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herniated disk and SI Joint Injury???

shimano105sshimano105 Posts: 5
edited 06/11/2012 - 7:41 AM in Lower Back Pain
I am a Lieutenant in the US Army and have been injured for 13 months. Here is my story:

In SEP of 2008, I started a vigorous training routine in preparation for Ranger School. My training was pretty hard on my body. We did such things as 3 mile buddy carries where if you were not carrying someone you were being carried. We also did a lot of walking with 50+ lbs packs. There were other fun things but the point is the training was extremely hard on my back. I pulled my hamstring on a 8 mile march and had to pull out of training for Ranger School. The injury was not serious and I recovered in a month. In early FEB 09, I was walking my dog , got up from sitting in a twisting motion, and was in terrible pain.

I managed to walk back to my car, pick up my wife and go to the ER on Fort Campbell. The doctor gave me an injection to relieve the pain, declared I had pulled my back and was given muscle relaxants and Motrin. At this point the pain was all over my lower back to include my spine. The pain slowly receded over 2 months but remained in my spine and left lower back. Once I was well enough, I began walking and a yoga routine. Both helped my back out a good deal. I would visit the Army doctors once a month to be told I still had a pulled back. They really did not examine me to come to that conclusion. The Fort Campbell pool opened up in May so I hit the water since I was swimmer. Within 2 months the pain in my spine was completely gone and has never come back .

In July I transferred units which means I got a new doctor to look at me. He sent me to the physical therapy and the chiropractor. Physical therapy was disappointing; I was shown some stretches that I already knew to help my back and that was that. The chiropractor declared I had a "stuck SI joint" and adjusted me. For the 1st time, I was pain free. However, the relief was short lived and I was in pain within a day. I could only be seen once every 10-14 days by the Army's chiropractor so I decided to pay out of pocket for a civilian chiropractor. I have been receiving adjustments, muscle stim and ultrasound treatments ever since. I see a chiropractor around 2 times a week.

During this time, I have scoured the internet looking for all info on SI Joint injuries. I discovered a brace that stabilizes the SI Joint and requested I get one. It helped for a while but then started to hurt more as I wore it. You can imagine my frustration when the orthopedic doctor at Fort Campbell did not know what an SI Joint brace was. The civilian chiropractor showed me stretches to aid my SI Joint. I also bought an exercise ball to sit on to relive by lower back from the stress of sitting down for long periods.

In DEC I practically begged for an MRI and finally got one 10 months after my injury. The MRI results showed I had a herniated L5/S1 disk, a bulging L4/L5 disk, and a loss of spacing in both disks. There was nothing about my SI joint in the MRI. I continue to swim, use an exercise bike , walk and stretch to remain in shape. All my current pain stems from my SI joint being out of place. I can tell when it slips out of place. It has never remained in place for more than 3 days.

Things are very critical for me. The Army could kick me out because I cannot do most of the physical things required of me. The treatment I have received thru the Army has been more than disappointing. Next week I am going to ask for a second opinion from a civilian doctor. If that request is denied I will pay out of pocket and go to the orthopedic clinic at Vanderbilt in Nashville.

Thank you for everyone who takes the time to read this and feel free to ask questions.
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Comments

  • :H
    So is it currently your sacro-iliac joint that is painful or your lower back as well? I was a bit confused over that.
    I have a sacro-iliac and L5/S1 pain, it can be quite confusing to distinguish the two pains as they tend to overlap.
    Do you have pain going down your leg/s? or through your groin?
    It must be frustrating for you when your used to being so physically active.
    Good for you to keep looking for answers.
    There are more seasoned members who will be able to give you some solid advice and/or direct you to where you can find some good info.
    Best of luck and keep us posted on your progress.
    Kylie
  • Hi and welcome,

    First, I'm pleased to hear you pushed for an MRI.
    Combined with your story, they are telling as to what may be the right care.

    I think I've been told that if you are seeing an Orthopedic Spine specialist, you should look for someone who is Fellowship trained. I think there is a sticky on it under "back/nec surgeries" section or see a neurosurgeon.

    They will ask you about your pain.
    Is it mostly back or does it radiate down your leg(s). Do you get numbness or tingling in your leg or weakness?

    Also, what shot were you given? Was it a steroid injection?

    I understand how frustrating it is to be diagnosed only to find out from an MRI that the diagnosis may be slightly different.

    The one good thing I found is that there is a study (I'm trying to find the name of it) in which they randomly paid people off the street in their 30's to have an MRI. Of the MRI's, several "participants" appeared to have an urgent need for surgery but when they were brought in, they had no symptoms that the MRI would indicate they should have.

    So the point is...your story + MRI results will help the doctor provide a fair diagnosis and treatment plan.
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  • Bummer that the Army docs are not holding up their end of the bargain. I do know that they are spread a bit thin. A friend of mine is an Army doc and she is responsible for about 700 soldiers as their PCM. Makes your head spin thinking about it.

    The good thing is that you can get a second opinion and TriCare will pay for it. As active duty you are enrolled in TriCare Prime and if there aren't adequate specialists in your area, then you can request another opinion by a civilian provider. Contact patient admin as well as the TriCare office and they can assist you.

    Another option which you can explore, is other branches of the service. I don't know where you are stationed at currently, but if you are close to any Naval base or Naval Air Station, see if they have a base hospital. The Navy has some of the best Neurosurgeons in the world!

    As far as the recommendation for fellowship trained surgeons, most military surgeons will do a fellowship rotation at Walter Reed or Bethesda and they see a lot of different injuries and issues!

    I wish you the best and hope to hear you have success finding a doc you like, soon.

    "C"
  • immyali said:
    So is it currently your sacro-iliac joint that is painful or your lower back as well? I was a bit confused over that.
    Do you have pain going down your leg/s? or through your groin?
    At this point my pain is all SI joint. There is also a lot of tension and some pain on my outer hip too. I have what feels like muscle spasms going down my left groin but my stretches keeps that under control. I cannot remember the last time I had pain directly on my spine. Both back flexation and extension have worked well for me.
    immyali said:
    It must be frustrating for you when your used to being so physically active.
    Fustration does not begin to describe my feelings. Before this injury I was toying with the idea of a triatholon.
    DNice said:
    I think I've been told that if you are seeing an Orthopedic Spine specialist, you should look for someone who is Fellowship trained. I think there is a sticky on it under "back/nec surgeries" section or see a neurosurgeon.

    They will ask you about your pain.
    Is it mostly back or does it radiate down your leg(s). Do you get numbness or tingling in your leg or weakness?

    Also, what shot were you given? Was it a steroid injection?

    I understand how frustrating it is to be diagnosed only to find out from an MRI that the diagnosis may be slightly different.

    So the point is...your story + MRI results will help the doctor provide a fair diagnosis and treatment plan.
    Unfortunately with the military I do not have a choice of who I see. I was pretty mad when my extrays showed "something" in relation to my hip yet there was no follow up. My initial injection was something related to liquid motrin. I have tried to get a steroid injection but my schedule has been too hectic. I have gone away to Fort Polk 3 times for a total of 2.5 months in the last 5 months. This has caused me to miss 2 appointments for a consultation for steroid injections. Lastly, what got me irratated was not seeing a back specialist after my MRI results
    haglandc said:
    The good thing is that you can get a second opinion and TriCare will pay for it. As active duty you are enrolled in TriCare Prime and if there aren't adequate specialists in your area, then you can request another opinion by a civilian provider. Contact patient admin as well as the TriCare office and they can assist you.
    That is the next course of action for me. Next week I will approach the PA (physicians assistant) and ask for a 2nd opinion. Vanderbuilt seems to be a logical place for me to seek one. The issue with me is that this injury has gone on for so long the Army could kick me out. I have 10 years of service and want to stay in at all costs.

    Thanks to all for your questions and insight.

    Casey
  • Thank you for your service. I find your situation most disturbing in that your options are slim, you had to "beg" for an MRI, and if you don't get well in a certain amount of time, the Army may kick you out. In my opinion, this is not becoming of the best military in the world. Why do you guys have to kick, scratch, and claw for good healthcare? I hate that. Having said that, your options are likely going to be more injections or a double microdiscectomy depending on how the doctor sees your symptoms. I think it sucks that you would have to pay out of pocket to see a civilian orthopedic doctor. While you are waiting for you appointments, I would recommend going to a book store and reading the book, "Healing Back Pain Naturally", by Art Brownstein. He is former military and this books gives a heck of a lot of good stretches to help you with your pain. It describes back anatomy, his own personal story, and how stress can play into physical back pain as well. Also, read all of the reviews of his book on Amazon.com. Reading what people have said about his book will give you some hope. Good luck to you.
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  • I just ordered the book; I am headed out to the field for 10 days and will definitely have time to read it. Thank you for the recommendation.

    Here is the update on my SI joint. I transferred units which means I get to see a different doctor. He sent me back to orthopedics. The doc there was much more knowledgeable on the matter. He showed me the MRI and the bulge on the L5/S1 disk. The bulge was not pressing on the nerve which means the pain from my SI joint is probably not from nerve pressure. I must note that the MRI did not include my SI joint even though on the MRI request it said that is where my pain was coming from. Anyways he sent me off to get a CT which I had last week and will have the results on Tuesday. He also set me up for consultations for pain injections which will happen soon.

    Transferring units has been a Godsend. I am much closer to the pool so I swim 3 times a week. On non swimming days I walk and workout on an exercise ball concentrating on core strengthening. The pain in my SI Joint is at an all time low. Right now the pain is very dull. I have not seen a chiropractor in almost 2 weeks due to my schedule.

    That is all I have for now. May the CT scan produce something meaningful and thanks to everyone for your support.

    Casey
  • I'm a little late coming across your post, but I have a very long history of SI joint dysfunction and I just wanted to add one thing:

    In your initial post you said you were using an exercise bike. I would recommend discontinuing biking as it puts a significant amount of strain and twisting forces across the SI joint, and is generally not recommended for people with SI joint dysfunction. For me, I found that was one activity that invariably caused rotation in my pelvis and caused my SI joint to flare up.

    I hope your CT will provide some guidance to your doctors, and I'm hopeful that you will get significant relief with the SI joint injections. Best of luck and keep us posted!
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