SI Joint Pain...Frustrated.

[daisylubob]

Saw Sally today. She thinks it may NOT be a disc now, due to:
1. little to no relief w/ the cobra maneuver.
2. I can walk and stand w/out a lot of increased pain.
3. Forward flex bothers me, whereas a disc problem the patient would get pain relief w/ forward flex.

She gave me a new exercise: Lay on L side, L leg straight, R leg bent up. Pull up on L arm so L shoulder is all twisted around. Lay that way for 5-10 mins.

We may also try oral steroids to see if it takes away the pain, if it does, then there is inflammatory stuff going on. But we still do not know the origin. MRI is Wednesday at 6am.

[nscrbug]

Saw Sally today. She thinks it may NOT be a disc now, due to:
1. little to no relief w/ the cobra maneuver.
2. I can walk and stand w/out a lot of increased pain.
3. Forward flex bothers me, whereas a disc problem the patient would get pain relief w/ forward flex.

She gave me a new exercise: Lay on L side, L leg straight, R leg bent up. Pull up on L arm so L shoulder is all twisted around. Lay that way for 5-10 mins.

We may also try oral steroids to see if it takes away the pain, if it does, then there is inflammatory stuff going on. But we still do not know the origin. MRI is Wednesday at 6am.

Hmmm...that's interesting. I was always under the impression that forward flexion increases pain in those with disc problems present...and that the cobra relieves pain. I have a totally different back condition called spondylolisthesis, which is a forward vertebral slippage. I'm actually NOT supposed to do any kind of back extension exercises (like the cobra) because it can cause further slippage and instability in my lower spine. But bending forward (such as leaning on a table or countertop, brings me instant relief.

Your upcoming MRI will pretty much indicate right away, whether or not your issue is disc-related or something else. Good luck and I hope you find some answers soon!

[KnottedYet]

It depends which way the disc is bulging. (forward, backward, or to the sides)

I have a disc that bulges forward and slightly sideways right now. Bending forward (forward flexion) pushes that darn disc back into place for me.

60% of disc problems are discs that are bulging backwards. Bending forward pushes the disc farther out of place for those folks.

What Sally has given you now is the "million dollar roll". It works for discs that are bulging out at a different angle (not straight back or straight to the side, for example) or that are bulging in multiple directions.

If you run into trouble with it, or if you feel it is making you worse, call Sally.

(ETA: 2 and 3 would be typical of a posterior derangement, 1 would be typical of a posterior-lateral relevant derangement. Lack of lasting relief from a cobra could indicate a disc that is blooping out backward and sideways at the same time. Sally will work you thorugh the steps of various movements until she has exhausted disc behaviour as a cause.)

[daisylubob]

I seem to be doing OK, stable for right now. This "million dollar roll" feels really good So it must be doig something! The MRI was done on Wed, and I am patiently awaiting the results.
I did the trainer for 30 mins on Wed, and will do 30 again today. Sunday, it is supposed to be a little nicer outside, so I may attempt an EASY 30-45 min road ride!

[daisylubob]

MRI shows 'diffuse annular bulge w/ L posterolateral disc protrusion L4-5 encroaching into the neural foramen on the L. THis appears to be effacing the exiting nerve root.'

Not the greatest news, but Sally kind of knew this anyway. I saw her today, as the million dollar roll did not really do any long-term improvement. She is perplexed, and calls me her 'challenge' I am to have DH push w/ heel of his hand on the L4 area, 10x twice a day. And go back to her in a week. Appt w/ neuro guy is 5/17. I have not read/ heard great things about steroid injections or oral steroids (wt gain, puffiness, emotional issues, etc). They also just take away the inflammation, and don't fix the problem. This is somewhat discouraging....

on the other hand....I did a road ride w/ DH on Sunday for 1:10, slow and easy. Stopped once to stretch, and I did not feel too bad

[daisylubob]

Still having pain, still frustrated. Trying to be patient....this is not easy.

[NbyNW]

I haven't commented on this thread before but have been following it . . . just wanted to tell you to hang in there!

Do you at least feel like things are improving a little?

I'm not a professional health care anything, I just know from personal experience that it can take a LONG time to feel some relief. And it's frustrating when you can't have a day off from the pain and the limitations of your injury. So if you feel like you're in good hands, stick with the program.

I had a back injury a few years ago that took a long time to rehab. And it's just part of me now, that's something I've had to accept. I doubt I will ever NOT be aware of the trauma to that part of my body. So it's something I account for in my daily routines or any time I'm training for anything. I have to pamper it and condition it properly in order to do things that I love. And afterwards I have to be kind to my body and thank it for cooperating.

Good luck!

[tulip]

Still having pain, still frustrated. Trying to be patient....this is not easy.

It's likely that your back situation did not occur overnight, but rather over a lifetime of posture issues. That's the case with me. The "cure" will not happen overnight, either. Patience and consistency are key with PT. It sounds like you have the best PT one could ask for.