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SI Joint, Tendonitis or Piriformis??....

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:26 AM in Back Surgery and Neck Surgery
I have hit a wall. I am 7 mths. post op. I can keep my walking at 2 miles in the a.m. 1 mile in the p.m but any time I try any low grade core stuff or even increased chores, I flare up for a 10 day stretch...have 6-8 good days if I am reeeealllly careful and then do it again. I have a really tight muscle in my lower right butt cheek. It gets tighter after I've taken my walk. I take Narco & Valium every 5 hrs. on the button and now Motrin 600 twice a day. Can't sit for more than 10 min. and I can't sleep on my hip-lots of pressure. I called the doc, he said this isn't the norm at 7 mths. Instructed me to take the previous meds. and have an appt. Dec. 30th and mentioned that it could be hip tendoitis, I've had my SI rotate in the past but now that it is fuse to L4 & L5, can that still happen? Or is it my piriformis riled up for no good reason? Anybody experience something similar-anybody get relief from anything in particular??


  • Hi

    How did your appointment on the 30th come out?

  • thank you for remembering and asking :) I am sooooo frustrated. My Dr. is on a 2 mth. stint to Afghanistan and his fellow is covering. His fellow thinks it may be hip tendonitis but didn't tell me what to do. He ordered a CAT scan but he hasn't called with the results due to the holiday. The flector patches have an antiinflammatory that helps to sleep but because they are a NSAID he wants me to wait until we see how much fusion we have before we do anything else. I saw the x-ray and it definitely looked to be fusing but the iliac bone runs right by there so he doesn't want to mistake the iliac bone shadow as fusion. All in all the office is a mess with my Dr. gone. He will be back Jan 9th but what kind of shape will he be in after being on an air force base in Afghanistan for 2 mths? Will he be able to focus on my isssues since his other patients probably have had issues as well? Should I, at 7 1/2 mths post op., switch to another OS...do I try a hip Dr. since the problem seems to be my hip and maybe my SI?? Do I try PT first? Any advise here guys??
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  • If I were you, I would investigate the SI joints, and the "piriformis pinch" before looking further into a problem with the hip. Everything is so interconnected in the pelvic region, and any inflammation can cause problems.

    If you can find a PT that specializes in spinal conditions, that might be a good place to begin.

    As you probably know, the sciatic nerve, after it exits the sciatic notch, runs under the piriformis muscle. If you have any muscle spasm in the piriformis, or any inflammation, it will press on the sciatic nerve and can cause a lot of pain. Also having tight hip flexors can contribute to this problem. Having SI joints that are not "square" (level) can contribute to the problem as well.

    I am having something similar and have been trying a variety of alternate treatments after having a couple diagnostic nerve blocks, etc. that did not help at all.

    If you could find a PT who really understands the spine, s/he could tell you if your SI joints are out of alignment, whether your piriformis muscles are tight, etc. Massage therapy can also help.

    If you were happy with your doctor, I think I would see him again after his return. You'll probably have to wait that long, if not longer to get in to see a new specialist and then you'll be starting all over. Some specialists won't deal with you if you've recently had surgery with another doctor.
  • Thanks gwennie. I so appreciate your help. It is so difficult to assess and monitor your own care when you're the one in pain and being affected by the decisions.
    I am so sorry you too are going through this; but it is nice to have a friend to go through it with. Let's stay in touch and compare notes. Maybe we can short cut it for each other. I have a PT I have seen for years prior to my surgeries. Her specialty is the spine but she comes from the 'manual' medicine perspective. A tight muscle means alignment issuess. There are some PT that go the opposite direction and feel the tight muscle causes the alignment issue and do not do manual therapy. I will get back her with the CAT scan results and then decide what to do. I feel like I am soooo close and this one little muscle issue is standing in my way; however, treated wrong could become a HUGE issue blocking my way....know what I mean??
  • Please let me know what you find out. I am 6 months post fusion (L4/5) and am experiencing the exact same pain. Any attempt at tightening core muscles, pelvic tilts, etc. causes a flare-up. (I get hip buttock, low back, and pelvic pain.) Also, after 15 - 20 min of walking it starts to tighten up in my left butt cheek and left hip. It is making me crazy. Lie you, I feel like if could get this fixed - or better - I would be well on my way to recovery!
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  • Carol:

    I am in hte same boat> I had a 2 level PLIF in Feb'08 and still ahve pain in the SI joint and shooting pains down my left leg. My doc says it's piriformis and has me doing chiro and excercises.The escercises hurt like heck!
    If the chiro doesn't help, I will have another ESI then nerve ablation.

    Frustrating ain't it?? :''( :??
  • 7 weeks after my (revision) PLIF L5-S1. Thought I was improving. The left buttock pain (piriformis tight, ache, burn, like a hot knife shoved into a ball of pain) kicked back up. PT says exercise. My heart says do nothing, since it wasn't doing this before I started PT.

    Almost 4 years of this. Don't know what to do anymore...
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