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Sacroiliac pain after lumbar fusion

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:38 AM in Back Surgery and Neck Surgery
I'm 7 weeks post op two level fusion and I have been having moderate hip and groin pain and thinking it could be sacroiliac joint pain. It hurts when I walk roll over in bed and go up steps or walk up hills. I also have some thigh and leg pain again. I've never had this hip groin pain before fusion. I've read you can get sacroiliac pain after fusions but I wonder how they treat it after you have had a fusion. I'm worried this won't get better and sometimes the pain in my hip/groin so bad I can't walk. Sometimes my hips/groin area feels warm so I think I have inflammation and it happens to both sides . I've talked to the physicians assitance and he couldn't explain why my hip hurts so he just upped my meds until I see the doc. Does anyone know if this common and does it go away or get better. My post op xrays looked good so I don't know what else it could be.


  • of reasons for your pain. 1) did you have some of your own bone used for the fusion? They may have taken some from your hip, which would cause your hip to really hurt. They didn't take any of my own bone, but they did extract a bunch of my bone marrow to mix with the BMP, and it hurt like the dickens. 2) oftentimes, when the disc material is removed to put the fusion materials in, it takes some pressure off the nerve. We all think this is going to feel great, when in fact, it can often cause the nerve to become inflamed. After being compressed for so long, it takes the nerve some time to spring back. I had severe leg pain after surgery and was greatly relieved by some Lyrica. Other docs will prescribe neurontin or gabapentin. You might ask your doc if he thinks that is the problem. Especially in light of the fact you say the pain feels hot or burning, I'd say there's a good likelihood it's nerve pain.

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • At what levels was your fusion? You might need to have a steroid injection to calm things down. There are so many things right in the sacral/pelvic region that it is difficult to separate out what is the pain generator. There are many other options for what could be causing the pain.

    From your description of when it hurts, it sounds more likely that it is muscular or soft tissue causing the pain.

    It should be easy enough to have a PT or even the doctor put you through the tests they do to determine if there are SIJ problems.

    I think it is more likely that you either have some nerve irritation from the surgery or inflammation is pressing against the nerve. Nerves are very sensative and do not like to be messed with. Some let you know it by flaring up and being angry.

    It could also be soreness from the way you were positioned on the operating table. The table breaks away and the patient is sometimes placed in a position where the torso and head are on the table, but from the hips on down, he/she is kind of dangling down. This is done to open up the disc space to make it easier to work on. My femoral nerve was damaged during my fusion and I ended up with awful pain in the front of my thigh that is still not completely resolved almost two years later. Usually this kind of pain doesn't last nearly as long as mine has.

    Depending on how long you waited to have surgery, you have probably been compensating for the pain. The back muscles naturally grip harder to keep the body stable as they work to "guard" the weaker side. Both soft tissue and muscle can stretch and shrink as the spine is pulled out of alignment and the muscles become unbalanced.

    Now that you are surgically altered, all these tissues have to readjust once again. This can account for some of the new sensations you feel.

    I find it very helpful to lie on the floor several times each day. Lie flat on your back, knees bent, feet flat on the floor, with your arms close to the sides, palms facing upward. Keep your pelvis in a neutral position and the chin ever so slightly tucked. Breathe from the belly, long and slow and just relax. This is a natural form of traction that allows the spinal muscles and tissue to relax and for the discs to unload from the pressure of gravity. You don't need to stay in this position for more than five minutes at a time....I have been known to find a quiet corner in an airport concourse to do this exercise when I just can't walk any further.

    Try not to worry. I know how disappointing it is to develop a new pain after surgery. Talk to your doctor, who may know what's going on, but will probably profess he doesn't, or that he's never heard of this happening before. Chances are, it will go away in time.

    Good luck in your recovery. Remember to walk and rest, walk and rest, and do not try to do too much. Recovery is a long, slow process.

  • SIJ pain is quite common after L5-S1 fusion but not fusions higher up. Your surgeon and/or a good Physical Therapist can determine whether it is SIJs causing your discomfort and, if so, your PT should be able to work on your SIJs and fix the problem.

    I had SIJ pain after my L5-S1 fusion and my Physical Therapist was on top of it after a two sessions and coupled with exercises that she got me to do at home, the pain was gone within a month.
    Keep positive!


    ...an old timer here and ex-moderator

  • Hi there,
    I had an ALIF 7 days ago. It has already done wonders for my back pain and I am really pleased with the small horizontal access scar the vascular surgeon made ( it was originally going to be vertical until I got my way :)
    Anyway I do have a problem with constant horrible sciatica down the right leg, particularly when I lie on that side or sit or somehow 'stretch' the leg in any way. Its way worse than pre-op. Steroids and neurontin haven't helped.
    Has anyone else found this problem and if so did it eventually settle down? I just hope the exiting spinal nerve root isn't caught up somewhere.
    Many thanks and good luck to all of you !

    Age 37 female
    ALIF Oct 29 09 L4/L5
    Plastic fusing device/3 screws plus artificial bone graft
  • Thank you for your replys. To answer some questions they didn't use bone from my hip they used bone from my back when they opened me up and I had a l4-l5 fusion and they took my hardware out at l5-s1 where I am fused from a surgery 3 years ago and they also removed a bone spur at that level. I had adjacent segment disease above my fusion and I was wondering if maybe I have it below at the sacroiliac joint as well . I do still have left leg pain like prior to surgery but the hip and groin pain is new. Also I get abdomen pain with the hip/groin pain all on the left side . It is very frustrating because I'm suppose to walk but every time walk more than two blocks I start to get hip/groin pain along with a pain in my abdomen on the left side and I end up limping the rest of the day because I can't put weight on it. My appt. With doc is approaching but I'm just worried I'll get the what do you expect you just had major surgery quote. I've been through this three years ago and it just doesn't feel right and I don't think I'm recovering like I should. It's been almost two months now and I feel like I did before surgery.
  • I had a spinal fusion on 7-20-09 and have since developed ssi sever pain, i have started working with a PM dr who has done injections 2 different times,this week hws gonna give me what he called a super shot,and if it works hes going to burn the nerves,Has any one else Ever Had thiss done,and please ,,,,,,,,,,,,,,what was the out come?? I am a little more worried than i think i should be so all advice is welcome! Thanks
  • hi crazy-yes,I had a rhizotomy--burning of the nerves,on my right side. This is the side that was affected 2 years ago which led to my first fusion. After 2 si joint injections,the dr. did the rhizotomy,and I have not had any problems on that side since---that was this past summer.I felt relief within a couple of days---it is outpatient-they put you in lala land,and I didnot feel any discomfort--I hope this works for you!!!.........Jas-----the rhizotomy was the end result of me having si joint pain beginning about a year after my first fusion--so it is not unusual--but you are much sooner post surgery than I was---hang in there,and let us know---we are here!
  • Thanks Texas,I hope it workstoo ,because i was complainimg to my surgon after my laminoctomy in10-08,he never addressed the problem,just kept telling me i could not handle pain,and that i was gonna have to leatn how to handle some of it,,then the fusion on 7-20-09 it got worse and he was so aggravated with me,he thought all i wanyed was the pills,he finally sent me to pain managament DR. now he's Great and found the problem right a way,he's really working with me and at least he knows im not there just for PILLS!! I am glad you are feeling better,this is the worst i ever been in my life and want it to stop so i can get on with my life,sorry i talked your ears off,,but thanks again for taking the time to answer me Crazy (cheryl) have a good day
  • I had a 2 level fusion right at 2 years ago. I thought I was pretty macho and could stand any pain and would work through it. I was so wrong and found myself taking 1 step forward and 3 backwards many times during my healing process. I would think every surgery could heal differently like everyone on here talks about. I had alot of pain after surgery and had to start taking Lyrica which really helped with the nerve pain. I would try and walk on flat surfaces and avoid the hills and stairs. Laying on ice helped me more than ever and I still use it often when sitting. I too had groin pain and sometimes almost into my hips. I really think if you ask about some type of nerve medicine it will slow down some of your pain till you completely heal. Good Luck and just take a few steps back. Don't rush things and follow your doctors orders to a T.
  • i had L4-5 fusion on 1-7-11,after surgery i have that nasty groin pain that also goes into my right hip.The shooters that hit my right testicle stop me dead in my tracks.Doc seems to think i ture a mussle.No pt for 2 weeks.Hoping this dosent linger too much as I need to get around,at this time I can only get to the mailbox(Bout 200 foot long driveway just to get the bills since WC shut me down.That being said,anyone have any advise?
  • I have back pain since 2008, but now I have pelvic, middle abdomen pain since Mar. 2013 till now. I have seen many doctors, I have CT pelvic & abdomen is normal, but they don't know what happen in my pelvic. I just got the steroid injection last Wed. 9/10/14 it was help only 2 days and everything came back just like before. My MRI show I have L4, L5 & S1.

    Please let me know if anyone have the problem I have or advise?
    Thank you so much,
  • LizLiz Posts: 7,832
    This is a old thread, for best support and information I suggest you make a new thread in introductions, you can do this by clicking on 'create forum post' on the left column.


    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Hi had Tlif surgery 9 days ago .pain still a 10 . having right groin pain only when legs are elevated. Wonder where it's coming from. ,,,any ideas. Thx. This surgery is the worst constant pain I've ever had,
    James rinaldi
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