sacroillitis

Hi i'm kate,
i guess im on the forum, like alot of people who just want to find some answers. Recently diagnosed with left SI hypermobilty in my hip. Seen numerous PT's and back on forth from muscular skeletal clinics. Was told that my left hip is tilted forward and the SI joint is hypermobile, they say that my hip does not sit in the correct position.
After having this manipulated the pain has just become a thousand times worse, had this done over a week ago now and it still hasn't gone down, yesterday started suffering with some urinary incontinence which is so embarrassing! Its now at the point where i would cut my own leg off if i could!
For those guys with SI or anyone who knows, is it common to have bladder problems with SI?
I'm only 22 and this all started from an accident at work i slipped and nothing has been right since, i used to be healthy and fit and extremely mobile, some days i cant even walk and my left leg just collapses from underneath me i use crutches to get around and as soon as weight goes on my leg the pain is now unbearable.
Im currently on diazepam for the spazms i get, butrans patches, tramadol, amitriptyline and zopiclone due to not sleeping, aswell as pregabalin! some concoction!
I'm just looking for advice really, im stuck as where to go and what to do next, if i could afford to go private i would as i just want the problem solved!
Any help would be greatly appreciated!

Thanks!

katrina92, wow, sorry for all that's happened to you.

I have a hypermobile pelvis and have been living with SI pain for a long time now. Usually it's nothing, but sometimes I'll move wrong or whatever and it can really zing me. I've been in PT for problems related to my SI three times in 20 years.

By the way, there's a long thread on sacroileitis on this forum, which you might want to read through.

So Kate, why not ditch all those meds? The issue in your SI joint is a muscle spasm, maybe a bit of torn connective tissue. These take time to heal. A muscle relaxant might be all you need, maybe some NSAIDs to reduce inflammation. You need to stretch your lower back, hammies, piriformis and psoas to keep the SI from being pulled in all the wrong directions.

You can get an SI belt from a physical therapist and that can support your hypermobile pelvis while you build up core strength to support it the right way. I have found that Pilates is a great way to do this. Yoga is great too, but there is some risk there if you are hypermobile that you will reinjure yourself in certain postures.

My first physical therapist was a genius who taught me how to get my own pelvis back into alignment. I can try to describe it for you if you want, but I really recommend that you go back into PT and find someone good. Ask around. I've preferred sports medicine places more than "regular" PT for this.

The shooting pains in your leg, by the way, are due to irritation of the sciatic nerve. I don't think this could cause bladder incontinence, but your pile of meds might. I think you need to talk to whatever DR prescribed those for you.

If the MRIs of your SI are normal, you might also ask for a CT or Xray of the lumbar and sacral spine. I have no evidence of inflammation in my SI, but an abdominal CT showed significant arthritic changes to the L5 vertebrae at S1.

Look, I know you've said you have done PT, but clearly it has not "stuck." You really need to focus on building strength in your pelvic girdle and resolving the muscle spasms in your lower back and glute (that will largely relieve the sciatic nerve). That is done with intensive PT.

There are some surgical solutions to unstable SIs but you are very young and I would seriously expect you to be able to get yourself out of this pickle with exercise.

I tore my quadratus lumborum (look it up) when I was 31 due to my unstable pelvis, and I tore my hamstring at the origin when I was 47 due to my unstable pelvis. I recovered completely from the first injury with lots of exercise. The 2nd injury is relatively permanent - there is no way for me to "rest" my hamstring long enough for it to completely heal. I have modified my activities and get along just fine. I ran 5Ks, 10Ks, a half marathon, did downhill skiing, ocean kayaking etc. etc. all with my unstable pelvis. I've given birth twice (pregnancy actually helped because my huge uterus stabilized my pelvis beautifully - post partum was tough tho!).

Yes, my pelvis is perpetually misaligned. I also have scoliosis. Not a problem! I recognize the signs of a muscle spasm in my backside and I deal with it. I only go walking or jogging with my SI belt on. I try to keep my core active. I have done an ergonomic study at my work and have a good chair and keep good posture (mostly). These are all the lifestyle changes you will need to think about too.

And yes, you might need crutches until you can get past the sciatica. But you should be doing exercises every.single.day to build core strength. You should be stretching all of the connective tissue in your pelvis to unbind the spasms. You should be doing this in PT as prescribed by your DR.

good luck. i would take the above posters advice lol. i have sacroilitis as well but its due to ankylosing spondylitis and poly arthritis from an auto immune disorder. mine is nothing mechanical. the two are one of the same but treated very differently. do u think physical therapy could help? if its not aligned right it may be causing the incontinece. OR you may just have an underlying bladder issue.. but if theres no pain in ur bladder i would say its prob the hip issue.

good luck !! :)