Physical Therapy for Sacroiliitis

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Lu2011
Regular Member


Date Joined Apr 2011
Total Posts : 291
   Posted 4/15/2011 7:14 AM (GMT -6)   
Hi,
 
I've had sacroiliitis (inflammation of SI joints) for about 15 years, with it getting worse and worse.  Recently I've had an MRI, xrays and blood work done, all showing fine results.  So no fusion, deterioratino of cartlidge and even nothing showing in my blood.  However, a bone scan done years ago showed inflammation of my SI joints plus my symptoms are typical of sacroiliitis.  Someone on here also mentioned perhaps I have pirformis syndrome, which when I read it, makes total sense to describe the shooting pain.
 
On "good" days, I suffer from back pain...esp when sitting or if i carry something for long periods of time.  It can process to actual joint pain where the bone feels like it hurts or aches.  As warnings of a flare up, I get little pinches.  And in full flare up mode, I get shooting pain from my joint/bottom down my leg, where I can't even put weight on the affected side or even move, for that matter.
 
i recently tried cortisone shot (both sides).  it seems to work, but was short lived.  My rheumatologist says that exercise is good, but everytime I try, I am that much sorer the next few days.  And that's the good case.  It also often triggers a flare up with shooting pain (like last week).
 
I take celebrex, but can only take 1 max daily and have to be careful as I had ulcerative colitis (colon since removed).
 
So the only thing left to try is physical therapy.  I've been hesitating as:
1)  I tried it years ago and it did nothing
2)  It's physically time consuming...and I dont have much personal time as I'm a mom of 2 kids...of which I work during the day and pick them up right after school
3)  It's expensive
4)  I'm scared of aggrevating the issue more and causing a flare up.
 
Any advice from others?  And has physical theraphy worked for others in my situation?  Do you tell them anything specific?  has it ever made your situation worse? 
 
any advice is much appreciated
 
PS - This is the first website where I've found others who seem to be int he same situation with sacroiliiitis and UC or chrons

too young..too old
Regular Member


Date Joined Apr 2011
Total Posts : 56
   Posted 4/15/2011 9:55 AM (GMT -6)   
I have AS (Ankylosing Spondylitis) and deal with the inflammation of the SI joints as well as the lower lumbar area on a daily basis. I tried PT many times with no results, but was recently instructed to try it again. I did and am seeing results so far. Nothing is going to be a fix for me, but this definately is helping. I have also taken up Yoga, which is supposed to stretch your muscles and make them stronger, which in turn, will help support your back better.

Cortisone shots worked for me as well. Facet Joint injections were the best, but there is a limit to how much ones body can handle.

A good therapist will be able to read your reactions and learn your limits. He/She will not push you past those limits to make it worse. If cost is an issue, you can always go once a week and do daily upkeep at home.

kazbern
Veteran Member


Date Joined May 2010
Total Posts : 7304
   Posted 4/15/2011 10:09 AM (GMT -6)   
Many years ago when I first had SI problems I was in a Pilates program AND physical therapy. The PT was the one who "discovered" my SI problem - my pelvis was misaligned and she attributed that to hypermobile joints back there. She showed me a way to realign my own pelvis, and for years I used that method to get things back into place if I started to feel out of whack. But the main point of her message to me, and what I did in Pilates for years, was to build strength in the pelvic girdle so that muscles would carry more load and not my SI.

IF you do any PT, get them to show you exercises for building core strength, pelvic girdle strength and some good hamstring and iliopsoas stretches. These routines will help support your SI and prevent misalignments from tight muscles. Keeping up your core strength is, in my opinion, the best defense against the hip and back pain that you're experiencing.

I was able to jog for fitness, sometimes up to 25 miles per week, until a few years ago when the arthritic changes in my SI were too far along to prevent other injuries (I tore my hamstring). I miss it terribly but I am glad that I was able to stay fit with jogging for so long. I need constant reminders to keep my core strength up, and now I do a yoga class weekly as a way to force the issue. But I will be forever grateful to the brilliant physical therapist who taught me how my body works, almost 20 years ago.
*******************
48 yrs old, IBD diagnosis in spring '01. Proctitis, gastritis, ileitis.
Currently taking Pentasa (3g/day), Sulfazine (1.5 g/day), Prevacid, folic acid, vit. D (2K iu), flax seed oil (2 tsp/day), mesalamine enema as needed.

Lu2011
Regular Member


Date Joined Apr 2011
Total Posts : 291
   Posted 4/15/2011 11:33 AM (GMT -6)   
Thank you both for your resopnses.  Sound like you both talk positively of PT.
 
JFG, I definitely wouldn't go more than once a week.  But would ensure to do the exercises at home. 
 
kazbern, with PT, are you able to do any impact aerobics (or even low impact such as eliptical?)

kazbern
Veteran Member


Date Joined May 2010
Total Posts : 7304
   Posted 4/15/2011 12:01 PM (GMT -6)   
Lu, this morning I spent 20 minutes alternating a slow jog with a fast walk. It felt great. For the first two months of this year I went to a "boot camp" 3 mornings a week. I am always careful now to pay attention to my hamstring, because the tear I have will never heal and I need to protect it (it is in my groin and a direct result of my SI arthritis IMO). Even so, I enjoy the cardio work-out a lot.
 
I am not in PT now, and haven't been except for the immediate time around my hamstring injury, since that first time 20 years ago.
*******************
48 yrs old, IBD diagnosis in spring '01. Proctitis, gastritis, ileitis.
Currently taking Pentasa (3g/day), Sulfazine (1.5 g/day), Prevacid, folic acid, vit. D (2K iu), flax seed oil (2 tsp/day), mesalamine enema as needed.

Post Edited (kazbern) : 4/15/2011 11:04:28 AM (GMT-6)


Lu2011
Regular Member


Date Joined Apr 2011
Total Posts : 291
   Posted 4/15/2011 7:14 PM (GMT -6)   
kazbern, that's great that you've found a way to jog.  I try and do the eliptical once in awhile...and not as intense as I could from a "fitness" way....but it always makes things worse.  WIsh so much I could incorporate fitness.  Wonder if an SI belt would help???

kazbern
Veteran Member


Date Joined May 2010
Total Posts : 7304
   Posted 4/15/2011 9:42 PM (GMT -6)   
I have an SI belt and I do find it helpful to wear when jogging. On the elliptical...I don't remember if I've ever tried it. I used it in boot camp, but with all the different exercises and positions were were in it kept on sliding around. When I first started down the sacroileitis road I wore an SI belt around the clock for a few weeks because I'd torn a large torso muscle while preparing to run a marathon. Oops. So yes, SI belt gets a thumbs up from me.
*******************
48 yrs old, IBD diagnosis in spring '01. Proctitis, gastritis, ileitis.
Currently taking Pentasa (3g/day), Sulfazine (1.5 g/day), Prevacid, folic acid, vit. D (2K iu), flax seed oil (2 tsp/day), mesalamine enema as needed.

Fuhrmaj62
New Member


Date Joined Apr 2011
Total Posts : 4
   Posted 4/17/2011 9:45 PM (GMT -6)   
I have an illiostomy from ulcerative colitis and take Humira for RA.  I now have severe sx of sacroillitis from a surgery where a ligiment was disected over my tailbone  due to pudendal nerve entrapment.  I recently found a roll on gel called Blue Chill on Amazon.com  It has capsaisan and lidocaine in it.  For some reason, it really seems to help!  Especially after I exercise (brisk walking)  Can't use stuff like Icy Hot or ActiveOn as it eats up my skin because of Humira's skin effects.  Good Luck!
 
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