New question about connection between SI joint and leg weakness

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Discuss: when lower back complaints might be caused by the SI joint, how SI joint problems are diagnosed, treatment options for the SI joint, preventive advice, and more with the Spine-health patient community plus our physician faculty and guests from SI-BONE.

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Buela
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Joined: 08/04/2011 - 8:03pm
New question about connection between SI joint and leg weakness

Edited: I'm now thinking that I've had cause and effect reversed... please read second post.

For 10 months I've had leg heaviness and some tingling with pain very specific to my SI joint and down from there.

Two orthos shrugged after a clear lumbar MRI and said go get PT for lower back pain. Ironically, I didn't have LBP at that point, but now I do, even though my primary pain is still in the SI joint area, down my butt then down my leg -- which leads to my first question: Can an SI joint problem lead to lumbar/lower back pain? I'm guessing that it's simply from compensating for the pain, or maybe from 3 months of PT for lower back pain that I didn't have while ignoring the pain I actually had?!?

New primary doc diagnosed sciatica but treatment for that got me nowhere so he sent me to a pain management specialist, plus ordered a cervical MRI to placate me when it was clear that he didn't really believe that I was having the weakness and tingling in my arm that I was now describing. Pain management doc said he thinks it's SI joint problems and scheduled both a nerve test and an SI injection. Problem is, the next day he got my cervical MRI and immediately scheduled me to see a spine surgeon because the MRI showed that I have significant issues in my neck including a c-spine that looks more like a > than a C (twisted, kinked, backwards curve) with a hemorrhaged disk pressing into my spinal column, with evidence of myelomalacia. So I'm guessing that this is the cause of my arm problems, but are the problems in my neck the likely reason why my leg has been heavy/weak, or is the SI joint problems the likely culprit?

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Buela
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Last seen: 1 year 4 months ago
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Joined: 08/04/2011 - 8:03pm
The more I think about this,

The more I think about this, the more I'm wondering if I've had the wrong cause and effect in mind, with regard to my crazy symptoms.

So, I have to assume that the herniated disk pressing on my spinal cord is what is causing the weakness in my leg -- could the same nerve issues that is causing the leg weakness also be causing the SI joint problem? Could the loss of muscle tone in my legs also be reflected in the tendons around the SI joint, and that looseness be the reason why I have this SI joint pain along with the leg weakness? I remember the one PT that I had who was taking my SI joint concerns seriously (all the rest were just putting me on a generic low back pain routine), she said that it seemed to her as if the SI joint was ... I don't remember what term she used, but it was basically that it could either be too tight or too loose, and it seemed that mine was too loose.

So, probably related? Or not related and just happened to start at around the same time?

ohioispine
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Joined: 09/18/2011 - 3:06pm
Hello

In some instances pain along the region of the sacroilaic joint can cause weakness that is not neurologic such pain inhiibition weakness. However my concern is whether the weakness in the legs is associated with the cervical spine. Typically I would expect to see weakness in both legs increased with prolonged walking. Physical exam in the office may yield hyperactive deep tendon reflexes in the arms and legs with abnormal reflexes seen along the hands and ankles (hoffman reflex and ankle clonus). Do you have any bowel or bladder changes like accidents (incontinence)? However if the lumbar mRI does not chow any corroborative findings to suggest a pinched nerve emanating from the lumbar spine an atypical syndrome that can cause sciatic symptoms with weakness is piriformis syndrome. The electrodiagnostic (EMG/NCS) would yield qualitative changes to the muscles innervated by the sciatic nerve and if this is the case then a pirofrmis release would be the best option.

Your case is very interesting and there is alot that needs to be ruled out. Please email me with any other questions. Hope this helps. best

Amish R Patel DO, MPH