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View Full Version : SI joint injections for leg pain (post-op spinal fusion w/ screws in pelvis)



susancook
11-30-2013, 02:59 AM
Has anyone had SI joint steroid inj for post-op Leg pain? I have a spinal fusion with pelvic screws and have mid L buttocks pain. This occurs when i walk. My pain management MD thinks that SI joint steroid injection might relieve the pain. I did not have this pain before surgery. Thanks, Susan

tiona24
11-30-2013, 09:19 AM
Hi Susan, I had a steroid injection in my hip joint about 6 weeks ago. After 2 weeks, I had not seen any improvement. I had begun seeing a new physical therapist at that point, and she began treating my fascia. She gave me a medicated patch with batteries in it- the medication was an inflammation reducer, and the batteries (which were flat, like hearing aid batteries) forced positive/negative ions into the joint to stimulate blood flow in the muscle (if I am translating that correctly). I immediately felt relief. My pain doctor told me the injection could take a couple days to kick in, and both of my physical therapists told me they have had patients that it took a couple weeks, and the newer therapist said she often saw results when adding this patch to the injection site. So, I'm not sure what exactly improvement was from- but if I had to do it again, I would start with this therapist and the patch, and then do an injection if the patch doesn't work on its own. It likely was a combination of both, but, I think steroid injections should be a last resort.

Good Luck!

Tiona

WLB1
11-30-2013, 10:07 AM
Hi, Susan,

I had two,one in each several weeks ago. Relief was instant and immense. It was a new pain for me as well. The main pain was located in the back of my hip, centered near my sacrum. It radiated up my side and down my leg on the outer side to my knee. It was not a constant pain, more a come and go thing related to my activity. My pain management PA tested for it by having me draw my leg up to my shoulder and twisting the bent leg to the side as far as it would go. Ow means it's positive for SI joint. She said that having the pelvis be fused to the sacrum puts an extra heavy load on the SI joints. Inflammation builds up and if left unabated can destroy it. Go for the shots. After what you've been through they are no biggie!

susancook
11-30-2013, 02:21 PM
Hi Susan, I had a steroid injection in my hip joint about 6 weeks ago. After 2 weeks, I had not seen any improvement. I had begun seeing a new physical therapist at that point, and she began treating my fascia. She gave me a medicated patch with batteries in it- the medication was an inflammation reducer, and the batteries (which were flat, like hearing aid batteries) forced positive/negative ions into the joint to stimulate blood flow in the muscle (if I am translating that correctly). I immediately felt relief. My pain doctor told me the injection could take a couple days to kick in, and both of my physical therapists told me they have had patients that it took a couple weeks, and the newer therapist said she often saw results when adding this patch to the injection site. So, I'm not sure what exactly improvement was from- but if I had to do it again, I would start with this therapist and the patch, and then do an injection if the patch doesn't work on its own. It likely was a combination of both, but, I think steroid injections should be a last resort.

Good Luck!

Tiona

Thanks, Tiona. If you could get more information on the name of the inflammation reducer. Sounds interesting and I would love to talk to my PT about it and look it up on the Internet. Glad that you are finding relief. Susan

susancook
11-30-2013, 02:32 PM
Hi, Susan,

I had two,one in each several weeks ago. Relief was instant and immense. It was a new pain for me as well. The main pain was located in the back of my hip, centered near my sacrum. It radiated up my side and down my leg on the outer side to my knee. It was not a constant pain, more a come and go thing related to my activity. My pain management PA tested for it by having me draw my leg up to my shoulder and twisting the bent leg to the side as far as it would go. Ow means it's positive for SI joint. She said that having the pelvis be fused to the sacrum puts an extra heavy load on the SI joints. Inflammation builds up and if left unabated can destroy it. Go for the shots. After what you've been through they are no biggie!

Just tried your maneuver....not sure that I got it right. What direction do You pull your leg up? Front, I assume and I tried the twist. Yes, it hurt and right now my whole butt and leg hurts. It still hurts. Something is irritated anyway. Thanks for the information and glad that you had relief. I have it scheduled on Monday at 0730. Similar to you, I have never had a problem with any systemic problem with corticosteroid injections. I do worry about the effect that steroids can have on the bone, so hopefully both of us will not need too many injections. Thanks for the information. Susan

loves to skate
11-30-2013, 07:09 PM
Has anyone had SI joint steroid inj for post-op Leg pain? I have a spinal fusion with pelvic screws and have mid L buttocks pain. This occurs when i walk. My pain management MD thinks that SI joint steroid injection might relieve the pain. I did not have this pain before surgery. Thanks, Susan
Susan,
I have had steroid injections in my SI joint for pain in my left buttock and I really didn't get any relief. Some people get relief from them and some don't. If you decide to get one, I sincerely hope that it works for you. Take care, Sally

gardener
12-02-2013, 05:10 AM
Susan,

I haven't had surgery but have chronic SI joint pain and the injections have failed because the Drs. said I had too much arthritis which prevents proper needle placement. Anyway, my physiatrist has done a series of the patch procedures and it's called iontophoresis. A steroid medicine was placed on patch and then transmitted transdermally. These treatments have worked very well for me with one caveat. My doctor recommended a series of 10-12 treatments, 2-3x per week for several weeks but I developed a rash after a few treatments each time. The rash was akin to a localized bout of poison ivy. Despite the rash, I kept going for 5-6 treatments and the relief lasted many months. My current insurer limited these treatments but I'll have a new policy/insurer in January and I'll try it again. The relief lasted much longer than the rash, by many months. The second time I had the treatment, a different steroid formulation was used and that was slightly better, but the rash began eventually.

susancook
12-13-2013, 11:51 PM
Susan,

I haven't had surgery but have chronic SI joint pain and the injections have failed because the Drs. said I had too much arthritis which prevents proper needle placement. Anyway, my physiatrist has done a series of the patch procedures and it's called iontophoresis. A steroid medicine was placed on patch and then transmitted transdermally. These treatments have worked very well for me with one caveat. My doctor recommended a series of 10-12 treatments, 2-3x per week for several weeks but I developed a rash after a few treatments each time. The rash was akin to a localized bout of poison ivy. Despite the rash, I kept going for 5-6 treatments and the relief lasted many months. My current insurer limited these treatments but I'll have a new policy/insurer in January and I'll try it again. The relief lasted much longer than the rash, by many months. The second time I had the treatment, a different steroid formulation was used and that was slightly better, but the rash began eventually.

Just a suggestion and you have probably already thought about this....my guess is that you may be allergic to the vehicle that carries the steroid or the adhesive in the patch. Another possibility....any chance that Your rash is shingles (usually phenomenally painful, but maybe the steroid mediated the pain?) Just some thoughts. Thanks for the suggestions. I will look it up on the Internet.

Susan

susancook
12-13-2013, 11:58 PM
I am pleased to report that the SI joint corticosteroid injection greatly decreased my mid buttocks pain. I am very pleased! I was anxious to have relief and of course wanted the pain to decrease IMMEDIATELY....but it took about a week and the pain is gone! Funny thing about pain, but it took me an entire day to realize that the inj worked. It actually took me a day to miss the pain! I suddenly realized that my butt pain was gone, hallelujah! Susan

JenniferG
12-14-2013, 12:18 AM
Great news Susan. Long may it work.

PeggyS
12-15-2013, 08:00 PM
That's great, Susan! I'm glad you're getting some relief!

loves to skate
12-19-2013, 07:01 PM
Susan,
So glad to hear the steroid helped you.
Sally

WLB1
12-19-2013, 11:09 PM
It is wonderful relief, isn't it? And the shot, not a problem!

susancook
12-20-2013, 02:41 AM
It is great not to have the L butt pain. Hope that the steroid last for months!.....maybe forever!
Susan

Doodles
12-21-2013, 12:58 PM
I hope it lasts forever too, Susan! That's great news. Janet

leahdragonfly
12-21-2013, 04:55 PM
Hi Susan,

How much does the SI joint injection hurt? I have heard some reports that it is very unpleasant. I have some trouble with my left SI joint, the one that had a pelvic anchor through it (which was removed almost 2 years ago). What I assume is the joint pops and grinds when I lay down on my back, and many times when I rise from sitting, particularly getting out of the car, the SI joint gives a pretty hard click/pop. As far as I know all my hardware is ok.

I will be asking Dr Hart about this. Did you have your injection done at OHSU?

Thanks,

Gayle

susancook
12-21-2013, 05:44 PM
Gayle, the injection was just minimally unpleasant. I did not find it very painful. I saw Dr. Chen and her fellow. I have also seen Dr. Mohler who is the chair of the department, i think. Both Chen and Mohler are women and more compassionate than the male who is also an anesthesiologist who i found had the compassion of a head of lettuce. If you want to make sure that the procedure is less uncomfortable, tell her or whomever you see that you want sedation and they will give you an IV with meds. If you have sedation, you will need to have a driver to take you home. Let me know what you decide to do and I could probably transport you and then you could rest at my duplex which is about 10 minutes away from OHSU.

Then again, it is all a trade off and even if it is very painful for you or anyone, the pain would be just temporary for a longer term trade off. I figure that given the pain that all of us have endured, I could tolerate. Just about anything for a brief time. My thoracic denervation was phenomenally painful, mainly because the nurse could not find her keys to the main drug closet, so they used some other meds. My thoracic area has the large kyphosis, so maybe that made it difficult. That procedure on 3 vertebrae, bilateral took some minutes....seemed like forever. Even as painful as that was, I would do that again, which fortunately I do not EVER need to do because of my fusion. I recently had a cervical denervation bilateral C3,4,and 5 with minimal pain but the correct sedation (I guess that they finally found the keys!).

Take care and send me a message about when your appointment is with Dr. Hart.....I owe you lunch!
Susan