Sacroiliac Joint Dysfunction: Physical Therapy Take Two | Post 7 - Engineer Mommy
Apr 012017

In my last post, I discussed how exercising set me back and caused another flare-up of my sacroiliac joint dysfunction. The SI joint pain was no joke. It stopped me from walking comfortably, even around my house. I was going to try physical therapy again, but this time, I’d go to a new therapist for a new set of eyes.

After hearing my history, she began the physical examination. She quickly told me that my left ilium (hip bone) was anteriorly rotated (stuck in a forward position). My right SI joint was stuck and my sacrum (the triangular bone at the base of the spine) was not level. She felt confident that she could help get me back to normal.

One thing I did differently with this physical therapist that I didn’t do with previous therapists was that I spoke up more on the exercises that caused me pain. With the first therapist, I just did all the exercises all the time even if they exacerbated some of my symptoms. My bad! This time, I made sure not to do anything that made my pain worse.

She did help me. Within 3-4 weeks, I started to feel better. It was very gradual, though. It was like I had one or two days here and there, where I noticed, “Wow, I can walk across the house without pain and without a limp”. Those days were among other days that were bad. However, by week 3 and week 4 of physical therapy, I noticed I was having more and more of the good days. This was exciting. She did rehabilitate me!

However, I wasn’t 100% yet. It was still difficult to bend down or bend forward. If I did, I felt a tightness or a pulling sensation over the right SI joint. However, besides bending down, I felt pretty decent. I could walk around the house. I could walk around the supermarket and the mall.

I wouldn’t try exercising, because I knew that that was one of my pain triggers and I would not even risk it at this point. However, I did not stay great for a long time. I was only pain-free for about 2-3 weeks and then the pain came back. I went back to the physical therapist and sought answers. Maybe I was out of alignment again? Nope, she said I was in proper alignment. Frustrating!

She said my piriformis muscle (small muscle in the buttocks) was tight and irritating the sciatic nerve. She recommended stretches and I did them, but I didn’t seem to improve. Here’s what’s next for me:

  • SI Joint Injections: They inject an anesthetic and a long-acting steroid medicine directly into the SI joint. The anesthetic is intended to provide immediate pain relief – it basically numbs the joint. The steroid is intended to provide long-term reduction in inflammation & pain. This injection is considered the gold standard in diagnosing SI joint dysfunction. If the patient receives a significant amount of pain reduction as a result of the injection, then it can be inferred that the SI joint is the pain generator.
  • If the SI joint is proven to be the source of my pain, I might consider prolotherapy next. Prolotherapy is considered alternative medicine. In this treatment, often administered by an osteopathic doctor, a large series of injections of a sugar mixture are injected into the surrounding tissues. The theory is that these injections irritate the tissue and stimulate a healing effect. This effect strengthens the ligaments that support the joint. This treatment is most successful when the cause of SI Joint pain is lax (loose) ligaments. Insurance doesn’t cover the procedure.
  • Another treatment option is called radiofrequency ablation, in which a probe is inserted into the SI joint region. This probe targets the nerves that send pain signals to the brain. These nerves are deactivated using an electrical signal, thereby making the SI joint region numb.

So that’s where I’m at right now: trying to live with the pain and managing it the best way I can. I am staying hopeful that I will conquer this pain eventually and find a treatment that works! I will update on my experience once I have had the SI joint injections.

To see the next post in this series, and to see all posts in this category, please click here. If you’re dealing with SIJD, please share your experiences in the Comments section below.

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 April 1, 2017  Posted by

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