complicated back pain questions

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hi all: i have had back issues for a long time; my most recent back x-ray wasn't too bad; nothing too bad, just a little disc degeneration; i am 65 so that is expected. however in the past month i have developed a different kind of pain; it occurs with activity such as walking or golfing; it is sharp and i have to stop what i am doing; i then usually continue walking although i can't walk 30 min like i used to; now this sharp pain (in the left buttocks) is getting more frequent and it is interfering with my activities; i have a large fibroid uterus and my gyn said this could be impinging on nerves causing the pain; now let me say I am terrified of having a hysterectomy and then if that wasn't the real cause of the pain, that would be really awful. I wonder if i should get a CAT scan of my back which might show more detail that a plain lurabar x-ray doesn't show; does anyone have any ideas? i am confused.
 
Are you seeing your general practitioner or a specialist? Pain radiating in the buttocks does sound like a nerve being compressed but I am not a doc either. However, based on my own experience that is what it could be. An MRI and or a CT scan might show more but it doesn't always. I have a problem with my SI joint and it showed up only in the Xrays. I had back surgery 2 years ago as well. I haven't dealt with the SI issue yet. I would certainly look into getting another opinion before undergoing surgery. I hope someone here will be able to give you more information. I will keep you in my thoughts and prayers while you seek your answers and get some relief.

Sincerely,
Lisa
 
Hi Lisa: you are so kind to answer so quickly and pray for me; you must be kinda psychic cause when I went to the PM&R doctor he said he thinks I have an SI joint inflammation ( i forgot to mention that in my first post); he recommenRAB PT so I am considering this; the kinda odd thing is that the problem doesn't show itself until i am active like when I walk or golf and it kinda surprises me because i do stretching exercises before i walk or golf and there is no pain with stretching. So, how long have you had an SI inflammation problem, what are your symptoms and how do you treat it.
Again, thank you Lisa for your kind thoughts and I wish you the best as well.
 
If it is an SI problem, it is highly unlikely that surgery will be recommended.

The SI joint can become unstable as the ligaments stretch. In women in particular, sometimes the ligaments are too stretchy which also causes problems. I was recently working with a spinal physical therapist rehabing after a lower lurabar fusion...and we worked quite a lot on the SI. There were certain stretches that she did not want me doing for that reason.

I think you would benefit from at least a few sessions of PT so you know you are stretching properly for your particular issues. You might also ask him or her about piriformis syndrome. This is in that same general vicinity and the symptoms are similar.

There is a product called a sacroiliac belt that is sold by PTs, chiropractors and online...maybe pharmacies, too. It is a narrow, heavy elastic fabric that wraps around your lower hip area, velcroes closed and has two additional pieces that you velcro to make the whole thing tighter. You might try wearing it when you're golfing or walking as it provides some additional support.

I would also strongly recommend that you do exercises to strengthen your pelvic girdle and pelvic floor. This area also provides support to the lower discs and they attach to the SI joints in a roundabout way. The stronger ALL these muscles and ligaments are, the more support you will have.
 
thanks so much for all of your input; you all have convinced me to get physical therapy; i have been putting it off because it is so time consuming but i think i need to try it; several years ago i had a back issue and with stretching and walking the problem got better but his problem is made worse with activity, especially walking. thanks again.
Marilyn
 
I just wanted to share with you my situation. My back hurt a lot and I developed a nightmare pain in my hip which has made me limp since May of 2007. My PT thought it was the SI Joint, even though my dr. thought it was referred pain from my arthritis issues in my back (facet joint disease). I FINALLY found out a few weeks ago, after months and months of them not figuring it out...that it comes from L5-S1 facet joint disease. I got a rhizotomy 9 days ago and immediately that hip pain was gone. The nerve will grow back so I will have to keep getting it (hopefully later than sooner....although it was not that bad...the radiofrequency rhizotomy).
 
Hi: how did they finally find out what it was? what tests did they do to determine the real cause of your problems? glad that they finally found out what it was. Back problems are so difficult to accurately diagnose aren't they?
 
My MRI said I had 2 kinRAB of stenosis at 3 levels, 3 bulging disks at those same levels, and facet arthropathy at the same levels. I went thru hell finding out what the MAIN source of the pain was. It took about 6 months of injections to get to the bottom of it all (and tons of PT that did not work...it aggravated it). Its all a lot of trial and error, for sure. I had epidurals, facet injections, SI Joint injections, Xrays...several Drs... The test that told me the most was called a diagnostic MEDIAL BRANCH BLOCK. That was where they injected nurabing stuff into the nerve branch for the facet joints. They did one level and when I got up to walk, I was still limping not and able to put weight on my right side. Then I went back in and did a different level (right away) and BINGO....no more limp. So then he knew at least for sure one level that had to be done for the rhizotomy (the nerve burning thing)
 
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