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S1 and L5 vs. SI Joint, confusion!

Hi everyone,
     I just am wondering if anyone else is dealing with same issue. To make a long story short, 2 yeas ago I had extreme lower back pain and down my legs for no known reason. I am still dealing with pain today, not to the extent of when it started, but it has never fully gone away and still can't find work that doesn't flare it up. Last year I had MRI and the spine specialist said I have minimal bulging and it shouldn't be causing the pain. He diagnosed as SI Joint pain. So I've been treating it as that and even had SI Joint injections that did help, but not fully. Then today I went to get EMG from different doctor and she said left leg is effected by S1 and right leg is effected by L5. She seemed surprised and said her question is why this is happening at age 33. Now I'm confused because one doctor said my discs were fine and then this test shows it is related to discs. They want me to get a nerve block. My symptoms are: Pain in very lower back, down buttocks, side of thighs, sometimes front pelvis, down back of legs to feet. Worsens in the morning, very stiff, worsens when sitting, standing still, bending, and lifting. Gets better with walking and ice. Just want to see if anyone else can relate to this, thanks!


  • Hey, JM108!

    Have you had CT/bone scans done?  I ask because your symptoms sound familiar to what mine were--and nothing outstanding showed up on the MRIs or X-rays I had.  I literally spent years in pain, although the doctors I saw SWORE the herniated disc I had shouldn't be causing me so much trouble.  Well, it wasn't until my surgeon got me "on the table" that he found two broken bones (called a bilateral Pars defect) at my L5-S1 level!!  I was only supposed to be at L4/L5, but once he discovered the defect, had to fuse the L5/S1, too. This type of injury can and does often escape detection with MRIs/X-rays, and I sure wish I would've had a CT/bone scan so that the root cause of my pain could've been treated sooner.  I'm not, by any means, suggesting that this is what is going on with you--only a doctor can do that!!  What I am suggesting is perhaps asking your doctor if a CT/bone scan might be another tool to help point you towards an accurate diagnosis! 

    I wish you the best...I can understand how frustrating it can be when you're hurting and no one can tell you why.  Just a side note:  My surgeon hypothesized that my Pars defect may have happened in my adolescence when I was involved in gymnastics.  Wanted to add that in case you participated in any high-impact sports when you were younger? 
    Kimmy72, Spine-health Moderator
    Firm believer in PMA!
  • Thanks for your reply Kimmy72! Wow I can't believe you had to deal with that pain for years, I'm so happy you were able to finally find the cause! I never even thought that it could be a broken bone, I am going to ask my dr about this. At the time of the pain I didn't have any kind of physical trauma and I didn't play sports when I was younger. But 10 years before I was in a car accident where I was ejected from car and landed on the road. Not sure of this is related as it was 10 years earlier. Thanks for sharing your experience, I will definitely look into this!
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  • Thank you, Jm!  If I had a dime for every time I either heard, "It's not that bad," or worse yet, the insinuations that my pain was "all in my head", I wouldn't have had to use insurance to pay for the surgery!!  Yes, a high impact event such as the accident you described can lead not only to Pars defects, but compression fractures, too. 

    It's not like my pain just came along one day, and that was it.  There was no predictable pattern with either the frequency of the flares, or the severity of the pain.  Sometimes, I would experience a couple days of a dull roar that was easily handled with over the counter medications.  Other times, the pain would lay me out flat for 2-3 weeks, and I'd have to put in a call to the doctor for pain medications.  Bending even slightly forward during flares caused immediate agony, as well as attempting to touch my chin to my chest.   

    Another similarity?  The MORNINGS!!  Even with being on a good pace now with recovery from the fusion, mornings continue to be a bit on the rough side.  I joke with people that if they want to know what I look like in the morning, check out Darwin's theory of evolution poster.  It usually takes a good hour before I go from "all fours" to being "two-legged!!"  ;)  Before my surgery, if I woke up on my stomach, I knew I was in for at least a day of horrifying pain.  My only theory is it had to be the way my back was arched, but man, did that ever light things up in my lumbar spine!  Thankfully, I think my body must know on some subliminal level now not to flip me over in my sleep anymore...

    Feel free to ask about anything!  I'm always happy to share my experience in the hopes that it may help guide others into some productive conversations with their own healthcare providers!!
    Kimmy72, Spine-health Moderator
    Firm believer in PMA!
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