit its so painful. I do use a doughnut pillow/cushion and that helps some. I swim a lot and of course being weightless is wonderful. I also still ride my bike. I have a very narrow saddle and it seems to work as one of those sacro wedgie pillows where the pressure is taken off the SI joint. I have much less pain when I ride. I have had many steroid injections in my back, prior to my surgeries and none were effective. I hope this one will be different.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • That is EXACTLY what I am going through. I had a fusion at L5/S1 12 months ago and have been having a lot of pain in my back when I even do pelvic tilt, not even bending over. The worst thing though is the buttock pain. I just had my 1 year follow up with my neuro and they said that fusing that segment can put stress on the SI joints and I am probably experiencing some inflammation there. She said if it gets too bad, I can have ESI. I had never heard that before. I have other residual problems from my original disc herniation that caused Cauda Equina Syndrome which I am almost recovered from. I just have a lot nerve pain which I take meds for and numbness and tingling which I am used to.

    Val
    mybacktrouble said:
    Hi,
    I am 28 year old and have undergone L5 S1 fusion operation for disc prolapse and spondylolisthesis.Its been 1 year 6 months now.As per doctor I am fused a month back.Now I suffer from pain in and around my left SI joint.My lumbosacral Xrays and MRI looks fine as per the doctors.But I still have lot of pain in my buttocks and SI joints.Also the operated area feel very stiff and heavy most of the times.Does anybody has any such experience after this operation.Any suggestion to alleviate the pain will be helpful.
    Thanks!
  • I had a microdisectomy two years ago and six months ago i started to have spasms in my right calf and severe toe cramps. The doctor had me take a new mri which showed a reherniation at the L5 SI causing my spasms and pins and needles in my foot. He said unless I was in dire pain I should refrain from a spinal fusion and that the pins and needles in my foot would not get worse or affect my foot strength. ANy thoughts?
  • mybacktrouble said:
    Hi,
    I am 28 year old and have undergone L5 S1 fusion operation for disc prolapse and spondylolisthesis.Its been 1 year 6 months now.As per doctor I am fused a month back.Now I suffer from pain in and around my left SI joint.My lumbosacral Xrays and MRI looks fine as per the doctors.But I still have lot of pain in my buttocks and SI joints.Also the operated area feel very stiff and heavy most of the times.Does anybody has any such experience after this operation.Any suggestion to alleviate the pain will be helpful.
    Thanks!
    I have just been through the same as you and had SI joint pain. Prolotherapy has completely cured the ligament type joint pain but the nerve pain still exists
  • I had L4-L5-S1 fusion almost 5 years ago (early 2004) and never got the pain relief I was looking for. Continued to have extreme buttock pain and had SI joints adjusted through chiropractic 50 times per year. (I had a bad fall years ago on my buttock, and it gradually just got worse.) Was told by WI doctors there is nothing that can be done with SI joints. After researching it further, I finally had my right SI joint fused this fall with great success. It is a desperate move, and all other options should be tried first (as I did). However, there are doctors out there that specialize in SI joint fusion and there is a pretty solid test to confirm the source of the pain (SI joint injection). Just don't look for a specialist in WI.
  • I had a fusion done on L5-L6(yes, I have six lumbar vertebrae) and L6-S1 in February 2008 and I have SI joint pain. It feels like soemthing is pinching me and my buttocks feel as if there is a pen knife in them. My left foot still has numbness and tingling and I have spasms in my legs just before bedtime. My Dr. says my joint is inflammed and I have had flector patches and percocet. The next step will be chiropractic. I guess this is normal for our type of fusions.
  • Do you folks feel like your butt muscle is knotted in a small wad and if you could just cut it (which you can't), it would just release? Do you have pain & tightness along the lower edge of the sacrum? I'm wondering if the SI stuff is what I am experiencing?
  • Hello Everyone,

    Thanks much to each one of you for what you have shared regarding your experiences with the L5/S1 area/fusions.

    My L5/S1 have "slipped" (spondyloisthesis) and your info makes me better realize the risks involved with surgery.

    I certainly don't need more pain in that area than I currently have (about 1-2 with ESI).

    RichT

  • I'm very curious, does this affect your walking at all? can you walk without a limp? how many screws/rods did it take to fuse your SI joint?
    G.
  • Hi! I had the same pain in the bootie you all are talking about since just before my fusion surgery. It came back about 3 months after as well. It also spread to sciatica down my leg and a very swollen painful feeling in that side's SI joint. I have been diagnosed with piriformous syndrome which along with my back issues has been a major problem. It sound like some of you may have this as well, I would recommend asking your doctors about it. I got the shot(lidocane/cortisone) into the muscle(in the butt cheek) which helped not just the butt pain but also the leg and SI joint pain for about 2 months each time. My case is pretty severe and I may have to have a surgery for it. Carol, there is a surgery and they do actually cut the piriformous muscle. I will be having this if the next option (botox shot) does not work. Just my suggestion of what may be bothering some of you. Good luck!
  • I too am having the same pain in the right SI area and buttocks. I have nerve pain down my right leg and now it is going to left leg. I get the pins and needles feelings that goes all the way down go my feet which I didn't have before the fusion of L5/S1. I had an SI injection and trigger point shot in buttocks 1 1/2 weeks ago and it only lasted about 2 days and am waiting to here back from PM for next step. I am not glad that you are all experiencing this pain as I know it is very painful, disruptive of your lifestyle and frustrating, however, it is nice to know that others understand how I feel and that I am not the only one. I thought I was just being a baby. I didn't realize how many others are having the same issue after having a similar surgery.
  • Fusion of the SI joint causes no noticeable change in walking, flexibility, etc. :)
  • As to your second question: The surgeon first removed the rods and screws from my earlier lubar fusion, then added a rod (with 2 screws) to connect the fused SI joint to the previously fused L5. He also installed a small cage of some kind in the center of the SI joint itself that solidifies in the joint. Not sure of the actual terminology.
  • A friend who had fusion surgery had many SI joint pain issues. She got an injection followed by daily exercises from a PT who has lots of experience working with SI issues. The combination really worked for her!
  • That sounds like it - depending if it is both sides or not. If both SI joints are inflamed and local muscles spasm, the pain is more central across the top of the buttock/sacrum area. Otherwise it will be more on one side or the other.
  • Hi, it coincidentally happens that I just mentioned this in a response to another post. I had a 3-level fusion w/ lami in the summer - just went to my NS for f/u because of left leg, thigh, and buttocks pain...and yes, I was told that I have SI joint problem - arthritis, inflammation - none of which showed up 6 months ago on bone scans nor x-rays.

    My NS advised me that he has seen people with significant surgeries have such problems downstream - because your SI joint hyper-rotates (compensates for) due to lack of movement in the lumbar spine. You often hear that some folks need f/u surgery at higher or lower levels of spine after a fusion.

    It all makes perfectly good sense to me...

    Signed,

    Waiting for my knees to go next... :>
  • My SI pain did not show up on f/u xray and ct scans that I had after fusion either. The ortho sent me to PM because he couldn't understand why I was having so much pain and the PM was the one who found that I was having the issue in the SI area. He did say that I should have PT and manipulation after the injection and was going to refer me to a specialist who does the manipulation and can prescribe extended release pain meds and that doc was supposed to get a hold of me but I haven't heard anything. I keep calling PM doc to f/u and get refill on pain meds and his assistant is not returning my calls. I didn't have a problem with him before but his other assistant, whom I loved, was promoted to another position so maybe this girl is the one dropping the ball. I keep saying I need someone to call me back before christmas because I know I will be in more pain since I will be more active than usual with wrapping presents, cooking, cleaning, playing santa, traveling to family, putting toys together etc. Oh yeah and I am watching my neice and nephew (twins) who are 6 over christmas break for my sister because their daycare is closed. They are a handful when they get together with my 6yr old son.

    Merry Christmas and Happy New Year!
  • I had afusion of the above for spondylolisthesis this was 1976 I had 4 months of work and returned to truck driving and heavey lifting.My fusion was a trans..... something
    meaning bone was scooped out of and placed either side of the area to be fused.
    Pain stays with you but not the feeling of being twisted or
    in my case right leg problems knee/ankle and muscle wasteage
    I found a brace to be of benefit for stabilizing I wore this for 6/9 months it was like acorset with 2metal rods in
    the back 2 connecting ties under the groin front to back.
    As for the comment about movement this op does reduce hip movement (elvis impersonaters be aware)I had to learn to walk and running wellthat took awhile.
    What to look forward to;the possible forefoot numbness S1
    (mines completely dead) muscle wasteage my (calf 10mil thigh
    abit less)I also in dec 08 had ctscan and found S1 L4/5 disc's now bulge into the nerve canal and theres aslip forward its been over 30 years which is very good no intervention needed.
    To sum up try the brace that made areal difference my
    surgeon arranged that before I left hospital as part of the
    healing/therapy the S1 fusion has the least problems the higher the fusion the more likely for further surgery
  • I had this procedure after spodylethesis in '01.

    the first couple years sucked but the exercises are the only thing that will strenthen the errector spinnae and other muscles back there and got me off the NSAIDS on a regular basis; ya gatta get off the drugs; there are side effects from all that stuff.

    Anyway, I whitewater kayak, rock climbed , ice climbed, ice skated, biked I do everything i used to do starting about 3-5 months post op, but really pain free in about 1 1/2 years post op.

    My main complaint now is the clicking of my SI joint as I turn when hitting driver off the tee. OUCH!!!

    So it appears I gueard that movement and don't fully slide into my stroke and release my club properly without a lot of thought.

    The clicking is my SI joint saying stop...

    When it does get loose I can swing right and rip it 220-240. Ah, to be young again. I do a lot of stretches for the errector spinae, hamstrings and abdominals. rarely do i take any drugs or muscle relaxers, unless sometimes ZANAFLEX ( short acting ) clears fast....

    anyway, hope I wasn't too off topic...but your back will get better. Like I said i do everything i used to , except maybe throw a baseball cuz i can't pivot there like I used to....
  • SI Joint pain is quite common after L5-S1 fusion surgery and I suffered from this too, after my L5-S1 fusion.

    Seek treatment from a Physical Therapist who specialises in lumbar spine rehab after surgery (you are probably seeing one anyway, if you are on a formal rehab program after surgery). Specific physiotherapy manipulation of the SI joints over a few weeks, together with SIJ mobilization exercises that you can do at home, often helps. This cured my SIJ problem in a matter of weeks.
    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

  • I had L 3/4, 4/5, L5/S1 and one more screwed/fused in 3/08 and have recently developed that knot/lump in left cheek along with SI discomfort! What has happened in your world since your posting - any progress on yours or suggestions for mine?
  • SIGuy just saw where you had an SI Fusion, I had one in Feb of this year and OMG this is soo much worse then my lumbar fusion L5S1. Just wanted to know how much recoup time it took for you and if theres anything that helped you or didn't help you?

    I have a preplanned trip to Disney that was planned over 2 years ago that is in 3 wks now and really starting to get scared that Im gonna be miserable the whole time, other then when I'm in the hot tub..lol

    Any info you can give me will be greatly appreciated..

    I also do have home care, I have the nurse thats comes and helps with showers and a Physical Therapist that I wish I could take both to Disney with me..lol
  • I am hoping to revive this chat. I had si/L5 and l4/l5 fusion 8 months ago and now have severe SI joint pain. Can't sit. Can't work. I have done shots, a lot of PT, and now am trying nerve ablation.

    Has anyone had success with SI joint fusion? any drs. recommended? Esp in CA?
  • I am hoping to revive this chat. I had S1/L5 and l4/l5 fusion 8 months ago and now have severe SI joint pain. Can't sit. Can't work. I have done shots, acupuncture, a lot of PT, and now am trying nerve ablation.

    Has anyone had success with SI joint fusion? any drs. recommended? What else worked?
  • I am horrified. I fell down the stairs 6 years ago and have been in a nightmare ever since. (also was in a car wreck and got horrible whiplash which lead to occipital nerve entrapment - that has been really fun.

    I took another tumble over the holidays when I simply was not paying attention at the Titantic Exhibit in TN and stepped off the curb, turning my ankle badly and bam, I was staring at the pavement. It twisted my ankle, leg - hip terribly. I have been in horrible pain ever since.

    The SI JOINT came from the fall and I have been BATTLING it for a long time. The things I do that help are: TENS UNIT - DMSO OIL MASSAGE (good hubby) - ICE ( I live on it)- exercises that stretch that buttock muscle where it feels like a KNIFE has been inserted. If you look on web you can find great you tubes and info on GOOD EXERCISES...though one stands out. Lie on floor - pull knees up. Cross one leg over the other bent knee and grab the leg on the floor and pull gently. It is an awesome pull on that muscle and I can get relief IMMEDIATELY. It was DISLOCATED in fall and now they are wanting to do a FUSION - I've heard awful, awful things about them - and that they lead to other problems up the spine. I already have a TON of other problems up the spine, but cannot live like this any longer. I have serious, serious GROIN PAIN with it now. It is CRIPPLING !!!

    The spurs at L 1-2 causes pain to wrap around my waist and into my abdomen. Had an Epidural in Dec. 2011 and it helped immediately.....well, almost immediately, but side effects were scary. Lost control of my bowels 3 hours later and I could not move my legs immediately. They were JELLY for about 10 days. They would only shave the spurs. This abdomen and groin pain are the worst of the worst. I'd rather my BACK hurt than the referred pain to my abdominal area.

    I am horrified of back surgery....said I'd never have it, BUT.............You all already know about that as I have read what many of you have been through. I also have SEVERE FIBRO - am 63 and in terrible health, so cannot imagine what it would do to me, but I also can't imagine walking without SI JOINT pain and abdominal pain from L 1-2. I have had 3 injections in C-1 and and one in C 5-6 (lost use of my arm). I also had an SI JOINT Epidural and it did help for a long time. Had inguinal nerve entrapment and had that nerve blocked too. No words to describe that pain. I could walk immediately after nerve block.

    My hubby has shoulder next Thursday. A torn rotator cuff - almost torn off....he doesn't even know how, but thinks it was lifting the generator by himself. HAPPY 2012........we have it going on. I have learned so much from reading from you all. Thanks for sharing. Discussion boards are a wealth of info and I appreciate this one so much already.

    Does anyone here have FIBRO also ? Have you had surgery ? How did it go ? I would appreciate more info from ANYONE. Sorry to be so long, for those who are STILL with me. :-) THANKS
  • I had an L5-S1 fusion about 18 months ago. It wasn't until about three months after the surgery that I began having SI pain. I didn't even know what an SI joint was. I felt I was recovering well from the fusion but this new pain cropped up. I'll never forget telling the doctor about the pain that had started there. I was standing up with the big gown on and he walked over and asked me to turn around and pushed in just the right spot, saying "is it here?" and I just about hit the ceiling. When I landed, I turned around with tears in my eyes - it was so painful, but I was shocked that he went right to it in spite of the big gown. But, it confirmed his assumption. Like many of you, he indicated that it can happen after this surgery.

    He suggested and I went ahead and got an injection - I had relief within a few days and have felt great since. I occasionally will get a tweak of pain there, but nothing to write home about (although I just did). Good luck with your SI pain and I hope you find a way as successful as I did to get relief.
  • corexccorex Posts: 2
    edited 08/28/2015 - 12:11 PM
    hi people wondering if this is "normal"" i have a fusion 1 month ago and this new pain from my left hip is kicking me very strong , beside the regular pain and discomfort , also i notice numbness when i laid down from my left leg, is any one have something similar ? advice ? i know is early from surgery buy i though after surgery a better feeling will start showing . thanks

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