Melissa,
I am having the same problems, just wondering if you had the surgery or did you continue with PT. Sharon

Did you end up having surgery? I'm having problems with my si and was wondering what is out there for treatment. Thanks, Sharon

SI Joint surgery
 

Oh boy did I! The first time I was referred to Emory Hospital in Atlanta. (I live in Charleston, SC) I went first for a consultation. I was scheduled for the complete pre-op workup about a month later. By this time I was told that the joint ws flail. I had one leg about 2 inches longer than the other. The did like a SI joint block under fluoroscopy but without pain med and with dye. They needed to see if the pain was exactly duplicated and what the joint looked like with dye running through. You know the joint itself is very difficult to see. Afterwards, I went to a neurologist in the same building for a nerve conduction to see how much nreve damage or nerve root was involved. I also met with Vicki Mims who put the joint back in place. I got up and walked around to see how long it would stay and it didn't. While I was with her, this gorgeous young woman came in to meet me. She was about 20 years younger than me and a former soccer coach. After the surgery she could no longer do that kind of work but her recovery seemed wonderful. She was walking without assistance.
I went into surgery the following morning and , let me tell you that was the most painful experience I had ever had at that point. It was a very difficult recovery. I was under the impression I'd be out of work for 6 weeks, use the walker for around 3 months and then graduate to a cane for about 6 months. It was honestly not a good experience at all and regret it tremendously. Is the pain better. Excuse the expression but HELL NO X 10. First of all I will never have surgery by a surgeon that is 400 miles away. The physical therapists here, despite being given a specific protocol, seemed unnsure and really weren't sure what should be expected in terms of results. Eventually the pain returned with a vengeance, worse than ever before the surgery. There just happened to be an orthopedist who had a special interest in the treatment of this area and had some experience with this problem so he was kind of my last resort. After an MRI,Cat scan, it was determined that the pins were moving which meant the joint fusion had not healed. He was not at all optimistic that things were going to get better but he did offer me a surgery using larger pins and the removalof about 4 square inches of sacrum, ground it up and mixed it with bone cement. Again, this is not for the faint of heart. It was considered salvage surgery because by that time I was hardly able to walk. Well, I am now one year post op from the second surgery. Still walk with a cane but on really bad days I still use the alker. Pain is better controlled but I still use a long acting opiate as well as a short acting. To give hime credit, he told me to expect recovery to last anywhere from 6 months to a year. I am better. Just starting to get back to work. (I only work 6 hours a day). I'm terribly sick this week. I've tried to use less narcotics and have been using too much ibuprofen. I have several ulcers, so I'm week and sick. Oh yeah, my last x-ray one year after surgery showed that the fusion has healed still. This may be something wrong with me though by not being able to gro new bone. I had a cervical fusion about7 years ago and it took twice as long as it should for that to grow.

If I had it all over to do it again, the non-expert orthopedist here in Charleston would have been my first choice over the guy in Atlanta who is supposed to be such an expert and will tell you he has never had a failed fusion. Bells sould have rang then, failure to fuse is not necesary a reflection of the surgeon, it just sometimes happens and I didn't feel I was given a really informed consent and the possible complications or failures.

I'm never going to be the same again but then I couldn't live the way I was before. Way carefully how you are now and then find out the HONEST possible results afterwards. I am not happy with things but now that the pain is allowing me to do more things, I know it was probably the only way I could ever get around and 2 years later(since the first surgery) I am starting to get some of my old self back. I rode on the back of my husbands motorcycle Saturday and I never thought I woul be able to do that. It just takes TONS of patience.

new member post
 

Does anyone out there with this problem (post surgery) have difficulty with joint areas still "locking up" and with being able to "manipulate" the area into "moving". This is what I am experiencing. I have ongoing pain, with the tendency to relieve it a bit when it "crunches" as I move it around. Does this mean my fusion is unstable? I just had a CAT scan and xrays that the doctor says reveals that the fusion is "fused." Could this be a misdiagnosis? Also, what are the other possibilities? Torn scar tissue? Torn or sprained ligaments/tendons? I had lifting to do before the end of the school year, had several personal "movings" to do at home this summer, which all have resulted in chronic pain again with these SI joints. What do you guys think?

Post SI joint surgery
 

I'm a year post fusion and my last x-ray implicated that the fusion was still not complete. I sometimes get a slipping feeling associated with a click like it's goingg back into place. How long has itbeen since your surgery?Whee was itdone? The doctors all seem rather evasive about the soundness of the fusion. I wonder if I'm still growing bone ir if you just heal so much and that's it? I do seem to feel a bit more stable.My surgeon said to epect a 6 mont to a years recovery time.

lindamae
 

I have a SI dysfunction and I can't handle the pain anymore. I was at the point of thinking maybe SI fusion is what I want to do. But after reading your entries I don't know what to do. I have no life or hope. Help me I am so discouraged. lindamae

Gosh do I understand how you feel.A lot of people have had better success than I did. Its a year now since the 2nd attempt and I am still on long acting opiates and probably always will. You should make your decision after having speaking to a surgeon who SPECIALIZES in this. Most are very discouraged by the results yet I met a woman older than mself (I'm 51) who has done very well. It is a very hard recovery. I have to admit I am starting to feel somewhat better as my doctor is getting more aggressive with pain management. I work part time 6 and a half hours a day and have actually made 3 full weeks in a row. I've also had a lot of setbacks. I probably had a mild stroke while under anesthesia so I fell quite a few times, 6 weeks postop I totaled my car (shouldn't have been driving), now I'm dealing with a GI bleed due to Ibuprofen which is why I think they are pushing the pain meds. Right after the surgery I lost my beloved pet and the stress of the years of pain really has taken a toll on my marriage. I may have done better if he understood more and was more supportive. You will really need some to care for you for about a month almost full time. This is notone of those surgeries here the sooner you get up and walk the better. In fact, its quite the opposite. I am starting to get up but I will never be the same. Don't give up. Talk to a qualified surgeon, maybe two. DON'T GIVE UP!!!! Write to me anytime (my e-mail is eynon@musc.edu) I sure could have used a support person and I would be glad to be yours.

Wondering how GA was?
 

Hi there,
I'm new at this forum thing so forgive me if I'm doing with wrong. But after reading about your discussion about going to GA, I'm really curious of how things went with Vicki and Dr. Weiss. I live in Idaho and had an injury 6 years ago that damaged my SI joint. After lot of pain and research, I finally got Vicki's book and number. I'm currently planning a trip there myself. I would feel more at ease if I understood the process better. Just wondering how and what everyone is doing. Lindamae

Has anyone found any good exercises or stretches for SI / low back/gluteus maximus pain?

I have something in those areas that comes and goes and lots of under the skin stiffness or {fascia/myofascial} tightness.

I don't have any zaps or shooting pain down the leg- just more in the SI area and spreads into the butt cheek muscle.
more of a moderate discomfort then sometimes a moderate sharp pain and a low level throbbing.

chiro can fix it up, but it eventually keeps coming back after I do something to flare it up and it is bothersome for about a week or so.

I do have some hypermobility issues , I think this is part of the reason it keeps returning.

Have a look at this website Jo*Mar.
http://www.spine-health.com/wellness...nt-dysfunction

This page has an exercise regime specifically for those having problems with their SI area. If it's not what you're looking for... try searching the site from their home page. I found most things I was looking for were well covered, so tend to think it's a very comprehensive site.

While checking out this particular link, I found what I thought was probably the root of my own lower back pain and the terrible nerve pain I've been experiencing in my buttock and thigh recently, and when I mentioned it to my physio today, he totally agreed with me. I now have a much better idea of what I'm dealing with.

Help me I am so discouraged!!
 

:confused:That is sooo where I am right now also. I just had a second injection in to my left SI joint on Friday. Today is Sunday and I can't hardly stand the pain. No position is comfortable. I am doing anything I can to find out more about this surgery, cuz I am afraid that if I have it done, I will 1) feel worse than I do now or 2) be unable to do the few things that I can still do now.
My life for the last year has been so down hill. I am only 50 years old and my 77 year old father has a more fulfilling life than I do!! I don't feel well enough physically to do anything. This pain is life draining. But I also don't want to end up in some rehab center at this age. I want to LIVE again!!!
Some one there please give us a ray of hope. Also discouraged...Cindy

Hello all this is my first post. I'm guessing from previous that most members are in the US. I live in the UK so as you probably know the whole medical treatment system is totally different.

I am 30 yrs old and have suffered from SI pain for about 8 years. I don't think it was a direct result of some injury, it just kind of crept up on me It has been getting progressively worse to the point now I take pain medication almost every day. I would say that mostly the pain is bearable but now and then I have episodes where I am in agony, I cannot get in or out of bed or vehicles, it is extremely painful to walk, I cannot bend or raise legs to put socks etc on and strong painkillers don't really seem to help. These extreme episodes used to be few and far between but are becoming more and more frequent.

I have been treated by two chiropractors and two physiotherapists over the years and whilst they provide a little bit of short term improvement, I have still noticed worsening of the condition overall. The past few times I've seen my GP I have just been prescribed more painkillers and muscle relaxants (which only help to a certain degree), but never any diagnostics or long-term solutions. I use a SI belt now and then but find it only decreases pain by approximately 10%, if that.

On my last visit to my GP I basically said "enough is enough', please refer me to a specialist, which they have and I have my appointment on the 26th Oct.

Sorry for the long post but my question to fellow sufferers is what would the long term prognosis be for this condition? I have a job which is physically demanding at times and although I have never had any time off because of my pain, I am now starting to notice it affecting my work. I hate to think what position I'll be in if the condition continues to get worse at the rate it has been.

Many thanks.

mbhall99 and kaydee

I would love to know your experience with Vicki Sims.. did it help??? very desperate miself.. Please share ur experiences. Thank you. GB

My low back sacorilliac Pain
 

My symptoms began in 2008 after a jumped a farm terrace on a snowmobile. The snowmobile and I were airborn, as the sled hit the ground, I hit the seat, in the seated position, I hit hard, it jarred my upper body. I have suffered from low back pain ever since. I am unable to sit stand or walk without pain.
On July 1st of 2011, I went golfing after 3 holes, I was unable to continue due to severe pain in my lower back on the right side of my spine.
On July 3rd I began limping, which is a new symptom. The pain was servere, I called our local Dr on July 5th, went to see him, he scheduled me for an epidural injection as I had 1 in 2010.
July 18 MRI showed a 2mm buldge at L4~L5 but was not erffecting the sciatic nerve some mild degeneration.........
July 29 I went to my Dr in Des Moines ~ still in pain
August 5 ~ Epidural same place, this one seemed to help a bit
Sept 23rd went to the local Dr, again severe pain
Sept 30th Epidural same place
Oct 13 back to my Dr in West DesMoines, no improvement my right foot is now numb and pins and needles, also the right side of my female area is numb ....
Oct 31st went to an Orthopedic Surgeon ~ he looked at my MRI, and had bacck xrays taken, he didn't feel surgery was necessary as the nerves were not affected buldge on my disk and he suggested another MRI
Nov 7 MRI ~ now shows 2 perferated discs and 2 buldges ~ none of which show they are touching or pinching the nerve also some narrowing of the spinal canal
Nov 29th went to a neurosurgeon, he set me up for an EMG
Nov 30th EMG
Dec 1st back to the neurosurgeon~ EMG showed the nerves were working properly
I showed him om my back where the pain is the worst, he said, "that's your SI joint" ...
Wow! After all of this.... he recommends an xray of my right hip/pelvis
Dec 6th xrays
Dec 9th ~ my Drs nurse called, they xrays do not show any issues

Tomorrow, I go back to my Dr ..... I have no idea what is next. I have had no "life" since Sept 23rd, pain, depression, confused, what is wrong with me, why do I limp so terribly, why am I in so much pain, and nothing shows up on xrays or MRI????

Any suggestions?

Hello!
 

Hi, I hope you don't mind me replying, my name's Charlotte and I was diagnosed with Sacroiliac Joint Dysfunction a few months ago, I'm only seventeen years old so it's really difficult to keep up a part time job, and college and applying for uni this year whilst getting on with my ack problem. It's apparently quite rare for someone to get it so young. I really struggle with it and was in hospital for three weeks, they told me it was all in my head and they had done EVERY hospital check, but referred me to the pain clinic and within half an hour I was diagnosed, it was really hard for me, being a teenager and taking tramadol like their smarties is horrilble, it really gets me down and even though I try joke about it it makes me want to cry as I can't do normal things like every other teenager on the planet. I had my injections 2 days ago and they have stopped the backache, but i'm really worried because my stomach has bloated and become rock hard and I have a constant ache in it. I'm really struggling and will ring the hospital tomorrow if it doesn't calm down. I was so happy to find this forum as no-one I know has this disease and so it makes me feel like I'm not alone!!!:)

Botox injections instead, after ten years it's not SI
 

Hi. I've been getting injections for over ten years and they really didn't help. All this time I was told and thought I had lumbar spine problems and other SI issues but this year my pain doctor hit the spot. It is piriformis syndrome. The medicare approved solution is very painful surgery to cut the muscle. The actual best method as I understand it is a simple botox injection. I am changing to a doctor that has lapriscopy in his office because the surgery center and hospital won't allow the injection and I don't want my pain doc shooting blind. Will post with results in a couple weeks. I haven't been able to sit, walk, stand, or even lay comfortably for a very long time. I've missed funerals, weddings, church, and countless other things. I hope and pray this is the cure!

Welcome to the room and the forums
bellatrixblack, and hiatthome

I have had these symptoms for over a year. But just started to do physical therapy yesterday. I also do messages because I have fibromyalgia. I hope that bella, you will work through the issues. And come back often. Being so young you can handle this. Please do call the hospital and your doctor tomorrow if you haven't already. They need to know what is going on.

Also see if your doc would allow you to do some PT to get some exercises to see if you can get some other relief.

Donna:grouphug:

I've had SI joint pain for years & years. Chiropractor visits didn't help very much. The very best thing I've found is these exercises:

Well, it won't let me post the link. Google Richard DonTigny and click on the Kalindra rounds.

Doing some of them every night keeps the worst of the pain away.

Hope this helps you! :)

I've dealt with severe SI joint instability for six years. Mine was because of a work related injury. I knew something was wrong because I could not place any weight on my left leg. That night I went to see my Dr. who took me off work for one week and gave me pain pills. The next day my daughter called my name ( I twisted ) her direction and down I went. My whole back gave out. I spent the next three day in the ER with clean MRI'S, XRAYS, etc. They just said "we don't know what is wrong with you."

Because of the " I don't know " the Workers comp company denied my claim and my doctors were denied any treatment. So, we were foreced to sell our house ( before we lost it ) and move.

After we had moved I started my own rehab program at the gym. Something was really wrong! It kinda fealt like a wrench was turned sideways in my pelvis and I could not stand without a weight belt around my hips.

Anyhow, because of money issues I was forced into finding another job. With the help of body bracing ( anything that kept my pelvis from moving ) I worked for about six months. Then It gave out again.

We never understood waht was going on because every one said ( pt's,chiro's) it was my lower disc. And the spine doctor would always say it was not. So, I was left with no answers at all.

Then one day somebody told me about this PT that helps people at the hospital. When he first saw my pelvis he said " your sacrum is twisted "

After all this time:mad: I've been working with him for three years and I am better..but, not good enough for our needs. I still can't sit for over twenty minutes, etc. With the help of a personal trainer I was able to get my muscles back working again. But,,,,nothing is keeping my si from moving around. I've had several injections that have helped for short periods of time.

Two neurosurgeons have said I have "sacroiliitis" over these last three years. But.. the treatment is always the same. Injections just don't help instability.

I started working with another doctor that deals with lumbosacral issues. And after doing several test he wanted me to have a CT guided injection deep inside both si joints. This test not only helped it showed my whole issue!
According to the CT scan I have severe scoliosis and bone spurring in both joint. The DR the did the CT scan and injection said he knows of a doctor at UCLA that can help me? He said I have severe SI joint instability causing the scoliosis.

Sorry for the rant and any spelling issues.

I really don't know what way to turn? I want my life back

sacroiliac joint
 

His guys

I have had possibly some sort of SI problem for 3 months now, i had had lower back ache for a month or so but thought nothing of it, as everyone gets back ache, then one evening went for a quiet drink with my friends, returned home about ten, started to play poping some bubble wrap with my feet, within an hour I could nt move, my partner had to assist in getting me to and of the loo.

Was in complete agony in my entire lower body lower back, hips, bum, thigh and calfs with sharp shooting stabbing pain radiating all over in about 3-5 places at anyone one point in both hips, thighs, calfs and bum and bed riden unable to move for about a week or 2.

after a week or 2 complete bed rest, I attempted work, I work as a designer which envolves sitting straight for 8.5hrs a day, this was impossible as I could only manage about 20 mins at a time before I was reduced to tears, so after 2 days was off work again and back to the docs.

after a while I finally managed to return to work on reduced hours, slowing uping my hours as time went by from 3-6.

have seen 4 different doctors and a physio, and have good and bad days. Im finally booked in for an MRI just to double check that, I am receiving the best treatment, and that it is SI problem and not a disk, due to teh amount of nerve pain im getting, as after last week my first full week of 8.5 hours sat solid and physio on friday my nerve pain returned with vengeance, so have been of work since. I currently have no life, as I only have so many hours of activity I can do, so my hours have been spent trying to work meaning, no cleaning doing the washing or cooking when i return home, you can imagine the state of me and my house.

I live of tramadol, and naproxen which makes me out of my nut and sick, but I have no option. I have already lost out on promotion due to this problem and being of my head attempting an interview. I need to get better asap so I can think about getting a new job. It gets you very very down and I spend most of time, either a. of my nut or b. in pain and crying. This is also not helping at work because it has left me with a shorter fuse then normal.

Im so desperate to return to normal life asap and even sat her for 20 min typing this has given me my nerve pain back down my legs I only find laying helps to ease it, well somtimes, But as you can imagine, you can't lay at work, can't lay to do washing/clean, lay to meet your friends at the pub or club. Im so sick of this and just want to know if other sufferers have found any treatments that really help, get ride of this problem.

I have been called the durecell bunny before, as im the sort of person who is always doing something up and about, cleaning, sorting seeing freinds, love to go out and dance the night away, to having active fun jumping around playing with kids. For me this life im leading at the moment would be my idea of hell on earth. being pretty much bed/sofa bound, im not a lay and watch tv person.

If anyone has tried any treatments that help to mend this problem, I would love to know about it. I really am desperate to get myself better asap

Sacroiliac Joint
 

Hi BellatrixBlack,
I know it's over a year since your post but I am hoping you are still checking this forum as I would like to know how you're getting on because your story is similar to mine.
I have suffered with SI joint dysfunction since I was little due to a heavy handed midwife pushing my hip the wromg way when she checked them just hours after my birth.
I couldn't do forward rolls, jump a hurdle etc when at Primary School and like you I was told it was in my head. Luckily my parents pushed the doctors to investigate further because they believed me although when I was 18 I was told to come back when I was 50 for a hip replacement!
I managed with anti-inflammatories and physio for many years until in 2002 my L5 disc became prolapsed (because of the SI joint issues) and I then couldn't walk at all because of the pressure it put on my SI joint.
My hip feels like it doesn't fit properly, abit like if you took the leg off a barbie doll and out it back on sideways...it wouldn't fit and that's how my hip/SI joint has felt for as long as I can remember.
I finally was diagnosed with SI joint dysfunction in 2003 but I was also told had the doctors got it right when I was 18 they could have manipulated it back but due to the disc problems I now have, if they tried to manipulate it there is a high chance my spine will react by unwinding and I will end up in a wheelchair!
I've had injections and tests but I've not found any that gave good enough pain relief.
I now have Fibromyalgia, IBS and a sleep condition (similar to narcolepsy) and a swollen foot all of which are side effects of taking strong pain killers for many years.
I delayed taking morphine for 4 years but I now take 38 tablets a day including Oxycodone.
The Oxycodone does help more but every morning I struggle to get out of bed due to the pain and I struggle with work and with everythng I do. I use a stick when walking and an SI Joint belt but I try not to use the belt too much because I don't want to become reliant on it.
I would love to have SI Joint Fusion Surgery but I've read so many dufferent stories of people still having pain after surgery and when I was first diagnosed by GP told me to be careful of anyone saying they can cure me and avoid surgery unlessy could guarantee I would be cured.
i would love to hear from you or anyone else with SI Joint Dysfunction who has had similar or different experiences to me and if anyone has had surgery and it's been successful, please let me know.
Thanks
Rach

Hi aussie, I also live in Australia and suffer from sij disfunction and have done for 10 years. I have been told by soo many doctors that nothing is wrong with me and that its all in my head though a Physiotherapist told me its my sij I recovered about 60% but cant seem to recover any further. my research shows that no one in Australia is specialized enough for this disorder and vicki sims in america, who I have emailed seems to be the top person to see. Though like you im unable to sit for a long time but im seriously considering drugging myself with sleeping pills and pain killers to be able to sit for the trip I would do anything to make this horrible pain go away.....forever!

I have heard by many that the surgery doesn't help if it does it doesnt help much. I had a belt but save yr money they move and come undone and uncomfortable. I have had prolo therapy and it helps but for me I found no perminate relief. I have done all the exercises given to me with some relief and some improvement but nothing seems to be perminate or repairs me to pre injury. I have done my research and there is a lady in America named vicki sims she is the leading person experienced in sij disfunction, currently there is noone in Australia :( (if you're in america your lucky)

I am a new member. Thank you all so much for your informative posts and a very informative article.

Years ago in my 20's I was T-boned which resulted in a bad whiplash and left SI joint dysfunction. Then 8 years ago, I was in my little car and was rear ended by a big truck, which totally flared up my symptoms.

It does not take much activity or carrying of loads that are too heavy for my SI joint to go out. I end up going weekly to physio, which helps short term but doesn't last more than a few days.

When my SI joint goes out, I do get pain right at the joint. But it feels like my entire spine gets twisted like an old dish rag. I feel absolutely exhausted, have insomnia, bowel and bladder changes, and I get massive headaches which just do me in. I then feel cognitively compromised and have a hard time thinking straight.

Does anyone else have symptoms like these?

I also wonder what has been the most helpful treatment for people. For those of you who have had surgery, was it worth it, and did it help?

Thanks so much in advance.

Island Mist Woman

SI joint pain
 

I would like to ask those of you that have had an injection into the SI joint, did that help?

I see it mentioned that you can even do a RFA for SI joint pain.. but where do they do the ablation?

Seems like that would be a nerve and the SI joint injection is an injection into the joint itself, but what nerve does the ablation work on?

And thanks for the tip regarding DonTigny, some of those stretches seem to help and others can't do.

J.

FYI: my pain is at the left hip and to the left of my spine on the SI joint.

herniated and dripping disk L5/S1
herniated L4/L5
cervical herniation C5/C6

SI fusion
 

Hello out there!
I had a right SI fusion done back in 1995. The recovery was 4 months! Not to frighten any of you, as the technology has come a long way since then. I was not allowed to drive, walk or even touch my my toe to the ground for three months. Thank the lord I was young at the time, and had all of the finest Doctors here in Denver watching over me very closely. At the same time there was talk of fusing my lumbar spine from L-3 all the way to S-1. I dodged that by having the SI done first. I will never be out of pain all together, but the surgery did allow me to continue to work, and as a single mother that was a priority.
Now that many years have gone by, the SI is acting up again, along with my lumbar problems and the newest gottcha which is my right hip. It now needs a total hip replacement.
10 years after my SI fusion, I did a little research and found that a huge percentage of SI fusion patients had terrible problems with the hip on the same side as the fusion. The surgery is different and better now, but ask questions!!

si joint pain i have suffering for 3yrs
 

I have had pt inujections epiduals surgery and nothing has helped. My doctor said there was nothing else they can do for me. I also have a stimulator in my back for cronic back pain. I feel I have no quality of life and all my friends have disappeard. I use a cane and a scooter, I can not stand for more than 10 minutes at a time.
been denied for disability and think about sucidie all the time. The ony thing stopping me is husband. I feel trapped and alone. QUOTE=GJZH;96790]I was wondering if anyone has Sacroiliac Joint Dysfunction and if you have it, did you have surgery for it? Has the surgery been successful? As I read more about this I think this might be a part of my pain and problems since my surgery. When I read this article it describes my pain, during the night especially. I really do not want more surgery. If you have had surgery, has it been successful for you? This seems like a very big surgery...I was wondering the success for it. Does anyone know?

A Patient's Guide to Sacroiliac Joint Dysfunction

http://www.eorthopod.com/eorthopodV2...f61e50b/area/5

http://www.eorthopod.com/images/Cont...nt_intro01.jpg
Introduction
A painful sacroiliac joint is one of the more common causes of mechanical low back pain. Sacroiliac (SI) joint dysfunction is a term that is used to describe the condition - because it is still unclear why this joint becomes painful and leads to low back pain. Sacroiliac joint dysfunction can be a nuisance but it is seldom dangerous and rarely leads to the need for surgery. Most people who suffer from this problem can reduce the pain and manage the problem with simple methods.

This guide will help you understand

how the problem develops
how doctors diagnose the condition
what treatment options are available
Anatomy
What part of the back is involved?

http://www.eorthopod.com/images/Cont..._anatomy01.jpg

At the lower end of the spine, just below the lumbar spine lies the sacrum. The sacrum is a triangular shaped bone that is actually formed by the fusion of several vertebrae during development. The sacroiliac (SI) joint sits between the sacrum and the iliac bone (thus the name “sacroiliac” joint). You can see these joints from the outside as two small dimples on each side of the lower back at the belt line.

The SI joint is one of the larger joints in the body. The surface of the joint is wavy and fits together similar to the way Legos® fit together. Very little motion occurs in the SI joint. The motion that does occur is a combination of sliding, tilting and rotation. The most the joint moves in sliding is probably only a couple of millimeters, and may tilt and rotate two or three degrees.

The SI joint is held together by several large, very strong ligaments . The strongest ligaments are in the back of the joint outside of the pelvis. Because the pelvis is a ring, these ligaments work somewhat like the hoops that hold a barrel together. If these ligaments are torn, the pelvis can become unstable. This sometimes happens when a fracture of the pelvis occurs and the ligaments are damaged. Generally, these ligaments are so strong that they are not completely torn with the usual injury to the SI joint.

The SI joint hardly moves in adults. During the end of pregnancy as delivery nears, the hormones that are produced causes the joint to relax. This allows the pelvis to be more flexible so that birth can occur more easily. Multiple pregnancies seem to increase the amount of arthritis that forms in the joint later in life. Other than the role the joint plays in pregnancy, it does not appear that motion is important to the function of the joint. The older one gets, the more likely that the joint is completely ankylosed, a term that means the joint has become completely stiffened with no movement at all. It appears that the primary function of the joint is to be a shock absorber and to provide just enough motion and flexibility to lessen the stress on the pelvis and spine.

Causes
What causes this problem?

There are many different causes of SI joint pain. Pregnancy may be a factor in the the development of SI joint problems later in life. Also, if a person has one leg is shorter that the other, the abnormal alignment may end up causing SI joint pain and problems. Often, an exact cause leading to a painful SI joint condition can't be found. The joint simply gets painful, and the patient and provider don't have an answer as to why the joint has become painful.

The SI joint is a synovial joint, similar to all joints such as the knee, hip and shoulder. Because of this, different types of arthritis that affect all the joints of the body will also affect the sacroiliac joint. This includes conditions such as rheumatoid arthritis, gout and psoriasis. The joint can be infected when bacteria that travel in the blood settle in the joint causing a condition called septic arthritis. This is perhaps the most worrisome cause of SI joint pain and may well require surgery to drain the infection.

http://www.eorthopod.com/images/Cont...t_causes01.jpg

Injury to the SI joint is thought to be a common cause of pain. Injury can occur during an automobile accident. One common pattern of injury occurs when the driver of a vehicle places one foot on the brake before a collision. The -->magnetic resonance imaging (MRI) scan can be used to look at the lumbar spine and pelvis in much more detail and to rule out other conditions in the area. The MRI scan uses magnetic waves rather than x-rays and shows a very detailed picture of the soft tissues of the body.

A computed tomography (CAT) scan may also be used to show a much more detailed look at the bone of the pelvis and the sacroiliac joint.

A bone scan is useful to see how the skeleton is reacting to any type of "stress," such as an injury, an infection, or inflammation from arthritis. This test involves injecting chemical "tracers" into your blood stream. The tracers then show up on special spine X-rays. The tracers collect in areas where the bone tissue is reacting strongly to some type of stress to the skeleton, such as arthritis and infection of the SI joint.

The most accurate way of determining whether the SI joint is causing pain is to perform a diagnostic injection of the joint. Because the joint is so deep, this must be done using X-ray guidance with a fluoroscope (a type of realtime X-ray) . Once the doctor places a needle in the joint, an anesthetic is injected into the joint to numb the joint. If your pain goes away while the anesthetic is in the joint, then your doctor can be reasonably sure that the pain you are experiencing is coming from the SI joint..

http://www.eorthopod.com/images/Cont...iagnosis05.jpg
Treatment
What treatment options are available?

Nonsurgical Treatment
Doctors often begin by prescribing nonsurgical treatment for SI joint dysfunction. In some cases, doctors simply monitor the patient's condition to see if symptoms improve. Anti-inflammatory medications, such as ibuprofen and naproxen, are commonly used to treat the pain and inflammation in the joint. Acetominiphen (for example, Tylenol) can be used to treat the pain, but it will not control the inflammation.

Your doctor may ask that you rest your back by limiting your activities. The purpose of this is to help decrease inflammation and calm the muscle spasm. Some patients benefit from wearing a special brace called a sacroiliac belt. This belt wraps around the hips to hold the sacroiliac joint tightly together, which may ease your pain.
http://www.eorthopod.com/images/Cont...reatment01.jpg

Patients often work with a physical therapist. After evaluating your condition, a therapist can assign positions and exercises to ease your symptoms. The therapist may design an exercise program to improve the strength and control of your back and abdominal muscles. Some therapists are trained in manipulative techniques that attempt to treat the pain in this manner. You may be able to learn how to adjust your SI joint yourself and ease the symptoms. If your physical therapist is not trained in manipulation, he/she may be able to suggest a chiropractic physician or osteopathic physician in your area who can provide this treatment.

If conservative treatment is unsuccessful, injections may be suggested by your doctor. As described above, injections are used primarily to confirm that the pain is coming from the SI joint. A series of cortisone injections may be recommended to try to reduce the inflammation in and around the SI joint. Cortisone is a powerful anti-inflammatory medication that is commonly used to control pain from arthritis and inflammation. Other medications have been injected into the joint as well. A chemical called hyaluronic acid has been used for years to treat osteoarthritis of the knee. This chemical is thought to reduce pain due to its lubricating qualities and the fact that it nourishes the articular cartilage in the synovial joints. The true mechanism of action remains unknown, but it has been used with some success in the SI joint. All of these injections are temporary and are expected to last several months at the most.

Another procedure that has been somewhat successful is called radiofrequency ablation. After a diagnostic injection has confirmed that the pain is coming from the SI joint, the small nerves that provide sensation to the joint can be "burned" with a special needle called a radiofrequency probe. In theory, this destroys any sensation coming from the joint, making the joint essentially numb. This procedure is not always successful. It is temporary but can last for up to two years. It can be repeated if needed.

http://www.eorthopod.com/images/Cont...reatment03.jpg

Surgery
Surgery may be considered if other treatments don't work. Surgery consists of fusing the painful SI joint. A fusion is an operation where the articular cartilage is removed from both ends of the bones forming the joint. The two bones are held together with plates and screws until the two bones grow together, or fuse, into one bone. This stops the motion between the two bones and theoretically eliminates the pain from the joint.

http://www.eorthopod.com/images/Cont...reatment04.jpg
This is a big operation and is not always successful at relieving the pain. The operation is not commonly performed unless the pain is debilitating. SI joint pain is seldom this severe.

Rehabilitation
What should I expect as I recover?

Nonsurgical Rehabilitation
Doctors often recommend physical therapy for patients with SI joint dysfunction. Patients are normally seen a few times each week for four to six weeks. In severe and chronic cases, patients may need a few additional weeks of care.

When movement of a joint is limited, the pain and symptoms of SI joint dysfunction may worsen. Getting more motion can give you the relief you need for daily activities. If you don't have full range of motion, your therapist has several ways to help you get more movement including joint manipulation, stretching, and exercises. Active movement and stretching as part of a home program can also help restore movement and get you better faster.

Therapists commonly prescribe a set of stretches to improve flexibility in the muscles of the trunk, buttocks, and thighs. In addition to the treatment you receive by your therapist, you may be given ways to help your own SI joint if your pain returns. These exercises usually require that you position your hip and pelvis in a certain way and either stretch or contract and relax specific muscles. Follow the instructions of your therapist when doing these exercises.

If the SI joint has too much mobility and problems keep coming back, you may need extra help to stabilize the SI joint. You may be issued a SI belt to stabilize the joint. A belt like this can often ease pain enough to let you exercise comfortably.

You'll learn some exercises to help you build strength, muscle control, and endurance in the muscles that attach around the SI joint. Unfortunately, few muscles actually connect to both the sacrum and the pelvis. Key muscles to work are the gluteus maximus, as well as the abdominal and low back muscles.

After Surgery
You will normally need to wait at least six weeks before beginning a rehabilitation program after having SI joint fusion surgery. You should plan on attending therapy sessions for six to eight weeks. Expect full recovery to take up to six months.

During therapy after SI joint surgery, your therapist may use treatments such as heat or ice, electrical stimulation, massage, and ultrasound to help calm your pain and muscle spasm. Then you'll begin learning how to move safely with the least strain on the healing area.

As your rehabilitation program evolves, you'll begin doing more challenging exercises. The goal is to safely advance your strength and function.

As your therapy sessions come to an end, your therapist helps you get back to the activities you enjoy. Ideally, you'll be able to resume your normal activities. You may need guidance on which activities are safe or how to change the way you go about your activities.

When treatment is well under way, regular visits to your therapist's office will end. Your therapist will continue to be a resource. But you'll be in charge of doing your exercises as part of an ongoing home program.[/QUOTE]

si joint pain i have suffering for 3yrs
 

I have had pt inujections epiduals surgery and nothing has helped. My doctor said there was nothing else they can do for me. I also have a stimulator in my back for cronic back pain. I feel I have no quality of life and all my friends have disappeard. I use a cane and a scooter, I can not stand for more than 10 minutes at a time.
been denied for disability and think about sucidie all the time. The ony thing stopping me is husband. I feel trapped and alone. QUOTE=GJZH;96790]I was wondering if anyone has Sacroiliac Joint Dysfunction and if you have it, did you have surgery for it? Has the surgery been successful? As I read more about this I think this might be a part of my pain and problems since my surgery. When I read this article it describes my pain, during the night especially. I really do not want more surgery. If you have had surgery, has it been successful for you? This seems like a very big surgery...I was wondering the success for it. Does anyone know?

A Patient's Guide to Sacroiliac Joint Dysfunction

http://www.eorthopod.com/eorthopodV2...f61e50b/area/5

http://www.eorthopod.com/images/Cont...nt_intro01.jpg
Introduction
A painful sacroiliac joint is one of the more common causes of mechanical low back pain. Sacroiliac (SI) joint dysfunction is a term that is used to describe the condition - because it is still unclear why this joint becomes painful and leads to low back pain. Sacroiliac joint dysfunction can be a nuisance but it is seldom dangerous and rarely leads to the need for surgery. Most people who suffer from this problem can reduce the pain and manage the problem with simple methods.

This guide will help you understand

how the problem develops
how doctors diagnose the condition
what treatment options are available
Anatomy
What part of the back is involved?

http://www.eorthopod.com/images/Cont..._anatomy01.jpg

At the lower end of the spine, just below the lumbar spine lies the sacrum. The sacrum is a triangular shaped bone that is actually formed by the fusion of several vertebrae during development. The sacroiliac (SI) joint sits between the sacrum and the iliac bone (thus the name “sacroiliac” joint). You can see these joints from the outside as two small dimples on each side of the lower back at the belt line.

The SI joint is one of the larger joints in the body. The surface of the joint is wavy and fits together similar to the way Legos® fit together. Very little motion occurs in the SI joint. The motion that does occur is a combination of sliding, tilting and rotation. The most the joint moves in sliding is probably only a couple of millimeters, and may tilt and rotate two or three degrees.

The SI joint is held together by several large, very strong ligaments . The strongest ligaments are in the back of the joint outside of the pelvis. Because the pelvis is a ring, these ligaments work somewhat like the hoops that hold a barrel together. If these ligaments are torn, the pelvis can become unstable. This sometimes happens when a fracture of the pelvis occurs and the ligaments are damaged. Generally, these ligaments are so strong that they are not completely torn with the usual injury to the SI joint.

The SI joint hardly moves in adults. During the end of pregnancy as delivery nears, the hormones that are produced causes the joint to relax. This allows the pelvis to be more flexible so that birth can occur more easily. Multiple pregnancies seem to increase the amount of arthritis that forms in the joint later in life. Other than the role the joint plays in pregnancy, it does not appear that motion is important to the function of the joint. The older one gets, the more likely that the joint is completely ankylosed, a term that means the joint has become completely stiffened with no movement at all. It appears that the primary function of the joint is to be a shock absorber and to provide just enough motion and flexibility to lessen the stress on the pelvis and spine.

Causes
What causes this problem?

There are many different causes of SI joint pain. Pregnancy may be a factor in the the development of SI joint problems later in life. Also, if a person has one leg is shorter that the other, the abnormal alignment may end up causing SI joint pain and problems. Often, an exact cause leading to a painful SI joint condition can't be found. The joint simply gets painful, and the patient and provider don't have an answer as to why the joint has become painful.

The SI joint is a synovial joint, similar to all joints such as the knee, hip and shoulder. Because of this, different types of arthritis that affect all the joints of the body will also affect the sacroiliac joint. This includes conditions such as rheumatoid arthritis, gout and psoriasis. The joint can be infected when bacteria that travel in the blood settle in the joint causing a condition called septic arthritis. This is perhaps the most worrisome cause of SI joint pain and may well require surgery to drain the infection.

http://www.eorthopod.com/images/Cont...t_causes01.jpg

Injury to the SI joint is thought to be a common cause of pain. Injury can occur during an automobile accident. One common pattern of injury occurs when the driver of a vehicle places one foot on the brake before a collision. The -->magnetic resonance imaging (MRI) scan can be used to look at the lumbar spine and pelvis in much more detail and to rule out other conditions in the area. The MRI scan uses magnetic waves rather than x-rays and shows a very detailed picture of the soft tissues of the body.

A computed tomography (CAT) scan may also be used to show a much more detailed look at the bone of the pelvis and the sacroiliac joint.

A bone scan is useful to see how the skeleton is reacting to any type of "stress," such as an injury, an infection, or inflammation from arthritis. This test involves injecting chemical "tracers" into your blood stream. The tracers then show up on special spine X-rays. The tracers collect in areas where the bone tissue is reacting strongly to some type of stress to the skeleton, such as arthritis and infection of the SI joint.

The most accurate way of determining whether the SI joint is causing pain is to perform a diagnostic injection of the joint. Because the joint is so deep, this must be done using X-ray guidance with a fluoroscope (a type of realtime X-ray) . Once the doctor places a needle in the joint, an anesthetic is injected into the joint to numb the joint. If your pain goes away while the anesthetic is in the joint, then your doctor can be reasonably sure that the pain you are experiencing is coming from the SI joint..

http://www.eorthopod.com/images/Cont...iagnosis05.jpg
Treatment
What treatment options are available?

Nonsurgical Treatment
Doctors often begin by prescribing nonsurgical treatment for SI joint dysfunction. In some cases, doctors simply monitor the patient's condition to see if symptoms improve. Anti-inflammatory medications, such as ibuprofen and naproxen, are commonly used to treat the pain and inflammation in the joint. Acetominiphen (for example, Tylenol) can be used to treat the pain, but it will not control the inflammation.

Your doctor may ask that you rest your back by limiting your activities. The purpose of this is to help decrease inflammation and calm the muscle spasm. Some patients benefit from wearing a special brace called a sacroiliac belt. This belt wraps around the hips to hold the sacroiliac joint tightly together, which may ease your pain.
http://www.eorthopod.com/images/Cont...reatment01.jpg

Patients often work with a physical therapist. After evaluating your condition, a therapist can assign positions and exercises to ease your symptoms. The therapist may design an exercise program to improve the strength and control of your back and abdominal muscles. Some therapists are trained in manipulative techniques that attempt to treat the pain in this manner. You may be able to learn how to adjust your SI joint yourself and ease the symptoms. If your physical therapist is not trained in manipulation, he/she may be able to suggest a chiropractic physician or osteopathic physician in your area who can provide this treatment.

If conservative treatment is unsuccessful, injections may be suggested by your doctor. As described above, injections are used primarily to confirm that the pain is coming from the SI joint. A series of cortisone injections may be recommended to try to reduce the inflammation in and around the SI joint. Cortisone is a powerful anti-inflammatory medication that is commonly used to control pain from arthritis and inflammation. Other medications have been injected into the joint as well. A chemical called hyaluronic acid has been used for years to treat osteoarthritis of the knee. This chemical is thought to reduce pain due to its lubricating qualities and the fact that it nourishes the articular cartilage in the synovial joints. The true mechanism of action remains unknown, but it has been used with some success in the SI joint. All of these injections are temporary and are expected to last several months at the most.

Another procedure that has been somewhat successful is called radiofrequency ablation. After a diagnostic injection has confirmed that the pain is coming from the SI joint, the small nerves that provide sensation to the joint can be "burned" with a special needle called a radiofrequency probe. In theory, this destroys any sensation coming from the joint, making the joint essentially numb. This procedure is not always successful. It is temporary but can last for up to two years. It can be repeated if needed.

http://www.eorthopod.com/images/Cont...reatment03.jpg

Surgery
Surgery may be considered if other treatments don't work. Surgery consists of fusing the painful SI joint. A fusion is an operation where the articular cartilage is removed from both ends of the bones forming the joint. The two bones are held together with plates and screws until the two bones grow together, or fuse, into one bone. This stops the motion between the two bones and theoretically eliminates the pain from the joint.

http://www.eorthopod.com/images/Cont...reatment04.jpg
This is a big operation and is not always successful at relieving the pain. The operation is not commonly performed unless the pain is debilitating. SI joint pain is seldom this severe.

Rehabilitation
What should I expect as I recover?

Nonsurgical Rehabilitation
Doctors often recommend physical therapy for patients with SI joint dysfunction. Patients are normally seen a few times each week for four to six weeks. In severe and chronic cases, patients may need a few additional weeks of care.

When movement of a joint is limited, the pain and symptoms of SI joint dysfunction may worsen. Getting more motion can give you the relief you need for daily activities. If you don't have full range of motion, your therapist has several ways to help you get more movement including joint manipulation, stretching, and exercises. Active movement and stretching as part of a home program can also help restore movement and get you better faster.

Therapists commonly prescribe a set of stretches to improve flexibility in the muscles of the trunk, buttocks, and thighs. In addition to the treatment you receive by your therapist, you may be given ways to help your own SI joint if your pain returns. These exercises usually require that you position your hip and pelvis in a certain way and either stretch or contract and relax specific muscles. Follow the instructions of your therapist when doing these exercises.

If the SI joint has too much mobility and problems keep coming back, you may need extra help to stabilize the SI joint. You may be issued a SI belt to stabilize the joint. A belt like this can often ease pain enough to let you exercise comfortably.

You'll learn some exercises to help you build strength, muscle control, and endurance in the muscles that attach around the SI joint. Unfortunately, few muscles actually connect to both the sacrum and the pelvis. Key muscles to work are the gluteus maximus, as well as the abdominal and low back muscles.

After Surgery
You will normally need to wait at least six weeks before beginning a rehabilitation program after having SI joint fusion surgery. You should plan on attending therapy sessions for six to eight weeks. Expect full recovery to take up to six months.

During therapy after SI joint surgery, your therapist may use treatments such as heat or ice, electrical stimulation, massage, and ultrasound to help calm your pain and muscle spasm. Then you'll begin learning how to move safely with the least strain on the healing area.

As your rehabilitation program evolves, you'll begin doing more challenging exercises. The goal is to safely advance your strength and function.

As your therapy sessions come to an end, your therapist helps you get back to the activities you enjoy. Ideally, you'll be able to resume your normal activities. You may need guidance on which activities are safe or how to change the way you go about your activities.

When treatment is well under way, regular visits to your therapist's office will end. Your therapist will continue to be a resource. But you'll be in charge of doing your exercises as part of an ongoing home program.[/QUOTE]

[/QUOTE]

donnap9,

Have you seen a rheumatologist to rule out autoimmune issues that have an affinity for the S.I joints?