Sacroiliac joint (spine to pelvis)

[ScotHill]

I've been seeing an osteopath for back problems and they concluded that the aches and lack of mobility I have could be caused by problems in the sacroiliac joint, which is borne out by where the occasional pain is. A lot of the muscles around it can be tight or in spasm, but they think that's more of a symptom than a cause.

Anyone had any experience of this joint being problematic, what was it, and what ended up making things better? Nine months of this I've had so looking to get a bit more perspective on it!

[d_a_n1979]

I had issues a few years back after I'd slipped in the garden mid winter (it would have been better if I'd just let myself fall etc)

Years of heavy powerlifting (squatting/deadlifts etc) had made the muscles & joints strong but caused other issues when they pulled tight through spasms etc

Like you went to see my osteo to get loosened off; but also did a lot of specific exercises using a foam roller and hard ball:

https://www.youtube.com/watch?v=s2bqEP1O6_s&ab...

Worth giving them a bash as they helped me a lot

[Four Litre]

ScotHill said:

I've been seeing an osteopath for back problems and they concluded that the aches and lack of mobility I have could be caused by problems in the sacroiliac joint, which is borne out by where the occasional pain is. A lot of the muscles around it can be tight or in spasm, but they think that's more of a symptom than a cause.

Anyone had any experience of this joint being problematic, what was it, and what ended up making things better? Nine months of this I've had so looking to get a bit more perspective on it!

Yes - I’ve had a number of back ops, recently had my left SI fused. One thing I’ve learnt with potential SI joint problems is that 99% of people haven’t got a clue if it’s the SI joint or not causing the problem! Look up piriformis syndrome as this is way overlooked, alongside muscle weakness in that area. You can get a steroid injection into the SI for diagnosis, might be worth trying.

[ScotHill]

Thanks, my insurance agreed to an MRI scan, purely because of how long the problem’s been going on for, so hopefully that will rule a lot of things out and might identify some contributory problems, realise they’re not a panacea though.

From doing a bit of reading it seems that some of the stretches the ‘tight muscles’ brigade have been recommending might actually have been making things worse…. :-/

[LuckyThirteen]

Been there

Inversion table. And learn how to properly, and carefully use it.

Then, exercise. Cross trainer has been brilliant for reducing inflammation there for me.

The siaz (sp?) muscles that often do tight can be stretched on the inversion table too.

Then, diet. Get a blood test, find out what I tolerances you have. Follow the results, it'll lead to less inflammation.

But, inversion table is a decent first thing to purchase. Mine's from Teeter.

[LuckyThirteen]

Also,
For S1 especially.

Do NOT twist getting into and out of a car. Or off a chair. Legs round, and stand. The twist is baaaadddd.

In bed, (when awake) pillows under knees. Takes some pressure off.

But above all, don't twist. Especially when sat. Change your habits for how you move.

[LuckyThirteen]

And, if you're fat. Lose weight.

(Sorry if you're not)

[ScotHill]

LuckyThirteen said:

And, if you're fat. Lose weight.

(Sorry if you're not)

I’m not, don’t be sorry.

I’ve never heard an inversion table mentioned by a professional I’ve talked to or any articles I’ve read, so I’m not going to go down that route unless someone brings it up with me, I’ve tried an SI belt though, with mixed results, sometimes helps, sometimes doesn’t.

I definitely think it’s as much about not doing some things as well as doing more of the good things though, the good-to-bad setbacks come quite quickly but I’ve never quite nailed the causes, life just keeps getting in the way, especially with two small children to chase and carry.

[LuckyThirteen]

My story.

Suicidal by 34. Had been through 'top' neurosurgeons, privately. Had 6 years of medical advice.

Existing on co-codomol 30/500 or tramadol along with diclofenac, diazepam and in the evenings washing it down with whiskey or rum.

Bad attacks would leave me bed bound. Unable to walk for anywhere up to a week.

I'd gone from 92 kilos, 27" waist and training in extreme martial arts. To a cripple.

Happened to meet the right guy at just the right time. 11 years ago.

Now, after been told by the 'professionals' (including one well renowned surgeon) that life was about 'pain management' and ultimately, to avoid being in a wheel chair by 55 I'd need fusion for certainly 3 vertebrae....and that I'd never drive sportscars again......

Well, now, this morning as is normal for a Sunday it begins with 24-28 minutes on the cross trainer, heart rate @158 at the finish, resistance halfway and averaging 72 revolutions per minute.

From there it's calisthenics, weights, reflex ball, squats (holding weights) and other exercises depending on mood. Finished with the inversion table. 3 mins slowly getting inverted, @5-7 minutes fully inverted and stretching, then good 3-4 mins slowly getting back upright.

(Stretch thoroughly before exercise of course too).

The guy that would 'never drive sportscars again' won an endurance racing championship in 2018.

Has gone from a flabby 104 kilos and 37" waist (aged 36 after years of being crippled and medicated) to today 96.4 kilos and 32" waist

Frankly on this, from my experience 'f#+k the professionals'. I'm walking proof that you can heal. From the inside out.

Sorry to rant. I feel strongly about this. I now have a wonderful wife, 2 great kids, a successful business and am into Motorsport. I have a great life.

Yet 11 years ago was ready to end it. Because of untreatable heavily trashed discs. And MRI scan horror shows.

Edited by LuckyThirteen on Sunday 16th June 20:29

[LuckyThirteen]

To add,

The first time I got on a CrossT (after months of being told 'it will help, you have to exercise' I was scared, really scared.

Did 10 seconds! Then just built up adding a couple of seconds each day.

Put off looking into food intolerances as I was sure it was bunkum. After a good couple of years of being badgered......well the results were shocking. Not as shocking however as being able to actually pin down much back ache and stiffness to an actual food intake.... That was eye opening. Took time but WOW.

Inversion table, scary. Very. And it's been a rough ride learning how to use it. Now I have however it's a revelation.

There are other routes open to you.

[M11rph]

SI joint issues should lead your doctor to rule out AS (Ankylosing Spondilitis). There's a blood test to check if you have the tissue type associated with 95% of those with AS (HLA-B27).

One common symptom is SI inflammation and fusion. It presents in a variety of ways and severities, many people don't know they have it until an unrelated injury sees them getting a scan/x-ray and it being picked up as a result.

Associated pain is usually worse in the mornings and eases with exercise.

Exercise and lots of treatments are now possible. I'd suggest until you have a diagnosis to avoid any of the "robust therapies"...chiropractor, various devices for putting your spine in traction etc.

Edited by M11rph on Sunday 16th June 20:42

[ScotHill]

M11rph said:

SI joint issues should lead your doctor to rule out AS (Ankylosing Spondilitis). There's a blood test to check if you have the tissue type associated with 95% of those with AS (HLA-B27).

One common symptom is SI inflammation and fusion. It presents in a variety of ways and severities, many people don't know they have it until an unrelated injury sees them getting a scan/x-ray and it being picked up as a result.

Associated pain is usually worse in the mornings and eases with exercise.

Exercise and lots of treatments are now possible. I'd suggest until you have a diagnosis to avoid any of the "robust therapies"...chiropractor, various devices for putting your spine in traction etc.

Interesting, I'll bring up AS with the specialist who reviews the scan, if they don't mention it first. GP has mainly been for referrals at the moment, some physio and osteo was provided on work insurance although I did go to a couple of private sessions once I'd reached the limit.

Yeah I don't think I'm a serious case (yet!) and am happy with osteopaths as a midway between physios and chiropractors; the physios have been pretty much useless though. I'm active although if problems flare up I reduce that, as above doing a little of the wrong thing can set me back.

I'll update after the MRI if there's anything interesting, but I realise it's not always commons to be able to point at a scan and say 'that's 100% the problem'. At least it could rule out some things, and might identify some weaknesses that I can target with specific activities.

[Mutton]

I had plenty of issues with my left sacroiliac joint and had lots of physio etc but no joy. Eventually got referred to a specialist who carried out a CT scan guided steroid injection to accurately get to the problem area and not had any issues since.

[ScotHill]

Mutton said:

I had plenty of issues with my left sacroiliac joint and had lots of physio etc but no joy. Eventually got referred to a specialist who carried out a CT scan guided steroid injection to accurately get to the problem area and not had any issues since.

I take it injections wear off, so what was the long term fix for you? Was it directly informed by the scan?

[ScotHill]

M11rph said:

SI joint issues should lead your doctor to rule out AS (Ankylosing Spondilitis).

A bunch of grapes for the man in the hat - looking up the symptoms of AS, this is pretty much me, and what I've been telling physios/osteopaths from last October onwards:

--
Symptoms of inflammatory back pain include:-

Insidious onset.
Duration for at least 3 months.
Marked and protracted early morning stiffness (>30 minutes duration).
Pain at night (with improvement on getting up).
Improvement with exercise.
No improvement with rest.
--

If it turns out to be AS it's frustrating that it's not been picked up so far, or even mentioned in passing - two physios were useless, one osteopath blamed me for not doing all of the stretching exercises and expensive sports massages that she'd advised when I went with a different problem two years ago, and one osteo who has generally been very good and inquisitive maybe almost got there but didn't make the connection.

I've been saying it feels deep, like bone pain, for a long time, and it never made sense that tight muscles were the cause, because I've ALWAYS had tight muscles, and how would that mean I could be walking around fine in the afternoon, but lie flat on my back for ten minutes and stiffness and immobility comes on right away.

[Phooey]

You need to see a spinal surgeon. There's no harm first trying physios etc but if it doesn't help you really have to go to the top of the chain. Lots of people (including me) spend thousands on physio etc not to mention the time and pain but it's really the specialist and MRI that can tell you what you need to know. I've got stuff like failed discs and lateral recess stenosis. No one could of told me that other than the surgeon I paid to see.

eta - Everything comes back to money and budgets - in an ideal world everyone would go straight to specialist. Physio after professional diagnosis.

Edited by Phooey on Monday 17th June 10:10

[M11rph]

ScotHill said:

...If it turns out to be AS it's frustrating that it's not been picked up so far, or even mentioned in passing... -.

It can present in many different ways which some health care professionals struggle with. They tend to look at the direct symptom and don't explore further.

Given that the tissue type HLA-B27 is so strongly associated with AS and a simple blood test is available, it really should be something that gets explored early on in the process. However, the average time to diagnosis from first symptoms is something like 7 years.

It may not be the cause of your problems, but clearly worth finding out. If it is then there's no reason why you can't get on with your life and not be doubled up in pain when all you lower back muscles/abs etc go into spasm.

[Mutton]

ScotHill said:

Mutton said:

I had plenty of issues with my left sacroiliac joint and had lots of physio etc but no joy. Eventually got referred to a specialist who carried out a CT scan guided steroid injection to accurately get to the problem area and not had any issues since.

I take it injections wear off, so what was the long term fix for you? Was it directly informed by the scan?

The steroid injection was used to reduce the inflammation which hadn't been possible by other means, and in my case this was the end solution rather than a short term fix as the soreness didn't return once the injection wore off (whenever that was, probably a few months later). I had similar success some years before with a steroid injection in my plantar fascia in my foot and the soreness I had for that never returned so maybe I'm lucky that I respond well to those type of treatments.