Pain on right upper buttock cheek that does not radiate

Hi,
reviving old thread.
I've had 4 surgeries, last one in 1987. My back has been kind ifof more of a mess on and off for about 5 years with terrible muscle spasms. MRI shows severe spinal arthritis but also protruding disks from L2 down to S1.
I can't stand up in the kitchen anymore (tile floor maybe?) So bought a stool on wheels for dishes etc. The stool went out from under me and I hit flat on my butt on tile from waist height. So much pain in my right butt cheek. Sharp disabling pain. (I live with CRPS from the hips down so I have a pretty high pain tolerance.)

I was already in PT so just kept going until (already on crutches for years) I couldn't walk even with them. Xrays, ? Occult fracture of spine but neg for that but a lot of scar tissue. So, MRI, then ortho surgeon who says its an SI joint sprain and offered me a shot. Refused. With CRPS anything invasive is a no-no.
My MRI results were 1.5 pages long. Long paragraph for each vertebrae. My back is a mess, has been since I was 23 (nurse slipped discs moving a patient.) .I'm 69.
A PT on YT had tests to do to see what replicated the pain. A twist to the left did (right buttock) so now what? Dic says "you don't want a fusion." No, I don't.

But its worse everyday to where a lot if this week, living alone, I've been bedridden a lot. I can barely put weight on my right leg. I use forearm crutches but have gotten along ok till now, post fall.

I can't walk with severe pain - esp getting up from a chair. Just really severe pain. I've lived witg crps pain for 45 years but THIS! is unbearable. Not traveling down my leg.

Starting seeing chiropractor and feels better till I sit down again and can't walk again. Chiro is $80/wk out of pocket (2 visits) for what medicare doesn't cover. She says sciatica. Dr say si. I feel hopeless. Trying to do life alone. Sink full of dishes. I still work and run a small graphic design company from home but can't work.

For those with SI joint, have you heard of an si joint sprain? Online says it will get better in a few weeks. This is getting worse. Medicare pays for nothing for home help. Medigap only pays if medicare pays.

I'm at a loss over here. People guess at a dx, then say cortisone or go away. Pain doctors only do invasive things. Any thoughts? Esp living alone and can't function. Friends seem to have disappeared when you can do less and less things. Feeling very hopeless. Thanks.

I take meloxicam tho I dint think it helps much. Doing cold and heat. I have to work. Deadlines for clients so I sit at the computer when I can and cry. Pressure to get thjngs done and i can't think.

Who should i see next? I'm in Asheville so not the best medically. Go to Duke if I can drive that far and get told the same thing? Sorry, I'm just so discouraged. I'm only 69. I would not even consider a nursing home. Shouldn't have to. All thoughts welcome.

When drs ignore you, blow toy off, basically say "too bad, so sad" and you can't do life anymore... thanks for reading.
Sorry so long.

Hi BeBold - Damn I'm sorry for what you're going through. I've had sciatica problems on both the left and right side. My lumbar spine has scoliosis, it curves, and stenosis, narrowing of the spinal canal due to arthritis.

I'm 69 now. I was 57 when the disc at L5/S1 ruptured into my spinal canal (not herniated, ruptured). I totally get how awful it is to not be able to stand. The pain was in by buttocks and hamstrings, and probably my calves. When I was standing, the pain seemed to be everywhere. I had no doubt it was my lower spine.

I saw a spine specialist, and he would only operate by doing a fusion. I got a second opinion, and that surgeon said that while a fusion would be a correct diagnosis, he could try a laminotomy first. His point was if that didn't work, I could then get some of the vertebra fused.

The laminotomy consisted of drilling holes in the back of my S1, L5, and L4. The ruptured disc was removed (there is some healthy disc left at S1/L5, but not much). He also used those holes to clear away arthritic spurs and create more room in the spinal canal to reduce pressure on my sciatic nerves. Nothing he could do for the scoliosis, but that alone wasn't causing problems.

The result - it worked and without fusion and that was 12 years ago. I retired and I'm in the gym 7 days a week. Never felt better. I'm 5'10" and in the last six months I eliminated refined sugar from my diet (well, almost all.....) and I started spin class to up my metabolism and lose more weight. In 8 months, I've gone from 190 lbs to 165 lbs, and virtually all of the weight lost was "visceral" fat surrounding the organs in my torso.

All of our cases are unique, and I'm not suggesting that what worked for me would work for you. I do have some suggestions for you:

1. Until you see an orthopedic spinal surgeon, put the chiropractor on hold. There is a place for these people, but not when the spine has devolved, as it has apparently in your case. If you really want to see a chiropractor, I would see if you can get a referral from a real spine surgeon, and only after an updated diagnosis.

2. Get an updated, complete picture of your spine, specifically the lumbar and sacral spine, and find out what is wrong and what can be fixed. I mean no disrespect, but it seems you're all over the place. Whether you need fusion or not, I'm pretty sure a real spine surgeon can help you.

3. I would do all of this through a new surgeon, a fresh set of eyes. Find a surgeon in his or her late 30s to mid 40s, with a solid med school/residency pedigree. Great surgeons do residencies at places like the Cleveland Clinic or Mayo, where you have to have a good med school record just to get in. These Drs are the best of the best. They are young and still ambitious, very talented and up to date on advances in spine health and surgery, and have done hundreds if not thousands of procedures already.

I hope you find something here that helps. I know what the pain you are going through is like. Medical science has made incredible advances.

As for me, I recently moved and had to find new orthopedic surgeons. I used the criteria outlined above and found a great Dr. to replace both knees.

Even though I have had no symptoms of sciatica for 12 years, I still booked a preventive appointment with a spine Dr. referred to me by my knee guy. The good news - my "core" is in great shape and is completely supporting my still f#$%^d up lumbar spine. After looking at my X-rays, the surgeon was surprised I could walk.

And somewhere down the line, you may consider working on your core, as your condition allows. The core consists of 30 different muscle groups in our torso. These muscles can keep the lower spine stable. In fact, my new surgeon said that if I did need surgery - if sciatica returns - he will have to fuse two or more vertebra. His advice - keep up the exercising of the core muscles.

First things first. Get an updated evaluation and recommended course of action. If the surgeon want to fuse, I would ask if there is another way, similar to my case. That may not be possible, but it doesn't hurt to ask. And no matter what you hear, get a second opinion. And please drop the chiropractor. I think they are fine for most people with healthy spines, but not for people like you and me.

This is a really long response, but I think it is a good course of action and will eliminate a lot of uncertainty you seem to be dealing with.

I wish you all the best my friend. I've had my share of ailments, but nothing was as painful as the problems caused by my lower spine. Fortunately, there is help.

All the best! Joe

I hear your frustration and am living with similar problems. I have both spinal arthritis and have had SI joint arthritis as well. Your pain since the fall sounds like SI pain, not sciatica, if it’s not radiating down leg. Sometimes when we’re hurting so much we forget about some basic relief items. I would try ice packs when you can, plus diclofenac gel over the painful side rubbed in well and a lidocaine patch 4% to cover the area . Both are OTC. I also think chiropractic treatment could make it worse. An inflamed joint needs rest, not manipulation. A pelvic girdle type splint snag around the buttocks and front of pelvis will immobilize the SI joint and may help. Your PT may be able to help you get that. I would consider taking time off from work to give yourself time to heal. You’re dealing with so much, you must set priorities and take care of yourself first. Our health care system is sorely lacking in assistance for chronic conditions and disabilities!