Facet joint and sacroiliac joint issues

Posted by tan77 @tan77, Aug 9, 2023

I NEED HELP AND OPTIONS! I can't take this pain anymore. I've been having lumbar back problems since 2016. Hip pain since 2019. I was seeing a spine doctor for a year and a half. He said I needed lunbar fusion surgery. Recent MRI shows no bulges or herniated discs. I've had 8 epidural injections last year to no avail. I have since gotten 4 other opinions from other doctors. All four doctors say my spine is fine and that I have arthritis in facet joints and muscle inflammation in lower back sacroiliac joint and I don't need fusion surgery. One doctor said it's my hip. Got a hip MRI, needed a hip replacement. Could be the cause of my back pain. I got the hip replacement 2 months ago but my back is still killing me! Now a nerve block or ablation is recommended. Has anyone gotten relief from these procedures? Anybody have sacroiliac joint issues? What procedures has helped the most with facet and sacroiliac joint problems? I NEED something that will work.

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You could look into platelet rich plasma therapy- PRP- a form of prolotherapy offered in major physiatry offices in our hospital system, but you have to pay about $1,000 out of pocket. Greatly helpful for a family member's chronic SI joint issues after years of trying other things.

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This is just my experience. I fell hard on lower back in 2016 while skiing. Things seemed to be improving that summer, until a whole lot of pain suddenly kicked in while weed whacking. I had several rounds of epidural injections, none helped. I had a few rounds of nerve ablations. No help. Finally saw a neurologist in 2017 who prescribed several pain meds. After a few days of adjustment, it was a game-changer. I was able to get back to cycling and doing stuff around the house without extensive days. I still had occasional bad days. I was talked into spinal fusion of L5-S1 in Sept of 2017. Did not help. In summer of 2018 It was suggested that a spinal cord stimulator might help. I did the trial and it worked quite well. Did permanent implant. Not quite as effective as trial but still good.Between that time and Feb. 2021, my life was almost back to normal. Then the pain returned. Have seen more pain docs than I can recall. No one is trying to pinpoint the root cause as to why I am having pain in the butt when sitting, and pain in my feet, mainly the right one. I just had a pain pump implanted back in April. Once the dosage was adjusted to a higher level, I felt pretty good for about 2 weeks...then not much help. I am puzzled and distressed why I can't ding a doc willing to try and find the root cause of this mess and address it. Good luck. My prayers are with you.

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@windyshores

You could look into platelet rich plasma therapy- PRP- a form of prolotherapy offered in major physiatry offices in our hospital system, but you have to pay about $1,000 out of pocket. Greatly helpful for a family member's chronic SI joint issues after years of trying other things.

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I'm actually going to Mexico to get the nerve block. I have to pay $1700 in cash anyway. But I don't want to spend the money if it's not gonna work. I will look into PRP. How long does the process take usually?

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@heisenberg34

This is just my experience. I fell hard on lower back in 2016 while skiing. Things seemed to be improving that summer, until a whole lot of pain suddenly kicked in while weed whacking. I had several rounds of epidural injections, none helped. I had a few rounds of nerve ablations. No help. Finally saw a neurologist in 2017 who prescribed several pain meds. After a few days of adjustment, it was a game-changer. I was able to get back to cycling and doing stuff around the house without extensive days. I still had occasional bad days. I was talked into spinal fusion of L5-S1 in Sept of 2017. Did not help. In summer of 2018 It was suggested that a spinal cord stimulator might help. I did the trial and it worked quite well. Did permanent implant. Not quite as effective as trial but still good.Between that time and Feb. 2021, my life was almost back to normal. Then the pain returned. Have seen more pain docs than I can recall. No one is trying to pinpoint the root cause as to why I am having pain in the butt when sitting, and pain in my feet, mainly the right one. I just had a pain pump implanted back in April. Once the dosage was adjusted to a higher level, I felt pretty good for about 2 weeks...then not much help. I am puzzled and distressed why I can't ding a doc willing to try and find the root cause of this mess and address it. Good luck. My prayers are with you.

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I have Oxycodone it helps for a couple of hours then I'm back in pain. I do t know what to do. I hope you get some relief...

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@tan77

I'm actually going to Mexico to get the nerve block. I have to pay $1700 in cash anyway. But I don't want to spend the money if it's not gonna work. I will look into PRP. How long does the process take usually?

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@tan77 PRP takes about a half hour. My daughter was in pain for 10 years and was better in 24 hours after PRP. But it only works well for certain people. Her joint needed tightening and it was a soft tissue problem, not bone, making her a good candidate.

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I am so sorry for your pain and the mind-bending distress it can cause for you and your family. During a flair, you feel as if you are trapped in this torture chamber of your own body.
I was diagnosised with Facet disease after a CT Scan. Therefore I was sent for Ryzotomies - thankfully, with great success.
My right SI joint was dislocated (and sacrum fractured) due to an encounter with a violent patient in 1993.
I have had physio++++ and cortisone shots for this with varying degrees of success.
The SI joint can erupt at anytime into a painful and debilitating mess. Drugs can help at times, but I find that being very careful about certain movements, slight angles seems to keep the monster at bay.
Preventing getting into a major flare up is the best route, in general: paying attention to those twinges and getting off my feet as soon as there are any.
Ice packs, I have several, seems to calm, or just freeze the SI area.
Also acupuncture and a T.E.N.S. unit are helpful.
I do not think there is one magic treatment.... it is a combination of treatments that bring some comfort.
I do hope you are able to find what helps you. .. it is trial & error until you find what works.
Wishing all the best for you.

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SI joint injections have helped me tremendously. I have spondylolithsesis. I have had back issues since 1975. I refused fusion surgery 3 times. When things are bad I wear a custom brace. There is a minimally invasive surgery we have recently talked about to fix this. I may consider it. irene5

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SI joint pain is really miserable... it feels like sciatica is going across the back your hip down your leg sometimes all the way to your foot and in your knee across the outside part of your hip as well as the back. All I needed so far for that is cortisone injection in my SI joint which my primary care physician was able to do and then later I had my orthopedic surgeon do it before I had my hip surgery and it just helps immensely for long periods of time like I'm talking years for me. SI joint pain really mimics having lumbar herniated disc pain and sciatica. I also have had a hip replaced and that pain is completely different it just makes your whole area of your hip hurt and in my case I also had a some torn cartilage and such. Anyway it took a full 2 years to get over the pain and wobbling and misery of having hip surgery... it was not a fast deal like the doctor said it was. But now I walk pretty good. I am 72. The way I know the difference between SI joint pain and sciatica from my herniated discs is I push my finger into and around the middle of my back of my hip and if you hit a spot that makes you want to yelp and crumble to the ground you know that's the SI joint that's causing all that pain.

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Yes, that’s the pain described exactly!! There is a minimally invasive SI joint fusion surgery involving titanium implants that I am considering. I am 73 and have had back issues since 1975 when my spondylolithsesis was discovered after something “gave way” slipped while pulling my son out of a high chair table. I have a very high tolerance for pain which isn’t necessarily a good thing. My back doctor commented he was surprised I was still walking when he saw my recent x-ray. I’m having lumbar injections on Monday, but I feel I need SI joint ones instead. This growing up thing is highly overrated! ( Irene5)

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I can recommend facet blocks and ablation as well as branch blocks. The risk is low. They aren't permanent. Don't suffer.

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