It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Back Problems Message Board


Back Problems Board Index


Welcome to the board. The reason that brought you here is very common.

The fact that the ESI provided some relief is good news, and with some diligence on your part, you may be able to heal that herniated disc and resolve your pain issues.

You have had a set-back because you made a common mistake made by many who suddenly have their pain relieved. They feel great and can't wait to get back to doing all the things that their pain has kept them from...and they bend, and twist, push and pull and do way more than they should...and they end up right back where they were, or worse.

SI joint problems are becoming a catch-all for various and sundry painful conditions. Often it is difficult to tell if a patient's pain is coming from the lower back or the SI joint. Since you know you have a disc herniation, and since you responded to the ESI, my guess is that you have irritated that situation again, and perhaps, the SI being out of alignment is a secondary issue.

It is not unusual for someone to have one leg that appears shorter than the other, or to have a slight rotation in the pelvis. Sometimes this begins with a foot problem such as pronation...which causes an inward rotation of the knees, which almost always causes some pelvic misalignment and leads to lower lumbar problems, often with the discs.

I would suggest you ask your PT to evaluate your postural alignment, beginning with the feet which is the root of all posture. If you feel the exercises are causing more harm than help, discuss it with your PT. You can get into a vicious cycle if the SI joint is out of position and you are doing certain exercises that pull on the piriformis muscle. If there is a problem, it can irritate the sciatic nerve that runs directly under the piriformis, which can cause pain in the groin, hip, buttock and/or running down the leg.

Every time you do the exercises, try to ice afterward to prevent inflammation.
But before another session, I would discuss these issues with your therapist. If you feel he/she is not adequately listening to you, AND you feel like you are getting worse, not better, you may want to take a break for a bit and let that joint calm down.

Has anyone ever told you there is a spondylolisthesis connected with the disc herniation? This is a situation where the top vertebra slides over the adjacent one. Sometimes a patient is given a flexion/extension X-ray to diagnose it; sometimes it is obvious on MR imaging.

After talking with the PT, if I were in your shoes, I think I would stop the PT for now and get another steroid injection. Then I would acquire a copy of "Treat Your Own Back" by Robin McKenzie, and begin SLOWLY doing the exercises he shows in the book...to see if I could get that herniation to "heal" without surgical intervention. (I would have had the postural alignment checked out to see what was up with the SI joint...but I would probably stop working with the PT if he was not responsive to my concerns.)

Bear in mind, I am not telling you to do this...just saying I think this is how I would approach it if your issues were mine. I would certainly go back to my doctor and discuss all this with him...and since ESIs are usually offered in a series of three, I would inquire about having a second one...and then I would be very careful afterward.

With a herniated disc or an unstable SI joint, you should avoid all activities that involve bending or twisting at the waist, pushing, pulling, reaching up overhead or to the side, and lifting anything more than a small amount (number varies depending on your issues, but anywhere from a gallon of milk to 30 pounds). Also going up and down a step ladder is very hard if your SI joints are unstable. Digging in the garden and raking are also bad activities for those with lower lumbar issues.

You could try wearing a SI belt to see if it makes you more comfortable. You can find them online or at a good pharmacy-- basically a band of stretchy elastic material, about 4" wide that holds the SI joints relatively tight as you walk.

Are you being treated by your PCP or are you seeing a spine specialist?

I hope my comments will not be confusing or upsetting to you. They are not meant to override anything your doctor tells you....I'm just suggesting some things that you may not have thought about. It's been my experience that standard PT seldom helps in generalized lower back pain issues...and sometimes causes the patient more pain. And I wasted over a year dealing with my well-intentioned PCP who thought he knew exactly how to treat me. I wish I had gone to a spine specialist a lot sooner, and taken the time to find a PT that specialized in orthopedic treatment.

Please post with your questions and comments. There are many of us here to support you and offer our opinions based on our personal experiences as spineys.

Good luck!

TT





All times are GMT -7. The time now is 03:56 PM.





Site owned and operated by HealthBoards.comô
© 1998-2018 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!