SI joint pain-Can you describe your symptoms please?

SI joint pain-Can you describe your symptoms please?

Welcome to Spine-health's Sacroiliac Joint patient community, sponsored by SI-BONE. SI-BONE representatives and health care professionals will join the discussion each week, sharing their answers and insights on Sacroiliac (SI) joint topics: 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. Learn more in: Could My Low Back Pain Be Caused By Sacroiliac Joint Dysfunction? Education Center on Spine-health sponsored by SI-BONE. SI-BONE is the maker of the iFuse Implant System® for minimally invasive surgical (MIS) sacroiliac joint surgery.

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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techgurl1988
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SI joint pain-Can you describe your symptoms please?

Hello, I am fairly new to the boards, been posting and reading the last couple weeks. I had a discogram done at 3 levels with concordant pain at L4/L5 and L5/S1 but the doctor doesn't trust the L5/S1 results because he thinks I was still in pain for the L4/L5 and could not tell the difference (I say it was concordant and I was NOT confused).

Anyway, my symptoms are burning pain at the top of the pants or let's say the belt line area. This radiates on both sides, like back of hips. It starts to burn worse towards the tailbone after sitting in an office chair for 15 min. In my recliner it starts around 20 minutes and feels like it is in my buttocks and tailbone. Again, it is a burning pain and if I feel back there, the skin is numb or tingling. I do not have leg pain but gluteus weakness like I have a hard time standing from a sitting position and the pain is temporarily worse in my tailbone area when moving from a sitting to standing position. Currently I walk with a cane and after 15 min I start walking funny due to back of hip groin pain.

The MRI for the L5/S1 area just says 1-2 mm bulge with Sclerosis noted about the articulate facets. See signature below for complete diagnosis. Mainly I am interested in others description of their SI joint pain. I also might mention that I have not been checked for SI joint pain, I have not had diagnostic injections to this area. Do you think they can do the injection without the steroids? I'm done with those!

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techgurl1988
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Anyone?

Sorry I just realized I left a pretty long paragraph above (second one)where I described my pain and didn't really ask the subject line question again so here I am again-

Can you please describe you diagnosed SI joint dysfunction pain? Please go into detail as far as is it being burning, stabbing, dull, sharp and the locations? Is it back of hip, middle of back, coccyx area? I wish I could put up an anatomical man and have you draw on it! Smile

Tracy,

Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
SI joints "messed up" not sure if I will get them fused at a later time
Had Open PLIF L4/L5 5/28/13
Woke up to permanent nerve damage in legs and feet.

chagland
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techgurl

The important thing for you and your doctor, is for you to describe and map out your pain and symptoms. Knowing symptoms of others suffering from specific maladies generally serves only to confuse and hinder the diagnostic process that doctors and patients go through.

It is easy to find anatomical drawings on the Internet. Print one out and over the course of a week or two, map out your pain on it and take it with you to your next appointment.

Best wishes,

"C"

techgurl1988
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Thanks

Chagland, thanks for the response. I see you are a moderator so I apologize if I have broken any forum rules.

I am one of those people that believe in being proactive and don't necessarily believe doctors have always got my best interests in mind. Not that doctors are evil, it's just that they are very busy and don't always listen while our bodies are constantly telling us something every second of the day!

With that being said, I have told my doctor repeatedly about my specific pain and he has not tried to do any diagnostic injection into the SI joint and has told me he thinks it is referred pain from the L/4 L/5 area. So I am giving him the benefit of the doubt and trying to research where others feel their pain, and specifically what type of pain. I realize mileage may vary, but I am a researcher, it's what I do Smile

I also have at least 50 different anatomical drawings on my hard drive since I work with doctors on developing reports for patients to fill out. I was speaking generally about having one for this forum where people could check mark their pain so I could gather the results (speaking only about SI joint pain).

If you know of any studies, I would love to read the reports. I have looked on the web and have found one pretty intriguing one, here is a portion of what it said:

"Slipman et al. (74) conducted a retrospective study to determine the pain referral patterns in 50 patients with injection-confirmed SI joint pain. In contrast to the findings by Fortin et al. (72) and Schwarzer et al. (30), the authors found the most common referral patterns for SI joint pain to be radiation into the buttock (94%), lower lumbar region (72%), lower extremity (50%), groin area (14%), upper lumbar region (6%), and abdomen (2%). Twenty-eight percent of patients experienced pain radiating below their knee, with 12% reporting foot pain. Based on the existing data, the most consistent factor for identifying patients with SI joint pain is unilateral pain (unless both joints are affected) localized predominantly below the L5 spinous process (30,59,72–74)."

Pretty interesting that 72% of SI joint pain was in the low back region which is consistent with what I have read here where people undergo a fusion at the L/4-S/1 region only to find out the pain is still there and later discover a positive diagnosis is made with a diagnostic injection into the SI joint. It makes me wonder why doctors aren't automatically checking or using the SI joint injection during diagnosing low back pain or at least rule it out on a consistent basis?

Tracy,

Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
SI joints "messed up" not sure if I will get them fused at a later time
Had Open PLIF L4/L5 5/28/13
Woke up to permanent nerve damage in legs and feet.

ouch2
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Hi Techgirl

I just read this post and I was in awe...your symptoms completely mirror my own. Have you had an SI joint injection since your post? If so did it give you any relief?
I have been very frustrated since I have had two lumbar surgeries in the last year and am still left with the same pain. I am now wondering if part of my problem could be my SI joint. I have so much burning pain in my sacrum and burning in my hips. At first it was only my left hip, but now it is both. I was diagnosed with coccydinia, and have a terrible stabbing pain when I stand after sitting...cannot sit for long.
When I lie on my back my sacrum area is very painful and it feels like the sacrum is going to break in half. My doctors have never mentioned any si problems on mri or xray, but have read on here that it can be hard to diagnose except with injection.
For those of you that have been diagnosed, were you diagnosed with injections and do my symptoms sound similiar to yours?
thanks all!

Hug Hug : Karen
L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
discectomy/lami July 2011-unsuccessful
adr L5-S1 Feb 2012

quicksilver
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Karen, we meet again

I had an L5S1 PLIF last July and I finally got my doctors to get me in for SI joint injections. I had them Monday afternoon. My sacral area was remarkably pain-reduced right after I awoke after the procedure! I went from nearly a 9 to a 5 in just minutes. For the first time in several years I found some real pain relief. After all this time, someone finally managed to locate a significant source of my pain.

My injections were a mix of lidocaine and a steroid of some sort. My relief was short lived as the lidocaine wore off that night. The next couple of days were more painful, as the doctor warned me they would be. Today I woke up and while I had my usual pain right above the pelvis (and up into my fusion), my SI joints were remarkably pain-reduced. I was at a 3-4 and felt a whole lot better. My day has seen a bit of an increase in pain, but not like I've been experiencing lately.

What makes this more amazing is that I woke up Monday morning in such pain that had I not had the injections that day I may well have called my doctors to tell them that I needed some disability leave. That phone call was literally just a matter of hours away. I have been in such constant and increasing pain that I was at my breaking point. I'm still not that far from it, but I am making some progress.

Michael

PLIF x 2 and still no relief. Currently in a disability holding pattern.

ouch2
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Well hello again!

Michael I am so happy for you that you experienced such a decrease in your pain right after your injection...to go from a 9 to a 5 is very significant. I hope that as the steroids kick in you will get some lasting relief.

Great that it happened for you at a time when you were considering disability leave and you now have hope. I have also been close to my breaking point lately, and have not been getting answers for my continuing pain. When I read techgurl's post I felt like she was explaining my pain. It gives me a hope that this may be a cause for my continuing pain. Do you also have hip pain and burning feeling in sacrum?

Did they say that the steroids could take up to a few weeks for you to feel the full effect? I look forward to hearing more about how you are doing as you progress. Did they let you know how often you can have the injection if it continues to bring relief?

My fingers are crossed for you that your pain levels continue to drop

Hug Hug : Karen
L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
discectomy/lami July 2011-unsuccessful
adr L5-S1 Feb 2012

quicksilver
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Karen

Thanks for your comments and support. My symptoms generally revolve around my hips and sacrum. As you've guessed, my sacrum often feels like it is burning. My hips occasionally feel as if a sharp stick has managed to find its way into that area. The maddening thing is that these symptoms come and go as they pretty well please. The only constant is a fairly sharp pain across the small of my back. Some days it shifts left and other days it shifts right.

The last two years have been a nightmare and the year just past (my post-op year) has been mostly pure torture. The best part is that my doctors have done their level best to try to wean me off of narcotics. Frankly, narcotics provide a very minimal amount of relief. I'd much rather that they identify the source of my pain and correct that! I'd be ecstatic if they could do that. I'd dump my pills in the toilet in a flash if I could find relief.

Michael

PLIF x 2 and still no relief. Currently in a disability holding pattern.

schoolgirl39
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SIJD symptoms

Symptoms can vary greatly from person to person. Mine started with lower lumbar back pain which progressed quickly in a two months time to leg weakness, si joint buttock pain, eventually going up my whole spine of stinging/burning pressure. It felt like my spine was being twisted and breaking! Eventually it was painful to even touch. It then progressed to where I was unable to sit or walk, then neurological symptoms followed, quick weight loss, vision changes, and severe tremors. Eventually became bed ridden only able to walk with a walker to get to bathroom. Husband and family had to care for me 24/7. MRI showed mild degeneration, arthritis, and I have scoliosis but Dr.s were baffled as none were significant enough to cause such symptoms or do surgery. Sent to pain management Dr. who prescribed steroid pack which did nothing, other than that she "did not know what to do". ordered blood test and other radiology of pelvis and head CT all negative. Also went to a rheumatologist who did full workup, all negative except positive for HLA-B27 gene marker that can be a precurser for rheumatic disorders. Finally went to orthopedic Dr. on my own who examined me and stated he thought it was the SI joint and to have pain Dr. do injections. Even though he diagnosed me he was not trained to treat. She reluctantly agreed stating " I dont think that is it" So I asked well then what do you suggest, she replied "I dont know'. I insisted she do injections to atleast try, her reply was " ok, but dont hold your breath". Had injections done with only local anesthetic as thats how She did them, which gave some relief in that area and quickly found another pain Dr. who thankfully was reassuring that she would do what it took to give me some relief. She scheduled me the very next day for injections with full anesthsia of facet joints in area of arthrits and again two weeks later as it usually takes two rounds. Through it all i was put on norco, fentanyl patch, Aleve for inflammation, flexeril muscle relaxers, and began taking Ensure mucle supplement, calcium, MSM, and glucosamine supplements, heat and ice also alternating. Slowly pain subsided some and I started Physical therapy with deep tissue message. Eventually the SI joint injections wore off and had to have them redone, again in two doses two weeks apart. Periformis muscle was also affected and injections were done in muscle which worked great. The injections eventually enable me to get back to walking without assistance, driving, and taking care of myself. But I was still limited as to time allowed up as pain would increase the longer i was up. Wanting to get back to work next month I finally decided to have the RFA (burning of nerves) at S1, S2, S3, L5 done just yesterday. And will have L4 and L3 done in two weeks. I am a little sore but nothing like the pain before injections. Injections have allowed me to get off fentanyl patch and I can manage with just Aleve some days or Norco once a day. I had ER drs. trying to put me on Valuim, and other pain meds and sending me home on four occassions before I found new great pain management dr. I refuse to keep being handed more and more pain meds and sent home! My first suggestion is to get injections in SI joints to see if it helps, I was nervous first time, but theay are really no big deal compared to the pain of SI pain. Can take up to a weelk to kick in but well worth it. I also found and consulted with another orthopedic Dr. who does treat SI joint and does surgery in case I end up needing it down the rode as a last resort. He confirmed to continue with treatment plan of new pain management Dr., injections, and or RFA, as this would also be his process first before considering surgery. Hope this helps and dont give up. You MUST be persistant with Dr.s and as I encountered it is difficult to find ones who treat this condition so do your research.

elise janssen

ouch2
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Hi Elise

Thank you so much for your informative post Smile How are you feeling now that it has been a few days since the RFA? I hope that it brings you relief. Is this RFA around the SI joint ? or Facet joints...or both? I had a facet injection once but did not have relief from it...even though I have moderate facet hypertrophy.
I really hope that my doctor will agree to give it a try and I can try an SI joint injection. I have had epiderals,caudal block, and facet injections...as well as two lumbar surgeries without relief of the burning pain in buttocks, coccyx, hips.I have asked about my si joints before, and was told they looked okay on MRI. The symptoms seem to match though...

Hug Hug : Karen
L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
discectomy/lami July 2011-unsuccessful
adr L5-S1 Feb 2012

finzzzup
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Elise...

Reading your post was like having a light bulb go off.. I have been treated for back pain this past year that seemed worse after my fusion.. Today I finally saw PM for the first time and he told me I have SI Joint problems that could be causing a lot of the pain in my hips and back (aside from the post fusion problems). I am scheduled fo an injection the 27th and am kinda excited to see if it does anything in alleviating the pain I have been under!

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