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3 years of pain

r_oxleyrr_oxley Posts: 1
edited 06/11/2012 - 7:58 AM in Sacroiliac (SI) Joint Problems
Hi all i have not yet read through all topics so apologies if this relates to any previous conversations.

In january 2009 i was involved in a car crash where a van hit me from behind after almost 3 years of pain and legal stresses, mdical examinations etc, a specialist who i saw for the second time around a month ago told me it COULD be my sacroiliac joint, i have read through other sites and majority of people commenting have only had this problem for days or months at the most. I have not seen anyone as yet where this problem has been ongoing for years.

The information i am after is can this problem be sorted after such a long period? as all the usual heat/cold methods stretches/excersises help for maybe hours or at the very most a couple of days of relief.

During my 3 years i have seen 2 specialist doctors, 2 pyscologists, 1 physiotherapist, 1 pain management specialist and my GP.

All of which have given me treatment (not for SI joint pain) but general treatment without success i am now told i need to see a chiropractor to help manipulate the joint from very little research i have read that they can "pop" the joint which provides relief but can just as easily "pop" back out again and be troublesome.

I have absolutely no idea about this and my main concern is obviously regaining full movement and to be pain free again so ANY advice at all would be a massive help.

Thanks, rob.
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Comments

  • It is important that we establish the diagnosis of sij dysfunction. The current gold standard is a diagnostic injection under xray guidance providing you with at least a 75 percent reduction of your painful symptoms with activities that typically increase them. If this is achieved then have the injection repeated one more time for consistency of results. If positive again then I would recommend a steroid injection into the sij with manual medicine with a physcial therapist, chiropractor or osteopathic physician. Hope this helps.
    Amish R Patel DO, MPH
  • In my experience, whatever the problem is, if it concerns the spine area, then I would think twice before you see a chiropractor.

    You need to have more investigations to ascertain exactly where the pain is coming from. Your specialist said it COULD be coming from the S.I. joint, but I think you need to know exactly before you embark on any treatments that may make it worse. If it's your S.I. joint only, then as the previous post said, steroid injections may confirm this if the pain is relieved for a short/long period of time.

    Obviously, everyone's pain is different and some people get great relief from having chiropracty sessions, but until you have had it confirmed, then I would exercise caution that's all. This is of course just my opinion, but I've had experience of chiropractors in the past and I believe my condition was made worse as a result.

    There is another way of confirming if the S.I. joint is the pain generator - which I only found out about last week - and I think it's called the 'Faber's test' - it's a physiotherapy manouvre. But here again, I do not know if it's 100 per cent reliable.

    Can you revisit your doctor and ask for more investigations to be done by a spine specialist or request a second opinion?
    SUE
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • Proceed cautiously. Though the SIJ injections should anesthetize the area, (the theory behind the differential injection), the anesthetic does not always reach the pain generator. That is, it has less than perfect sensitivity and and specificity. The perfect response (as a "gold standard") is a common misconception, and initially led to misdiagnosis in our office. We're cautious to look at all the data now. The FABER test (Flexion-ABduction-External-Rotation) test, we feel should be qualified by palpation.
  • It seems to me that the SI joint pain is less known about than other lumbar conditions (perhaps here in the UK, I don't know) and I've heard of some people being treated for all sorts of back-related problems over many years only to EVENTUALLY find out that it's their SI joint all along that caused the problem in the first place.

    How is SI joint dysfunction really confirmed?

    As I said above, my SI pain has increased since the fusion (more on the right, but now starting on the left also :( The pain totally went away for 24 hours after steroid injection last May, and the surgeon did palpate the area (OUCH!!!) as well as the Faber test. But is there any other examination/test that can definitely say if that's the pain source or not?

    I'm hoping that my next injection leaves me pain free for much longer, obviously, but failing that there's nothing more that can help as far as I know, in the UK.

    I've read on SH that in the USA they do an 'Ifuse' or SI fusion, or something like that - but I would not have another spine operation again and there is never a guarantee that any pain won't be made worse as a result.

    So I'm wondering. You know these spinal cord stimulators people on SH speak of - or internal TENs-like machines - can they be used specifically for SI joint pain? Would you know?

    Not sure who to ask about this, so if you have any further information, I'd be pleased to read about it.

    Thanks alot
    SUE
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
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