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Author Topic: SI Joint Dysfunction  (Read 6270 times)

blessedmom

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SI Joint Dysfunction
« on: December 12, 2010 at 06:02 PM »
I have been on bedrest (although I am not well-behaved about it 100 percent of the time - due to chronic spinal pain, I NEED to move sometimes!) since September. Part of my back problems included a hypermobile SI Joint. The hormones now in the 3rd trimester have completely torn the right SI joint. I am crawling to the bathroom. The relaxin loosened the tendons/ligaments and my SI Joint which is supposed to move 1-2 MM is moving inches! They are going to try a rhizotomy (to burn the sensory nerves) after delivery, but wondering if anyone has had theirs fused? Physical therapy would take forever and I worry it wouldn't help much. I went through it when my SI joint was moving centimeters and it took a year and never fully gave me relief or stability. I have an SI Joint belt stabilizer, but can only wear it so often - rubs the belly! Just wondering if anyone has run into this. Very painful. Even lying in bed. But I prefer this to anything that could hurt the baby!!!!  Thank God for that. Of all the problems to have - this I will take any day over preeclampsia or diabetes! Hope you all are doing well and not going nuts! I know it is hard, especially if you are just starting out, but hang in there! I have made it 2 months and I do not think I have gone insane yet! This site is a Godsend!

stayinthere

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Re: SI Joint Dysfunction
« Reply #1 on: December 13, 2010 at 01:58 PM »
SI joint pain is the worst! I am a physical therapist and a PT could come to your home to show some exercises to improve your comfort and also tape the SI area (usually with a tape called kinesio tape or maybe even leukotape). If the belt is difficult to wear the tape might help.

You also want to avoid any single leg activities. Get dressed sitting down, never sit cross-legged, walk slowly to limit single limb stance time, avoid stairs use caution stepping off curbs, sit down in the car and then swing your legs in v stepping one foot in first, sleep on one side with a pillow between your knees. Avoid bending and twisting especially at the same time. Also, varying your position every 30 minutes or so seems to help as staying in one position seems to mobilize joints through pressure.

As far as fusing joints, I believe there is a hormone that can be injected to your SI joint during pregnancy that is safe, but I am not sure if it is the same as they use when they fuse your SI joint. If it is torn you are probably a candidate for SI joint fusion. It is usually a last resort treatment because when you fuse a joint you put added stress on the surrounding joints and may cause other complications in those joints.  You may also want to talk to your doctor about a c-section if your pain is still severe around the time of your delivery to avoid worsening the issue for yourself. This is an extremely personal issues so that is why I would think about it and discuss the pros and cons of a c-section with your physician.

There are also exercises that can be done. I am surprised it took months for you to recover after seeing a PT last time.  My general rule of thumb is you should have improvement in 2-3 weeks tops or I will refer you back to the physician for further evaluation. I really like to see even mild pain relief by the end of the first treatment or two.
Pelvic tilts and strengthening the transversus abdominus muscle - the deep abs that run by hips like a corset are crucial for pelvic stability. The exercise where you push one leg down while you push the other leg up lying on your back with knees bent (kind of like scissors work) Is a good correction technique, but if your SI joint is torn I would use it with caution and it is also important to know which side has slipped which direction so you perform this exercise the right direction and don't make your problem worse. A PT could assess and tell you which direction your SI joint has slipped.
Good luck to you, I hope this helps!! Feel free to message me with any other questions.
   


blessedmom

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Re: SI Joint Dysfunction
« Reply #2 on: December 13, 2010 at 06:58 PM »
i have chronic pain due to a severe head/spinal injury. i also have hypermobile joints. i have had more than ten rhizotomies on my neck and we were about to do 2 on my low back. we did an mri and found the baby! my husband had a vasectomy that reversed itself. we had chosen not to have kids because of my physical problems and progressive disability. my docs have insisted on a csection due to two PFOs in my heart and my back and hip problems. my hips were not bad until I had an SI Joint injury at work that was diagnosed as lumbar pain (incorrectly) by 2 DRs, 3 PTs, over a year and a half. I finally found a great PT that diagnosed it. It was moving a few cm.s when I got to him and a year and a half of wrong treatments and bedrest had made it worse. He worked magic, but it took months and never fully recovered. I still wear the SI belt to work, stores, and have to rent wheelchairs for vacation or whenever I will do a lot of walking. Last week, I felt the right side tear. My chiro and OBGYN confirmed. There is more than an inch and a half of SI movement! It is unbearable! I know the exercises and just cannot do them right now, but the tape would help. I have slept with a pillow btn my legs now for almost 3 years. I adjust position because of my SI and my back/neck. The spinal injury has progressed to Chronic Myofascial Pain Syndrome. I was told to stay on the percocet through pregnancy as my pain levels are more dangerous to the baby than the meds, but I ent off the valium, effexor and elavil. The pregnancy was an unwanted blessing that I could not be more grateful for, but it has taken its toll on my body and the tendons tearing was really the final straw. I cannot put any weight on my right leg or turn over without excrutiating pain. We will most likely do an SI rhizotomy the week after delivery. Then see if we should fuse. Thet are saying yes, but I am worried that it will restrict movement and cause more lumbar pain. I cannot do epirdurals due to cushings. thanks for the info. appreciated!!!! im harder to handle with the hypermmobile joints and previous injuries. that is a great idea to call my old PT to have him come over!

stayinthere

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Re: SI Joint Dysfunction
« Reply #3 on: December 13, 2010 at 10:30 PM »
Not all PTs do home health, insurance issues etc, but if your PT doesn't, they could probably refer you to one they would trust. Good luck