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So it has been a week. Usually I give injuries 2 weeks before I start to freak out, but I've never had anything like this before and it is not on a trajectory of improvement, but seems to be getting worse.
No problems at all, was on a walk last week and for most of the last week I couldn't remember anything that would have caused this, then yesterday recalled that in the minutes before the pain started on this walk, I had stepped into a hole that I didn't see and at that moment it was quite a sudden shock to my leg and back - but really didn't hurt and didn't think much of it at the time. But by the time I got home - about 30 minutes and 2 miles later - something was definitely wrong and I was limping pretty bad with pain in my right hip. Figured I was just tired but over the last week, the pain has made walking nearly impossible and deep inside my right hip hurts quite a bit with any weight-bearing. Gradually over the last couple of days, the pain has also spread to my lower back and now they both ache. Not a sharp shooting pain. I took ibuprofen and as usual, that did nothing.
I tore my rotator cuff 18 months ago and my doctor / insurance has been worthless for that. I went to physical therapy and it was a total waste of time. So I am reluctant to return and have the same thing happen but of course I will eventually have to - but n the mean time I'd like to hear if anyone here has had a similar injury and what it turned out to be. I don't see any external bruising or discoloration or swelling and I'm not even sure that hole I stepped in was the cause but I can't think of anything else unusual that would have caused it.
I have had a similar injury and what it amounts to is your hip has gone out of proper rotation which extends via tension of muscles into your low back vertebrae. It's like the old song, "the hip bone is connected to the back bone, the back bone is connected to the neck bone....etc etc " Traditional medicine is unequipped as it has no answer for spinal/orthopedic treatment other than drugs or physical therapy which by nature inflames even further, or surgery. Chiropractic care is the answer and unlike the past most insurers (even HMOs) include chiropractic care visits under benefits, typically around 30 per year. I used to live in Chapel Hill (see you're in Raleigh) and had a fantastic chiropractor there but is probably too far and an unnecessary long trip. I did a quick drilldown and see Dr Hanba is near you and similarly diverse in treatments as my recommendation in Chapel Hill. Consultations are almost always free with chiropractors and they can give you a sense of treatment plan/what to expect. Hope this helps and feel pretty certain it will.
After a couple more hours of detailed resarching online, the thing that it most closely sounds like is some sort of SI joint compression or related strain / sprain / bruise.
Some of the symptoms and causes under the broad "SACROILIAC JOINT DYSFUNCTION" / conditions / injuries etc......match in terms of both the location (lower back, deep inside one butt, hip areas) as well asa the causes (stepping off curb, into a hole suddenly, etc....) Walking is what hurts the most. I can barely get across the room and I just hope that giving it a couple more weeks will show some improvement. I just hope and pray there isn't anything cracked or permanently damaged.
For my shoullder, I expected an MRI to at least find out what was going on and the answer was something like - "insurance doesn't like to pay for MRIs until or unless PT is tried first". I am not going to be able to survive with this type of pain and incapacitation so I am hoping for a different response from the doc about an imaging test first before wasting more time with PT.
I've had a similar injury more than once from similar circumstances. Holes, curbs, and uneven ground are my enemy.
It's always my sacroiliac joint. In my case, there appears to be a familial weakness as my dad suffered from the same injury repeatedly.
A good chiropractor can really help to get you back to normal. It will probably take multiple visits until everything settles down . . . the muscles, tendons, and ligaments have all been traumatized, along with the SI joint. The chiropractor will probably give you home-based exercises to help the healing process - be sure to do them and then keep those instructions in case it happens again. Chiropractors deal with SI issues every day. You won't be the first one.
We're all different but I find that walking is very helpful. Careful and limited walking helps to loosen those spasming muscles. I also find that my sleeping position can make a difference. I usually sleep on my left side but when my SI gets in trouble, I'm hipshot to the right so sleeping on my right side can help to realign things. Mild stretches can help too.
One more thing . . . sitting doesn't help. Lying flat on the floor with my knees raised is my favorite and most comfortable position. A small pillow under your head makes it comfortable enough to watch TV or read. Standing is preferable to sitting if at work. Many times I worked standing, using the top of a file cabinet as my desk (before standing desks were a "thing").
Hope you find relief quickly. SI issues are no picnic.
Funny ...the stepping in a hole, that's big...then the 2 mile walk.
I simply shopped on concrete floors for hours not knowing ONE orthodic had come out of my shoe.
Took WEEKS to be ok again in the hip, lowback areas. When things are 'off' they cause a lot of trouble!
My Chiropractor helped tremendously. An Osteopath could have, too...if you like them better.
There IS hope, tho Don't stay with anyone that isn't helping within a couple weeks, you can tell...
move onto someone else....
good people are out there. From my exp, anyway.
^^^Oh, can I relate! I lost the heel lift in my right shoe one day and tried to get along without it. I only need one on the right since that's my shorter leg. It wasn't long before I was out of whack. Now I wear one in every pair of shoes or slippers. Summer is a problem with sandals but I found a way around it by using a whole-foot thicker insole on the short leg. It's virtually invisible as long as my foot is in the sandal. Flipflops and bare feet are problematic for the same reason. My leg isn't far off at all from being the same as the left, but just enough to tweak my back. It's all in the details!
It has been 8 days. I almost called the doctor yesterday, but figured I would give it a few more days. So far, rest, ice, heat 800mg of ibuprofen a day, stretching, etc....has resulted in no improvement. In fact, it seems to be getting worse. I really just want to know if there is a stress fracture. Too bad I don't have an X-ray and MRI here or I'd do it myself. I know for sure that it was that exact moment of stepping - unexpectedly and suddenly - down into that small depression. I was curious to drive back and take a look at it because I still cannot believe such a small insignificant thing could have caused this injury. Never had anything like this - not even remotely close.
After a couple more hours of detailed resarching online, the thing that it most closely sounds like is some sort of SI joint compression or related strain / sprain / bruise.
Some of the symptoms and causes under the broad "SACROILIAC JOINT DYSFUNCTION" / conditions / injuries etc......match in terms of both the location (lower back, deep inside one butt, hip areas) as well asa the causes (stepping off curb, into a hole suddenly, etc....) Walking is what hurts the most. I can barely get across the room and I just hope that giving it a couple more weeks will show some improvement. I just hope and pray there isn't anything cracked or permanently damaged.
For my shoullder, I expected an MRI to at least find out what was going on and the answer was something like - "insurance doesn't like to pay for MRIs until or unless PT is tried first". I am not going to be able to survive with this type of pain and incapacitation so I am hoping for a different response from the doc about an imaging test first before wasting more time with PT.
I've replied to a few threads about similar injuries and what could help or work. I'm going to copy over those replies, hopefully they will help you. My life was ruined twenty years ago from what sounds like the same thing except I had bad spasms in my back, butt and legs that I needed crutches in order to walk because my legs were like jello. The net was pretty new back then but some how I managed to find info about SI joint dysfunction but could not find a local doctor for it. I had also blown the L5S1 disk in my spine which I made the mistake of fusing.
To go to the thread my quotes come from, click the arrow next to my name in the quote. It was a sciatica issue thread which you have not said you have yet, it could come next.
Try to print out the images in my photo links for dermatomes, muscles, and nerves in the low back, you can then trace where your pain is to hopefully narrow down what in your pelvis area is the issue. You can google dermatomes to find the original online or right click on what I posted to open in a new tab.
Sounds like you need an MRI of the lumbar and pelvis areas.
Quote:
Originally Posted by Roselvr
I'm leaving you 2 links, please read them. I've shared extensive information on what helped me. I've suffered as bad as you. I used crutches though, couldn't put my leg on the ground. It's just too much information for me to bring over to give you as I've quoted from other threads in one.
See my replies starting here. See this part of my reply to see if it applies to you too. When laying like that, push on your butt to see if there are tender spots like I have. If so, your sciatic is probably from your butt area and not your spine.
Last night I could barely sit. I laid down on my right side with legs bent like I was sitting, could feel how sore I was where the legs meet the pelvis. I'll be surprised if I don't suffer sciatica at some point this week, with it being the cause.
...
I figured out laying down, pushing on myself by accident. I was doing something, moved my left leg a certain way where I was able to notice just exactly where the pain was coming from. I then used google to find photos of various anatomy such as nerves or muscles of body parts. Eventually more information comes online such as showing in the photo I posted.
Here is the dermatomes image mentioned i agree, it's a great image, you could print it and mark where your pain is
Quote:
Originally Posted by guidoLaMoto
A true sciatica is caused by an irritation of the sciatic nerve at its roots, usually due to a herniated disc in the lumbar spine. It does NOT cause back pain, but pain &/or specific muscle weaknesses &/or numbness down the leg & foot just as you've described.
Like any acute injury, there is often a good deal of initial swelling around the herniation that will go down after awhile with proper rest. The herniation itself may or may not shrink....Things like chiropractic manipulations or PT may actually make things worse (you don't wiggle the edges of a cut if you wan it to heal). Acupuncture, if it works at all, works between your ears, not on your leg.
If the herniation is big enough that it continues to cause pain &/or if it's causing muscle weakness that isn't improving much with time, then surgery is called for. An MRI or CT will define the surgical target (L4- S2). Occasionally a true sciatica is caused by spasm of the obturator muscle and not by a herniated disc. PT may help that...A spina tap with injection of lidocaine/cortisone will help temporarily, but your jaw doesn't stay numb forever when the dentist gives you Novocain.
The amount of disability caused by the pain/weakness/paresthesia and the pt's tolerance will determine how aggressive to get with the watchful waiting vs surgical treatment.....If you're really that incapacitated after a week, you probably oughta opt for the surgery.
This is one of the few times I disagree with you. I had disk fusion L5S1, it did not stop my sciatica because mine is due to my butt, not necessarily my disk herniation. Worst mistake I made was fusion, I know others who feel the same too. There are a lot of failures with fusion. It should be a last resort after everything else fails. He should try the deep butt injections like I've had luck with, it can't hurt. It took it away for many years.
If the OP really needs surgery, he should research artificial disk replacement in Germany to see what they've been using for 20+ years now. Spines are not meant to be fused stiff, they need to bend and flex.
OP do not make spinal fusion surgery without thinking because you could end up like me and others I know in worst shape needing a cane, giving up most things in life. Quality of life is poor. If my grandson wasn't so attached to me I'd apply for medical euthanasia in my state. You have to be terminal it says.
I was fused twice, first was with an LT cage in 2001 that did not fuse, I had micro-motion, bone rubbing metal when I walked. In 2006 they added rods and screws which hurt like heck, they feel like they're going to shoot out of my back when spasms get bad.
Quote:
Originally Posted by Roselvr
Brought over a few links for you. Look at the various images, find the ones that pertain to the pain you're having. The dermatomes one I posted is great to start with, you can drill down even more with muscles and nerves along with anatomy of the spine.
This will allow you to get a better idea of what is causing you pain so that you can decide what to do or not do in addition to figuring out if your sciatica is caused by your spine or if it's caused by your butt area. If you have tender points in your butt, deep inside, good chance it's from that and not your spine issues even though you have a lot of spine issues.
^^^ The problem with laminectomy or spinal fusion for disc hermiations is that we have no control over scar formation. Any surgery will result in scaring (healing), and the space in that nerve root chennel is very small-- even a little extra tissue can cause compression of the nervee root, hence, a less than perfect record after surgery.
--Not sure what you mean by "in my butt." If you mean your sypmtoms were referred to the butt area, that would imply sacral nerve root involvement, as opposed to lumbar. ...Hernation of the disc between the L5 and S1 causes syptoms in the leg & foot (foot drop is classic.) Irritation of the nerve there can be from spondylistheis-- a sliding of the vertebra forward so it's slightly out of line. That can rub the nerve root and more importantly, stretches the ligament holding things in line. That's equivalent to hyper-extending an elbow or knee, for example. Ligament stretch HURTS.
Another possibility is that the sciatic nerve is not pinched in the root canal, but as it passes THRU the pyriformis muscle. The nerve passes thru the muscle in something like 1 in 4 pts. (The anatomy books depict "average anatomy." There are a lot of less common variations.) People with pyriformis syndrome often complain of discomfort in the pudendal (private parts) area....same from pinching of the pudendal branch of the sciartic nerve by obturator muscle spasm.
It has been 3 weeks. Pain still terrible right at the SI joint. The hip/butt pain is slightly improved so I can walk a little better. But this lower back ache - I still don't understand how a small, shallow, unexpected little misstep into a depression in the pavement could have caused anything like this. I can press my fingers right at the spot it hurts now - which is right on those 2 SI joints that are easily felt.
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Don't stay with anyone that isn't helping within a couple weeks, you can tell...
