Has anyone had SI joint pain following a lumbar fusion?

I am going in for L3-4-5 lumbar fusion minimal invasion surgery through my left side and back for Scoliosis repair. Am I in for a world of pain as I may hold off. The Scoliosis pain is bad but I don't want to try to fix it if it just makes it worse ? Is getting 15 mg Oxycodone for pain enough ?

I had L 4,5 and S1 fused in 2011 and have experienced lower back and sacrum pain for years. My suggestions are to do what you can to build up your core without twisting, take ibuprofen and Tylenol (as advised), and sleep with a pillow between your knees. Walking was my best medicine but my walking has been interrupted by other medical issues.
Regarding pain, I can only say that everyone is different, and listen to your body and have an advocate in the room with you as much as possible at first. My biggest problem with Oxycodone was the constipation it causes. I chose to take as little as possible, but with my back fusion morphine did not provide relief and I was given Dilaudid. The pain was mostly from back spasms. I also recommend prayer.

Yes, I'm fused L2-L5 and about two years after the fusion I developed serious lower back pain. It may be SI, but I've had SI injections and they have now quit working. A SPECT done about two years ago showed active arthritis at the base of the spine and in the R S-I joint. I managed with steroid injections until about two years ago and have explored getting a spinal stimulator. Right now I'm awaiting a R hip replacement, so I'll see how much pain is left after that.

@denman55
I had my L3-L5 invasive decompression and fusion 8/2/2024. I stopped taking narcotics after 10 days and now only taking Tylenol or Advil, as needed. I dealt with the constipation with senna and Metamucil right after surgery. It was an extremely painful surgery (off the charts) but gradually reduced every day over 2 weeks. I am doing really well 18 days post op (pain about 3-4 mainly with certain movements, 1-2 with minimal movement). I have used Salonpas pain patches if I do too much reaching or bending and really trying to minimize this and especially any twisting.

I had severe stenosis/DDD/neurogenic claudication prior to surgery and also bilateral gluteal tendinopathy and hamstring partial tears. My hope is to start PT to strengthen my core and lower body muscles to minimize any new issues in spine/hips/pelvis/buttocks.

Did you get updated MRI/X-rays to see how your post surgery spine looks and MRI of your pelvis/hips to see if there is any soft tissue damage? If they do any injections, they need to know the source of pain if they want them to be successful in temporarily managing pain. Are you taking Cymbalta/Duloxetine or an antidepressant that helps to manage your perceptions of pain?

I was doing well until late July/early August when I got hit with this SI joint pain which has now become unbearable. If I stay on my feet to long, I'm in pain and have to go lay down in bed - which is the only thing that keeps the pain levels down. As I mentioned, I will be seeing a Pain Managment physician in September, and I will be having an MRI of the lumbar spine next week, and then will meet with my surgeon to review the results. I have been on Cymbalta for years and don't find that it helps me to manage my perception of pain.

@denman55
Hope you get relief. I wonder if the angle of your spine has changed post op (since standing brings on the pain) and if there is any new compression/shifting of vertebrae or discs or if you injured your back or twisted to bring on the new pain. I was told my recovery and full fusion would take 3 months so I want to be really careful not to twist.

The MRI will need to include your full lumbar spine and sacrum to compare to pre-op imaging.

Here is my recent X-ray.

I do happen to feel that there is and has been a shift in my spine --- because I now have a "bulge" outward that I can feel -- and when I sit back in a chair, the bulge touches the chair first before I am even seated back in the chair. But I had a CT scan of my lumbar spine recently and just saw my Neurosurgeon to review it and he didn't say anything about it, but I still feel something is just not quite right. I do believe that somewhere over the last 3-months I did something to cause this bulge, either twisting or more likely bending when I should not have out of necessity. My Neurosurgeon told me that the bone graft will take 12-months to fuse. I never thought I would be in this position 3-months post-op. Hopefully the Bone Growth Stimulator will help me, but I am anxious to see the results of the new MRI next month.

I do, but I don’t know that I would have wanted to jump straight to a pain management physician straight after surgery.

Have you considered any PT post-surgery? My PT explained that for my body, the fusion alters how I move. Because it’s overly fixed, there’s excessive motion around the ends of the fusion because something has to move, and that tends to put strain on my joints at the ends of my fusion—right between my shoulder blades and at my sacrum.

Everyone is different but she was able to guide me to exercises to help me recover some of the mobility lost after the fusion and figure out where I needed to gain strength that over time helped with the pain.

One really fast intervention though is she recommended an SI joint belt. I wasn’t expecting much, but it really helped. Specifically, my PT and physiatrist recommended the Serola brand. It’s pricey, but was worth it; it seems to be the most widely doctor and therapist recommended brand.

I still have pain, but I didn’t end up needing injections, though it’s still an option.

Let me first just say that every physician and surgeon works differently. My Neurosurgeon referred me to Pain Management. I can not possibly go to PT while I am in this much pain. My Neurosurgeon did not recommend any type of brace or SI joint belt. He ordered a Bone Growth Stimulator for me which arrives today. I'm happy that PT is working for you.

Has anyone had an ablation after spinal fusion for their SI joint?