SI Joint

[HGD24]

Has anyone here had any issues with their SI joint after having fusion surgery?

I had an appt w/my surgeon last week for my 2 year post op and told him about some pain I've been having in the back of my right hip. It started when I was 3 months pregnant and increased after delivering the baby when I was just 5 months along (she didn't survive). The PA did some tests and concluded that the pain is most likely due to my SI joint and she said it should clear up in a few months.

I have read that later on in pregnancy, the SI joint, which does not normally move, usually opens to allow for the widening of the hips, etc for delivery. I'm wondering if while in labor, my body went through the process of opening the SI joint and that's what pain is from or if it could be from my body adjusting to it's new shape and new balance of weight since my surgery in Feb 2005.

Any information would be appreciated.

[SandyC]

HI,
Yes, I started having problems with my SI several months ago. I'm fused from T4-S1. My surgeon told me it was my SI and I needed to see a pain doc. After a couple of rounds on injections and an increase in my Neurontin, the siatic pain is just about gone :)

[Cena75]

Heidi,
I've had problems with my SI joint, before and after my last revision surgery. In fact, I was at PT today and he was working on them. He mentioned that mine is tight partly because of my range of motion, but also b/c my pelvis is tilted. (tighter on the side that is higher), and my body is adjusting to the new balance and stance. My PT does manual therapy, where they get their hands into the joints to release them (it hurt at first but felt great afterwards). Stretches that loosen the hips also help (like pulling your bent knee across to your opposite side). Heat really loosened it as well. Take care!
Christina

[RoundTheTwist]

Hi Heidi,

What you are describing is actually called SPD (symphysis pubis dysfunction) which some women get whilst pregnant and is an over-loosening of the ligaments during pregnancy. I had this during my 2nd pregnancy.

Basically when you fall pregnant the hormones in your body cause all of your ligaments to loosen up in preparation for carring the baby and then later for the birth. During the birth it is nessessary for your pelvis to widen slightly to allow the baby's passing through, but in some people their bodies loosen up the ligaments a little too much and it can cause pain. I actually had the most pain in my pubic bone (at the front between my legs) and it made life very difficult for a while, but I have also had pain in my SI which I am certain is related to my SPD.

Docs say that SPD goes after you have the baby, but in my experience it hung around for a while and was easily aggravated by a slightly wrong move by me for several years after the birth of my son, so I don't know whether it causes those joints to be a little less 'stable' after a pregnancy or whether the condition is exacerbated by my Scoliosis and/or fusion.

The other downside is there is a chance that you could get SPD with any subsequent pregnancies :( Was the pregnancy you are speaking of before or after surgery? I am really sorry to hear she did not survive, very sad.

On the upside Physio is probably the best thing to help you, maybe you could get a referral?

Hope this helps,

Kat x

[Ken]

Hello,

Are you talking about having Sciatica after having revision surgery? If so, did they remove any of your lumbar discs?? And if they did, what did they replace them with??

Ken.

[SandyC]

Ken,
Yes, I had A/P in '02 after having had Harringtions put in back in '83. And, yes it is/was sciatic pain

[Ken]

I'm really surprised, I thought this was one of the benefits of having revision?

Did you have discs removed?

Do you know what is causing the sciatica pain?

[SandyC]

Ken,
As I stated I'm fused from T4-S1. At L3-4 I have what is called "cages", these replace the disks at that level. I should also add that I had to have my rods taken out 6 months after my A/P surgery in '02 because of a very bad case of MRSA, I was then fused. A year ago this past January I had to have 3 plates/fusion at C5/6/7. So you can imagine that there is a great deal of stress on my hips/SI and C1-4 area, which I contribute to the sciatic pain.

[Ken]

Hi SandyC,

Did you have Kyphosis above your H-Rod?

Feel free to PM or email me.. I'm curious to know how you are doing in your day to day living with that much fusion... I am currently fused T2-L2 but am planning my revision surgery and I have Kyphosis above my H-rod and so I may need additional fusion, they are also planning to extend my fusion to the sacrum - Lucky me, huh??

my email is: askforKen@aol.com

[HGD24]

Thank you all for your responses. I've started walking more at work (I work in a very large building and am trying not to use the elevators) and I am starting back up at the gym today too, so I'm hoping that getting back on the bike and eliptical will help. If it doesn't, I will most likely see my PT who helped me make an amazing recovery after my surgery. I noticed that even after my surgery, one hip is still tilted slightly more forward than the other so that might be the cause too. My Ortho said that there's not much he could have done to correct the forward tilt in the hips. Here's to hoping that working out helps alleviate the pain!

[Cakedec]

I had SI inflammation and sciatica before my surgery; they said it was from a twisted pelvis from the scoliosis. The PT exercises and stretches did help some, but it never really went away. The steroid injections just irritated it.

Since my T5-L5 fusion 7 months ago, the sciatica pain down the leg is better but the SI inflammation is still there. It gets sharp if I am on my feet very long or walk very much. Cycling is better for me. It hurts to lie on that side in bed. Saw my surgeon last week and he is sending me back to physical therapy so they can target that area.

Let us know how yours goes and I'll keep you posted on mine.

Deb
age 48
posterior surgery 7/24/06

[LindaRacine]

Ken...

The sciatic nerves go through a lot of small spaces in the spine and in the pelvis, so even fusion to the sacrum is no guarantee that the patient will never have sciatic nerve pain.

I keep trying to stress to you that, while you have an excellent chance of getting out of pain, there are truly no guarantees. Some people get no improvement, and some actually have worse pain. While I think it's good to be confident going into surgery, if you dismiss the possibility that you might have some complications, you could be thrown for a big loop.

Regards,
Linda

[geo]

Hi Heidi,
I too have had problems with my SI joint, although I have not yet had surgery. In fact, the sciatic pain I was feeling is what took me to the doctor in the first place, and led to seeing a specialist who recommended surgery for my scoliosis.
My physical therapist did not necessarily see a connection between the sciatic pain I was having and my scoliosis. She believes that it is from SPD that Kat mentioned, where the ligaments in my reproductive area loosen during my period. For the last three months, I have experienced lower back pain -- mild sciatic pain -- just before my period. The exercises she gave me really helped, and the pain has lessened with each month.
One exercise is laying on my back, with knees bent, holding a soccer ball between my knees. Basically, I just squeeze the soccer ball as hard as I can with my knees for 10 intervals of 5 seconds. Usually on the 2nd or 3rd squeeze, I will hear a popping sound in my groin area, which she explained is my SI joint realigning itself. She was also able to see a significant difference in my hip alignment before and after this exercise.

[Karen Ocker]

The sciatic nerves also pass near the mid portion of the buttock. That is why nurses/doctors need to be mindful of the correct place in the butt to give shots--upper outer quadrant. Laying on the area or profound streching of that area will stretch the sciatic nerve causing pain having nothing to do with the lumbar region. I did have sciatic pain post op when I started to do profound leg stretches, I also had it on occasion while healing from surgery because it certainly was disturbed while reducing my lumbar curve.