SI joint or piriformis

This is life altering for sure. I have suffered this pain on the left side only for more than 10 years and it seems to emanate from my left SI joint. But my doctor says it all starts with my arthritis of the spine. No cortisone or prp injection has ever helped except the lidocaine they use to numb up the area prior to injecting cortisone. But even that only helped with injections in my tailbone and it wears off in a day. NSAIDS (Voltarin and ibuprofen) did help me a lot but my kidneys are too negatively affected by those. Everyone is different so it’s trial and error. For me, a combo of spinal cord stimulator, cymbalta and lyrica work best but with the latter two, weight gain and drowsiness are side effects. So I am currently trying to figure out the least harmful doses. Right now I have dropped the Lyrica and taking Cymbalta in two small, rather than one large dose so that I can stay awake! If you decide to try Cymbalta my experience was that I could only tolerate it if started on the lowest dose possible accompanied by promethazine to prevent nausea. Then I was fine and it helps a lot. I wish you the bedt!

Piriformis injections have helped significantly for me, I suggest you try it. I've had SI joint syndrome for 12 years following to spinal fusion. Piriformis injections have helped with the referred pain

SI joint fusion has been suggested as a minimally invasive option for me. I just am worried that I will still have pain in other areas afterward if the joints are not the entire issue.

What are your piriformis symptoms? Or your SI symptoms like?

I had performing injection. Immediate relief. Pain never came back.

Would you mind sharing your piriformis symptoms with me including radiating pain? My diagnosis is under some question. Thanks

I first had a sharp pain in my butt near the hip joint. In a couple of days I was having pain radiating down my leg to the back of my knee and and a little bit into my calf. My doctor first ordered a CT of my back to make sure it wasn't a pinched nerve from my lower back. Since that was negative, performing is identified. The injection to the area of where the nerve starts. Immediate relief. Nerve came back. That was 5 years ago.

It can be both! It can be either or at times; it can be neither if it’s referred pain from your spine or your facet joints. You need to go to a really good orthopedic surgeon and a really good pain management doctor hopefully ones that work together. Also, you should try deep tissue myofascial release therapy that is amazing for piriformis, sciatic and tight SI joints, I’ve suffered with SI joint and piriformis dysfunction for 30 years. I have genetic scoliosis and that caused a problem as I aged. The muscles around your core and spine weaken and they start tugging. You can have nerves that run through your buttocks and you could have tight SI joints , and you can have press on those nerves and cause sciatic pain. There are so many possible combinations of things you can have that you need to see some good doctors who will work together and come up with some viable solutions. Eventually, I had a good deal of surgery done on L3 L4, L5 , and straightening that out helped a lot of the radiating pain that goes down my leg, causing numbness and muscle spasms and a terrible itch on the outside of my left lower leg. There’s something called a nerve conductivity test and your doctors can refer you for that and that’ll isolate where the nerve pain originates , when things get too out of control. I get a shot of Toradol in my buttocks and that resolves the piriformis inflammation and pain for years or months at a time. Nothing substitute for good physical therapy and good stretch exercises and good posture. Also managing one’s weight is really important. I was diagnosed with a piriformis dysfunction early on, and there’s nothing much to be done about it. Nothing magical. Eventually, the diagnosis lead to disc degeneration And stenosis in the facet joints Ulting in a major lower back surgery. It’s really important to go through all the diagnostic functions your doctor and pain management people can put you through. I don’t recommend all the steroids on a regular basis. Just use them purposefully to diagnose , and then figure out what you can do to maintain your body without pain. So use the cortical steroids, the epidurals, the Toradol, and all the things for an immediate treatment but over the long term you have to find other methods to maintain your good health.

I have it in spades but injections did little to help. I sleep left side right on the bad area but with sleep apnea, I have to. After hour and half I awaken in pain and end up sleeping with both legs on the floor which in a word=sucks!
I work out and have lost a lot of weight some 70 pounds which helps but thank god I have buprenorphine for pain. Does not remove it but takes the edge off,
Yes I have been on just about every opiate and opioid med but have extreme tolerance to them all. Made me look like a drug seeker which hey! I was! I just required higher amounts but am doing great on the bupe.

Glen

I would do physical therapy before I’d go for injections. It’s the least invasive and can provide you with the most ongoing benefit.

Hi, I'm going to reply to you even though you didn't direct the question to me. An MRI revealed my sciatic nerve going through my piriformis muscle. This, they thought caused my leg numbness and throbbing pain. I went to several surgeons and finally found one who operate. She did and the pain remained after the piriformis release. Now, I did my research and think it's the SI joint. My pain meds doctor injected lidocaine to numb up the area prior to injecting a steroid. The lidocaine worked for most of the day. In 2 weeks, I will probably get a steroid shot. I'm running out of ideas. Dougs72, if you want to talk about this PM me a phone number. I also have neuropathy in my feet. No fun living in pain. The biggest problem is finding out what's causing the pain, then treating it. I hope you feel better. It's not fun living in pain.