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Effect on Cycling of Radio Ablation for SI Joint
I have back pain in the sacroiliac (SI) joint, most likely the effect
of being struck by a car while riding several years ago. My pain management doctor wants to perform radio ablation to kill the nerves that are generating the pain. This is sort of like microwaving that part of the pelvis and cooking the cartilage and ligaments. This is supposed to provide at best temporary relief for as long as several months. I have corresponded with others who have had this procedure for similar problems, but I want to know if any cyclists have had this procedure, and what the effects were, and for how long, particularly the effect on riding. As things stand, the pain limits my cycling (among other things.) As a diagnostic procedure they shot an anaesthetic in the joint. The next day I could ride normally for the first time in months, but it wore off in a few days. I'm concerned because some of the people I've talked to had severe pain after the procedure, though some eventually had good results for several months, being relatively pain-free. However, none were cyclists, or even very athletic. It seems to me, if you kill the nerves, you can't feel the pain, and can make a problem worse by not backing off. At present I can ride at a recreational level for a few hours, but even training eough to merely suck is out of the question. Anyone have any experience? |
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#2
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Effect on Cycling of Radio Ablation for SI Joint
On 10 Aug 2005 13:58:05 -0700, "max" wrote:
I have back pain in the sacroiliac (SI) joint, most likely the effect of being struck by a car while riding several years ago. My pain management doctor wants to perform radio ablation to kill the nerves that are generating the pain. This is sort of like microwaving that part of the pelvis and cooking the cartilage and ligaments. This is supposed to provide at best temporary relief for as long as several months. I have corresponded with others who have had this procedure for similar problems, but I want to know if any cyclists have had this procedure, and what the effects were, and for how long, particularly the effect on riding. As things stand, the pain limits my cycling (among other things.) As a diagnostic procedure they shot an anaesthetic in the joint. The next day I could ride normally for the first time in months, but it wore off in a few days. I'm concerned because some of the people I've talked to had severe pain after the procedure, though some eventually had good results for several months, being relatively pain-free. However, none were cyclists, or even very athletic. It seems to me, if you kill the nerves, you can't feel the pain, and can make a problem worse by not backing off. At present I can ride at a recreational level for a few hours, but even training eough to merely suck is out of the question. Anyone have any experience? As a chiropractor I have a lot of experience. Your comment about masking symptoms and continuing, making the problem worse, is exactly my thoughts. Sacroiliac joints, like all joints, are made to function in a certain manner. Correcting that dysfunction and THEN strengthening the joint should be the goal. Not just stretching, strengthening, medicating, etc... and hoping it will heal. Even more interesting to you, as a cyclist, might be regarding SI Joint dysfunction and quadriceps muscle inhibition. J Manipulative Physiol Ther. 1999 Mar-Apr;22(3):149-53. The pain is limiting, as you know, but the dysfunction itself leads to inhibition of the quadriceps and therefore less output on the bike. Exactly the reason Discovery employs chiropractors. Dr. Jeff Spencer has been on the payroll since 1999. And you might have heard on the OLN telecast about how Armstrong is fanatical about making sure his pelvis is not "off". Sometimes things are so unstable that they can't be helped without invasive measures such as you describe. But chiropractic, prolotherapy, acupuncture, osteopathy, etc... would all carry less risk and a higher chance of correcting the problem rather than just making the symptoms. Good luck. I know how painful the problem can be. D |
#3
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Effect on Cycling of Radio Ablation for SI Joint
On Wed, 10 Aug 2005 18:22:38 -0400, D. Ferguson
wrote: On 10 Aug 2005 13:58:05 -0700, "max" wrote: I have back pain in the sacroiliac (SI) joint, most likely the effect of being struck by a car while riding several years ago. My pain management doctor wants to perform radio ablation to kill the nerves that are generating the pain. This is sort of like microwaving that part of the pelvis and cooking the cartilage and ligaments. This is supposed to provide at best temporary relief for as long as several months. I have corresponded with others who have had this procedure for similar problems, but I want to know if any cyclists have had this procedure, and what the effects were, and for how long, particularly the effect on riding. As things stand, the pain limits my cycling (among other things.) As a diagnostic procedure they shot an anaesthetic in the joint. The next day I could ride normally for the first time in months, but it wore off in a few days. I'm concerned because some of the people I've talked to had severe pain after the procedure, though some eventually had good results for several months, being relatively pain-free. However, none were cyclists, or even very athletic. It seems to me, if you kill the nerves, you can't feel the pain, and can make a problem worse by not backing off. At present I can ride at a recreational level for a few hours, but even training eough to merely suck is out of the question. Anyone have any experience? As a chiropractor I have a lot of experience. Your comment about masking symptoms and continuing, making the problem worse, is exactly my thoughts. Sacroiliac joints, like all joints, are made to function in a certain manner. Correcting that dysfunction and THEN strengthening the joint should be the goal. Not just stretching, strengthening, medicating, etc... and hoping it will heal. Even more interesting to you, as a cyclist, might be regarding SI Joint dysfunction and quadriceps muscle inhibition. J Manipulative Physiol Ther. 1999 Mar-Apr;22(3):149-53. The pain is limiting, as you know, but the dysfunction itself leads to inhibition of the quadriceps and therefore less output on the bike. Exactly the reason Discovery employs chiropractors. Dr. Jeff Spencer has been on the payroll since 1999. And you might have heard on the OLN telecast about how Armstrong is fanatical about making sure his pelvis is not "off". Sometimes things are so unstable that they can't be helped without invasive measures such as you describe. But chiropractic, prolotherapy, acupuncture, osteopathy, etc... would all carry less risk and a higher chance of correcting the problem rather than just making the symptoms. Good luck. I know how painful the problem can be. D Dear D., How do you treat turtles? Carl Fogel |
#4
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Effect on Cycling of Radio Ablation for SI Joint
D. Ferguson wrote: On 10 Aug 2005 13:58:05 -0700, "max" wrote: I have back pain in the sacroiliac (SI) joint, most likely the effect of being struck by a car while riding several years ago. My pain management doctor wants to perform radio ablation to kill the nerves that are generating the pain. This is sort of like microwaving that part of the pelvis and cooking the cartilage and ligaments. This is supposed to provide at best temporary relief for as long as several months. I have corresponded with others who have had this procedure for similar problems, but I want to know if any cyclists have had this procedure, and what the effects were, and for how long, particularly the effect on riding. As things stand, the pain limits my cycling (among other things.) As a diagnostic procedure they shot an anaesthetic in the joint. The next day I could ride normally for the first time in months, but it wore off in a few days. I'm concerned because some of the people I've talked to had severe pain after the procedure, though some eventually had good results for several months, being relatively pain-free. However, none were cyclists, or even very athletic. It seems to me, if you kill the nerves, you can't feel the pain, and can make a problem worse by not backing off. At present I can ride at a recreational level for a few hours, but even training eough to merely suck is out of the question. Anyone have any experience? As a chiropractor I have a lot of experience. Your comment about masking symptoms and continuing, making the problem worse, is exactly my thoughts. Sacroiliac joints, like all joints, are made to function in a certain manner. Correcting that dysfunction and THEN strengthening the joint should be the goal. Not just stretching, strengthening, medicating, etc... and hoping it will heal. Even more interesting to you, as a cyclist, might be regarding SI Joint dysfunction and quadriceps muscle inhibition. J Manipulative Physiol Ther. 1999 Mar-Apr;22(3):149-53. The pain is limiting, as you know, but the dysfunction itself leads to inhibition of the quadriceps and therefore less output on the bike. Exactly the reason Discovery employs chiropractors. Dr. Jeff Spencer has been on the payroll since 1999. And you might have heard on the OLN telecast about how Armstrong is fanatical about making sure his pelvis is not "off". Sometimes things are so unstable that they can't be helped without invasive measures such as you describe. But chiropractic, prolotherapy, acupuncture, osteopathy, etc... would all carry less risk and a higher chance of correcting the problem rather than just making the symptoms. Good luck. I know how painful the problem can be. D Have you seen any follow-up studies to that? I've been dealing with the same thing, with perfectly matching symptoms since I tore up the muscles around the SI way back in Feb. When we finally got a good diagnosis, the treatment was cortisone, and immobilization with a heavy duty brace when doing anything standing basically. My limit riding before my legs just flat stopped working was about 1 1/2 hours, yesterday after a couple of weeks with the brace and the shots a week ago I was able to do a solid 3 hours with more climbing than I've done in the past 2 years combined. But as you pointed out my legs aren't anywhere near full strength again, but I do seem to be really making progress now. Thanks for the info. Bill C |
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Effect on Cycling of Radio Ablation for SI Joint
On Wed, 10 Aug 2005 18:22:38 -0400, D. Ferguson
wrote: On 10 Aug 2005 13:58:05 -0700, "max" wrote: I have back pain in the sacroiliac (SI) joint, most likely the effect of being struck by a car while riding several years ago. My pain management doctor wants to perform radio ablation to kill the nerves that are generating the pain. This is sort of like microwaving that part of the pelvis and cooking the cartilage and ligaments. This is supposed to provide at best temporary relief for as long as several months. I have corresponded with others who have had this procedure for similar problems, but I want to know if any cyclists have had this procedure, and what the effects were, and for how long, particularly the effect on riding. As things stand, the pain limits my cycling (among other things.) As a diagnostic procedure they shot an anaesthetic in the joint. The next day I could ride normally for the first time in months, but it wore off in a few days. I'm concerned because some of the people I've talked to had severe pain after the procedure, though some eventually had good results for several months, being relatively pain-free. However, none were cyclists, or even very athletic. It seems to me, if you kill the nerves, you can't feel the pain, and can make a problem worse by not backing off. At present I can ride at a recreational level for a few hours, but even training eough to merely suck is out of the question. Anyone have any experience? As a chiropractor I have a lot of experience. Your comment about masking symptoms and continuing, making the problem worse, is exactly my thoughts. Sacroiliac joints, like all joints, are made to function in a certain manner. Correcting that dysfunction and THEN strengthening the joint should be the goal. Not just stretching, strengthening, medicating, etc... and hoping it will heal. Even more interesting to you, as a cyclist, might be regarding SI Joint dysfunction and quadriceps muscle inhibition. J Manipulative Physiol Ther. 1999 Mar-Apr;22(3):149-53. The pain is limiting, as you know, but the dysfunction itself leads to inhibition of the quadriceps and therefore less output on the bike. Exactly the reason Discovery employs chiropractors. Dr. Jeff Spencer has been on the payroll since 1999. And you might have heard on the OLN telecast about how Armstrong is fanatical about making sure his pelvis is not "off". Sometimes things are so unstable that they can't be helped without invasive measures such as you describe. But chiropractic, prolotherapy, acupuncture, osteopathy, etc... would all carry less risk and a higher chance of correcting the problem rather than just making the symptoms. Good luck. I know how painful the problem can be. D FYI the abstract is in pubmed: http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Citation I also have some kind of SI problem that seems to manifest as piriformis syndrome, but in my case may be due to some problems with the L3 joint according to a diagram I saw. I have loss of ability to contract the left gluteus, and my outer quad is often very tense, as well as the area to the outside and front of my hip joint. Here's a link to a diagram I made. http://s41.yousendit.com/d.aspx?id=0...Y0V9ADQT3XE9IX The places in red are the spasmed/affected areas, but include the piriformis region, also. A few times the whole thing has spontaneously relaxed and I spent the whole day without pain, no limping or anything. Ever heard of anything like this? I'd like to go to a chiro, but I'm a bit afraid of their 'high velocity' technique. It doesn't seem to have too great a negative effect on my cycling - my knee feels fine, and pedalling doesn't hurt. Can't jog and I limp some of the time. TIA, jj |
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Effect on Cycling of Radio Ablation for SI Joint
"Correcting the dysfunction" is what I'd like to do. I've attempted to
treat this for years (pt, chiropracty, and osteopathy.) The last helped the most but no longer. MRI shows calcified superior ventral SI ligament, and a bony structure arising from the ligament, bridging the joint. Osteopath says the joint is imobile on that side. I wouldn't expect prolotherapy to work as it treats hypermobile joints. Excision of the bridging structure even if it would work (physiatrist is doubtful) is a risky procedure requiring major surgery, which doctors seem unwilling to do without trying other modalities first. I've found a study which seems to show no better results that a placebo for ablation of the SI joint. I don't see any treatment obtions, and just trying RF ablation because nothing else is available doesn't seem so smart either. Stull, I was hoping maybe it had helped someone..... |
#7
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Effect on Cycling of Radio Ablation for SI Joint
On 10 Aug 2005 16:10:44 -0700, "Bill C" wrote:
Have you seen any follow-up studies to that? I've been dealing with the same thing, with perfectly matching symptoms since I tore up the muscles around the SI way back in Feb. When we finally got a good diagnosis, the treatment was cortisone, and immobilization with a heavy duty brace when doing anything standing basically. My limit riding before my legs just flat stopped working was about 1 1/2 hours, yesterday after a couple of weeks with the brace and the shots a week ago I was able to do a solid 3 hours with more climbing than I've done in the past 2 years combined. But as you pointed out my legs aren't anywhere near full strength again, but I do seem to be really making progress now. Thanks for the info. Bill C Conservative lower back treatment reduces inhibition in knee-extensor muscles: a randomized controlled trial. J Manipulative Physiol Ther. 2000 Feb;23(2):76-80. Related Articles, Links The biggest thing I find with SI joints is to first find out which direction they are misaligned and/or restricted in motion, correct that and then avoid specific postures and movements which stress the joint in that direction. Sleeping postures being one of the most common culprits. I could just about make a living telling people to take the damn heat off of it. I think only in America are doctors so dumb that they'll tell people to put ice on extremity problems but to put heat on their back. Imagine watching Shaq come off the court with a sprained ankle and wrapping a heating pad around it. D |
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Effect on Cycling of Radio Ablation for SI Joint
On Wed, 10 Aug 2005 19:35:44 -0400, wrote:
I also have some kind of SI problem that seems to manifest as piriformis syndrome, but in my case may be due to some problems with the L3 joint according to a diagram I saw. I have loss of ability to contract the left gluteus, and my outer quad is often very tense, as well as the area to the outside and front of my hip joint. Here's a link to a diagram I made. http://s41.yousendit.com/d.aspx?id=0...Y0V9ADQT3XE9IX The places in red are the spasmed/affected areas, but include the piriformis region, also. A few times the whole thing has spontaneously relaxed and I spent the whole day without pain, no limping or anything. Ever heard of anything like this? I'd like to go to a chiro, but I'm a bit afraid of their 'high velocity' technique. It doesn't seem to have too great a negative effect on my cycling - my knee feels fine, and pedalling doesn't hurt. Can't jog and I limp some of the time. TIA, jj I can see why it's confusing. You have indications of L3 problems as well as SI joint problems. I assume the symptoms are all on the same side? Have you had an MRI? As for going to a chiro and safety... the only real danger is rotational adjusting of the cervical spine which carries a risk 500% less than taking one aspirin. The rate of complications for low back adjusting are miniscule. Which is the reason chiropractors have malpractice insurance rates less than 10% of anyone else. Regarding "high velocity", there are over 100 chiropractic techniques and many of them are very gentle and beyond safe. You just need to find the right doc for you. D |
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Effect on Cycling of Radio Ablation for SI Joint
D. Ferguson wrote: On 10 Aug 2005 16:10:44 -0700, "Bill C" wrote: Have you seen any follow-up studies to that? I've been dealing with the same thing, with perfectly matching symptoms since I tore up the muscles around the SI way back in Feb. When we finally got a good diagnosis, the treatment was cortisone, and immobilization with a heavy duty brace when doing anything standing basically. My limit riding before my legs just flat stopped working was about 1 1/2 hours, yesterday after a couple of weeks with the brace and the shots a week ago I was able to do a solid 3 hours with more climbing than I've done in the past 2 years combined. But as you pointed out my legs aren't anywhere near full strength again, but I do seem to be really making progress now. Thanks for the info. Bill C Conservative lower back treatment reduces inhibition in knee-extensor muscles: a randomized controlled trial. J Manipulative Physiol Ther. 2000 Feb;23(2):76-80. Related Articles, Links The biggest thing I find with SI joints is to first find out which direction they are misaligned and/or restricted in motion, correct that and then avoid specific postures and movements which stress the joint in that direction. Sleeping postures being one of the most common culprits. I could just about make a living telling people to take the damn heat off of it. I think only in America are doctors so dumb that they'll tell people to put ice on extremity problems but to put heat on their back. Imagine watching Shaq come off the court with a sprained ankle and wrapping a heating pad around it. D I really like the guy I'm seeing, and he agrees with you on the heat 100%. He said, ice, no heat, get it stabilised then we'll work on strengthening the area. He works with, and refers a lot of people for further work to a couple of Chiros and a personal trainer that I really like and respect. Sounds like your someone he'd work well with. he shares your high opinion of some of the other people out there. Thanks for the additional stuff. Bill C |
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Effect on Cycling of Radio Ablation for SI Joint
On 10 Aug 2005 16:36:43 -0700, "max" wrote:
"Correcting the dysfunction" is what I'd like to do. I've attempted to treat this for years (pt, chiropracty, and osteopathy.) The last helped the most but no longer. MRI shows calcified superior ventral SI ligament, and a bony structure arising from the ligament, bridging the joint. Osteopath says the joint is imobile on that side. I wouldn't expect prolotherapy to work as it treats hypermobile joints. Excision of the bridging structure even if it would work (physiatrist is doubtful) is a risky procedure requiring major surgery, which doctors seem unwilling to do without trying other modalities first. I've found a study which seems to show no better results that a placebo for ablation of the SI joint. I don't see any treatment obtions, and just trying RF ablation because nothing else is available doesn't seem so smart either. Stull, I was hoping maybe it had helped someone..... Yuk, that's a tough road you've been on. I think the ablation will work. For awhile. But during that time you do risk more injury. However, if it really is imobile then it shouldn't be too much damage. Excision is certainly a risk but gaining mobility in the joint would be a step in the right direction. Example being, if you had to sit with your finger bent to a certain position all day it would start to hurt in that joint. Early on in SI joint dysfunction they now believe that muscles contract to support and become ligamentous, then finally calcify into bone. "The altered biomechanical environment produced by spinal fixation..... can affect the ligamentous properties in vivo, possibly serving as the impetus for low back pain." Spine. 1998 Mar 15;23(6):672-82; discussion 682-3. Good luck with whatever you decide. D |
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