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Is my luck running out?

Hi all,

  I had a 2 level (L4-S1 ALIF) done in 2007.  I've recently started having pain when I sit and when I lay down in bed.  It is bi-lateral pain that is about two inches off center of my spine line in the sacrum area.  I've read that there is up to 75% SI joint problems within the first five years post lumbar fusion.  I'm 11 years post op so I'm wondering from a statistical standpoint where 11 yrs falls into the probability of SI joint dysfunction.  I'm not technically on any lifting restrictions, although common sense keeps me from doing too much.  The pain has slowing been increasing, but in the past couple weeks has really come on strong.

  I'm also wondering, after having an SI fusion, how much mobility is lost and what are standard restrictions after the procedure.  Some of the SI comments on the board are a little terrifying to read! 

  Hopefully, my PM will want to do a diagnostic injection to rule in/out SI issues, but regardless if it is truly the SI joints, something down there is not happy!





  • memerainboltmemerainbolt IndianaPosts: 6,443

    I have the same problem, SI joint sitting on a nerve which shoots across my butt into my left hip. 
    The only thing that has ever helped me was a caudal block. This last 3-4 months and I will schedule another one next week when i see my PM doctor.
    I really hope this is not the case for you, you've got enough going on.

  •   Hi EMS Guy, I recently found out I have bilateral degeneration of the S.I. joints and have had a TLIF at the same levels years ago as you. I'm wondering if there is AS going on since L3-4 autofused, and now this S.I problem. Or is it from the RA I've been diagnosed with? It's so hard to tell what's what when you have several issues going on simultaneously. I think the dx injection will be helpful for you. Have you had an MRI or ct in that area yet?

    Sandra, are caudal blocks really painful? I remember how nervous I was about getting cervical RFAs. I hope the next one gives you longer relief.

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  • Hi there,

      I haven't had an MRI yet.  Since I'm a workers comp case, I know they are going to fight this tooth and nail.  I'll have to go through the normal protocol for WC to be compliant; exam - rest - PT - rest - Tylenol - rest (60 - 90 day time frame) - then finally, imaging.  Good times!


  • memerainboltmemerainbolt IndianaPosts: 6,443

    My PM doctor puts me out just long enough to do this procedure. I told him there was no way I could do that procedure without it.
    Keith, I'm so sorry that this is a WC claim. I just don't think they care.
    Good luck.

  • My WC company used to be great.  Then I got a new adjuster and things went downhill quickly.  I've had my case re-opened twice in the past two years with them trying to weasel their way out of covering me.  Both times I beat them, but it was nerve racking to say the least.

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  • Mayday

    Hi I've never had a causal block but have had several epidural median branch blocks si injection and rfas without being out under. Actually they aren't bad at all. I moved to a different state and they put you under. However if I need any more I'm going to ask to not be put under. The procedures don't hurt any more than the iv you get for sedation. I o my have one arm they can use due to a mastectomy and I don't want to wear those veins out. 

  • robmjrrobmj Posts: 46
    edited 05/23/2018 - 12:39 AM

    Hi EMS Guy - Everyone has a different pain tolerance, but I've had too many caudal ESIs to count and I don't get sedation for them anymore. The only (short-lived) pain is the lidocaine injections, then you'll feel pressure and nothing more. They are a piece of cake compared to your daily pain. For Radio Frequency Ablations (if you get to that point) - I recommend IV sedation (you're still awake - versed is usually used to take the edge off) since the procedure takes longer and there's nerve burning involved. I've had SI joint syndrome (Ankylosing Spondylitis) for 23 years. I am not a doctor, but symptoms usually are one-sided (or bilateral, especially when there's a previous lumbar fusion) and include pain in the SI joint area (palpable to the touch), hip pain, groin pain and pain down the leg. Hurts much more when sitting at 90-degree angles or for long periods (15-20 minutes for me), especially in the car, and feels a bit better when walking/standing. I'm so sorry for your pain - to help, I use OTC lidocaine topical analgesics that have a heating effect, ice/heating pads, TENS machine, Flector patches, an SI belt when walking and take NSAIDs and Tramadol. Please take care -


  • Hi Robyn,

      Sitting at a 90 degree angle doesn't work for me!  Way too uncomfortable.  I always sit at a 45 degree slouch.  My mom would have a cow if she were still alive!  She was the "sit up" queen!  I've had RFA twice in the lumbar area and your right, best to be medicated for that!  It's weird that this last weekend I was working around the house and it wasn't hurting bad at all.  But as soon as I came back to work and was sitting for a while at my desk, it was right back again.  To top it off, now my sciatica on the right side is talking to me.  If it's not one thing, it's another! 

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