Effect on Cycling of Radio Ablation for SI Joint

On Wed, 10 Aug 2005 19:52:54 -0400, D. Ferguson
wrote:

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?

Yes, the left side. I'm mostly unable to rotate my bent foot to the outside
- which I think is 'internal rotation of the hip', and I have trouble
crossing my left foot onto my right knee, seated.

Have you had an MRI?

Well it's a bit of a long story, but briefly, when I first injured myself
about 4-5 years ago, the doc disagreed with the physical therapist which he
-did- send me to initially. The doc was sure it was arthritis of the hip
joint and wanted to do an MRI with a galladium injection. I thought this
was too invasive and did not want my joint capsule punctured. I later
learned that it's possible to do a standard MRI, which may not tell you as
much, it tells you a lot. This was a worker's comp claim (which might tell
you something later in the story). So no, I have not have an MRI - he
didn't bother to offer me a less invasive option at the time, the son-of-a-
beyotch!

The PT thought it was straight piriformis syndrome and actually got me some
relief with some low velocity, high amplitude stretching and 'untwisting my
SI joint/sacrum'.

The sports med doc became irate at my foot dragging and insisted on doing a
THR, (I think he was irritated at a worker's comp claim, and I suspect it
wouldn't have bought him the big screen TV he was craving.g) In fact he
became so irritated he hit me repeatedly on the knee with his reflex hammer
until I actually said 'ouch!'

The problem was that there was -every- indication that it was -not-
arthritis of the hip joint and that this joint was fine. He based his
diagnosis on one set of xrays (no pre injury xray was available and he
decided solely on the basis of the thickness of my hip cartilage in -one-
hip joint - didn't even do the other hip to compare).

So in summary I quit going to him and besides a few PT sessions, I've just
been dealing with it. They used some half-fast ultrasound and stuff which
didn't do squat. At the time I wasn't clear where the root cause was and it
was only much later I found the diagram I sent.

The pain has reduced to a low level, but I still have some mobility
problems as outlined above. The biggest effect is the disparity in size and
function of my gluteus maximus which is almost atrophied on the left side.

I'm trying to talk my current doc into an MRI and he mentioned injecting
cortisone into the intra spinal cord area, which also sounds scary -
requiring a special procedure to do it - as a possible pain relief therapy.


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.

Ah, there's the rub. How does one do that?

Thanks for the info.

jj

D

On Wed, 10 Aug 2005 20:37:32 -0400, wrote:



Yes, the left side. I'm mostly unable to rotate my bent foot to the outside
- which I think is 'internal rotation of the hip', and I have trouble
crossing my left foot onto my right knee, seated.

Have you had an MRI?

Well it's a bit of a long story, but briefly, when I first injured myself
about 4-5 years ago, the doc disagreed with the physical therapist which he
-did- send me to initially. The doc was sure it was arthritis of the hip
joint and wanted to do an MRI with a galladium injection. I thought this
was too invasive and did not want my joint capsule punctured. I later
learned that it's possible to do a standard MRI, which may not tell you as
much, it tells you a lot. This was a worker's comp claim (which might tell
you something later in the story). So no, I have not have an MRI - he
didn't bother to offer me a less invasive option at the time, the son-of-a-
beyotch!

The PT thought it was straight piriformis syndrome and actually got me some
relief with some low velocity, high amplitude stretching and 'untwisting my
SI joint/sacrum'.

The sports med doc became irate at my foot dragging and insisted on doing a
THR, (I think he was irritated at a worker's comp claim, and I suspect it
wouldn't have bought him the big screen TV he was craving.g) In fact he
became so irritated he hit me repeatedly on the knee with his reflex hammer
until I actually said 'ouch!'

The problem was that there was -every- indication that it was -not-
arthritis of the hip joint and that this joint was fine. He based his
diagnosis on one set of xrays (no pre injury xray was available and he
decided solely on the basis of the thickness of my hip cartilage in -one-
hip joint - didn't even do the other hip to compare).

So in summary I quit going to him and besides a few PT sessions, I've just
been dealing with it. They used some half-fast ultrasound and stuff which
didn't do squat. At the time I wasn't clear where the root cause was and it
was only much later I found the diagram I sent.

The pain has reduced to a low level, but I still have some mobility
problems as outlined above. The biggest effect is the disparity in size and
function of my gluteus maximus which is almost atrophied on the left side.

I'm trying to talk my current doc into an MRI and he mentioned injecting
cortisone into the intra spinal cord area, which also sounds scary -
requiring a special procedure to do it - as a possible pain relief therapy.


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.

Ah, there's the rub. How does one do that?

Thanks for the info.

jj

D


Good Lord. A hip replacement?

Do you mean that you have trouble lifting the lateral edge of your
foot up? Are you weaker raising your big toe or that foot up in
general, flexing at the ankle?

Basically you have symptoms of left L3 nerve root irritation. left
L5/S1 nerve root irritation and left sacroiliac joint dysfuntion with
resulting piriformis muscle contraction(which itself can irritate the
sciatic nerve) and possible what is called scleretogenous
pain(referred pain). A lumbar MRI is going to tell you what and how
much encroachment there is on the nerve roots. With atrophy in the
glute and what sounds like "foot drop" you are, on a scale of one to
ten in needing an MRI, an eleven.

Hell, no wonder you're scared to trust what anyone says. It's been a
clusterfudge from the start.

As for finding a DC in your area if you tell me what city/state I can
usually come up with a name from a book that lists DCs and what
techniques they SAY they use. if you don't want
to post it up here. Not sure exactly who, if anyone, will be able to
help but you need to AT LEAST be getting some real information.

D

On Wed, 10 Aug 2005 21:32:33 -0400, D. Ferguson
wrote:

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.

Ah, there's the rub. How does one do that?

Thanks for the info.

jj

D


Good Lord. A hip replacement?

Dave, thanks for the kind offer. It is greatly appreciated. I emailed my
reply to your address. Let me know if you don't get
it and I'll try again. My address on the ng is a spam trap, but the email
return addy should be valid.

Best,

jj

On Wed, 10 Aug 2005 22:02:26 -0400, wrote:

On Wed, 10 Aug 2005 21:32:33 -0400, D. Ferguson
wrote:

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.

Ah, there's the rub. How does one do that?

Thanks for the info.

jj

D


Good Lord. A hip replacement?

Dave, thanks for the kind offer. It is greatly appreciated. I emailed my
reply to your address. Let me know if you don't get
it and I'll try again. My address on the ng is a spam trap, but the email
return addy should be valid.

Best,

jj

Oops, I forgot to include my location in the email, but quickly appended it
in a second message with the header "Correction". My bad. Sorry 'bout that.

jj

Thanks. The calcification appears to be ligaments, not muscle. The
bridging osteophyte may be a deformity from breaking the sacrum. My
left side, glutes and associated muscles, are hypertrophied, noticeably
larger than right side; The best study on ablation I found showed
results consistent with placebo effect in the "successful" group, about
36% had pain relief for an average of 6 months. The non-successful
group averaged 0.9 months of pain relief. Factor associated with
succesful outcome: atraumatic origin of SI syndrome. Factors
associated with unsuccessful outcome: determination of disability and
pain on lateral flexion. Reg Anesth Pain Med. 2001
Mar-Apr;26(2):137-42. PMID: 11251137 [PubMed - indexed for MEDLINE]

I have both the negative factors and have a traumatic origin. Doesn't
look like it will be very helppful. Among those I've talked to who've
had the procedure, most complain of severe pain afterward, for three
days to several weeks. I've elected to postpone the procedure, and
look for alternatives. It doesn't seem worth it given the odds. I
want to discuss it with my pain management doctor. I wonder if
prolotherapy on the other side, so the sacrum doesn't rotate in the
lateral plane of the body, would help. (Model I've constructed
indicates osteophyte would serve as a fulcrum with movement of the
sacrum, resulting in pressure in the joint where the diagnostic
injection found the nerves were causing the pain. I think pressure
from the sacrum on the pelvic side of the joint is the cause of the
pain.)

If I do seated intervals, I hurt all day. If I do a hilly ride and a
lot of climbing while standing, then it seems therapeutic; I feel
almost normal for days at a time. That is if I don't remain seated for
too long. Lying flat on my back on the floor is often the most
comfortable position I can find. :-(

On Wed, 10 Aug 2005 20:37:32 -0400, wrote:

I'm trying to talk my current doc into an MRI and he mentioned injecting
cortisone into the intra spinal cord area, which also sounds scary -
requiring a special procedure to do it - as a possible pain relief therapy.

Isn't that pretty much an epidural, ie something pregnant women the world
over get as a matter of course during delivery if they want? It sounds
scary, yes, but it must be something they really know how to do well.


Jasper

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.


Anyone have any experience?

I got hit three years ago, broke two vertabrae. BUT I too had a lot of
pain when riding. I did three none evasive things before I had anybody
give me shots or kill anything with radio waves.

Bike fit, Massage therapy and Rolfing. I can now ride as I did before
with onlt a wee bit of pain after 3 hrs or so. Try these non evasive
things before you get 'shot. I still see a massage therapist twice per
week, for riding but for standing for extended periods at the shop
also.

On Sat, 20 Aug 2005 13:41:39 GMT, Jasper Janssen
wrote:

On Wed, 10 Aug 2005 20:37:32 -0400, wrote:

I'm trying to talk my current doc into an MRI and he mentioned injecting
cortisone into the intra spinal cord area, which also sounds scary -
requiring a special procedure to do it - as a possible pain relief therapy.

Isn't that pretty much an epidural, ie something pregnant women the world
over get as a matter of course during delivery if they want? It sounds
scary, yes, but it must be something they really know how to do well.


Jasper

Can we take this thread to just one newsgroup? Hate to crosspost to all
three?

Yeah it is the epidural, aimed at quieting the sensory nerve at the T-3
area, (apparently). Having worked in the ER, and other parts of the
hospital for 30 years, you become sensitized to hospital/surgical
"problems". I don't want to trade a relatively minor problem for any of
those without a lot of careful thinking and trying everything else.

jj

JJ, stop being a baby an give yourself a chance to rid the pain with a
cortizone injection. You've let this get pretty well developed, on
your own. If as prior posts indicate your soft tissue is congealing
around your joint and calcifying, cortizone is a really good product to
effect the highest degree of mobility at the joint, again.

Just that alone may be enough to get you back on the bike.