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More pain after PRP in SIJ
I have had pain in my SIJ for one year now. I believe it was after a move and I stressed my joint. I had manipulation by my DO and it felt slightly better, but never back to 100%. One leg was longer than the other and my hip seemed jammed up into my pelvis and upon pulling the leg out it releived the pain slighty but not enough.
I then went to my family practice doc, who shot me with a cortisone shot, blindly and also gave me a 7 day steroid pack, neither helped.
Desperately I went to a pain doctor and got PRP injection with platelet rich blood. What a mistake! I had been walking daily with numbness down my leg and moving into my toes, however, I COULD walk. Now I literally can hardly get through the grocery store. I went back to that doc and he then numbed out the PRP because he believed it must then be a bulging disc. I got an MRI and in fact have a slight bulge in both L4 and L5. He then gave me a disco gram and numbed both L4 and L5 to no avail. The antithetic did nothing.
So the question is now what? I am on advil and tylenol every 4-6 hours and it doesn't touch the pain. I have an appointment with a different spinal doctor but I don't even know what the next steps should be.
I can't go back now, to not get the injection, but I really don't want to live with this pain anymore. It's achy and spasms if I go more than 100 yards. By the end of the day I literally can't stand for more than 30 seconds. Please help!
I then went to my family practice doc, who shot me with a cortisone shot, blindly and also gave me a 7 day steroid pack, neither helped.
Desperately I went to a pain doctor and got PRP injection with platelet rich blood. What a mistake! I had been walking daily with numbness down my leg and moving into my toes, however, I COULD walk. Now I literally can hardly get through the grocery store. I went back to that doc and he then numbed out the PRP because he believed it must then be a bulging disc. I got an MRI and in fact have a slight bulge in both L4 and L5. He then gave me a disco gram and numbed both L4 and L5 to no avail. The antithetic did nothing.
So the question is now what? I am on advil and tylenol every 4-6 hours and it doesn't touch the pain. I have an appointment with a different spinal doctor but I don't even know what the next steps should be.
I can't go back now, to not get the injection, but I really don't want to live with this pain anymore. It's achy and spasms if I go more than 100 yards. By the end of the day I literally can't stand for more than 30 seconds. Please help!
Sorry my PC is acting up and posted my response too soon. I'll continue on from where I left off.
I suggest you return to the D.O. that you initially consulted - or find one that you are comfortable with seeing. One OMT (osteopathic manipulation therapy) is not going to "do the trick". It will take several OMT and it may take one every month or so. The DO also needs to become familiar with your body what works and what doesn't work so well. My DO kept me working in a demanding career for years longer than any physician thought I should work. She knew my body better than I. So please give a DO another chance. Some trivia - a DO is trained to feel a quarter buried in the bottom portion of a Chgo phone book. That's how sensitive their touch and how well they can "feel" misalignment and so forth of our body. Amazing to me!
The information on PRP is all over the board. If a specific clinic utilizes this pricey treatment (normally not covered by insurance) there are glowing results - success is almost guaranteed. But one must look past the practitioners that are pushing PRP as a wonder procedure and search for the real facts and statistics - which can be difficult to find.
Failures of PRP is seen as lack of standardization. In December 2013, research critical of PRP treatments found a leading cause to be a “standardization of PRP preparation methods.” The research supported that published in Orthopedics Today warned against the high degree in variability among practitioners who use Platelet Rich Plasma.
The article goes on to say: "Unfortunately, like many new and upcoming treatment methods, there are good and not-so-good uses of the technique. Some physicians are rapidly jumping on the PRP bandwagon without having much injection experience or without any knowledge except for a weekend course in use of PRP. Prolotherapy is a specialized medical technique. It not only involves being able to choose the right proliferant for the patient’s particular pain complaint, but it also involves making a proper diagnosis, and then fully treating the injury. This is what we call Comprehensive Prolotherapy."
You may have come across a PMP that was not as schooled in PRP as he should have been. Remember, sadly in many instances medicine has become a money making business. Gone are the old days. That said there are still great medical professionals out there. You just need to search a bit harder.
Please return to your DO or find one of your choice. I encourage you to find another PMP - Good, kind, caring PMP do exist.
As Phil indicated you should be taking an anti-inflammatory - Acetaminophen (Tylenol) does not have those properties. Check with your PCP or trusted Pharmacist and they'll point you in the right direction.
Please let us know how you are doing. I'll be very interested in hearing from you again soon. I'll watch for your updates.
Best of Luck 7 Take Care,
~Tuck
I suggest you return to the D.O. that you initially consulted - or find one that you are comfortable with seeing. One OMT (osteopathic manipulation therapy) is not going to "do the trick". It will take several OMT and it may take one every month or so. The DO also needs to become familiar with your body what works and what doesn't work so well. My DO kept me working in a demanding career for years longer than any physician thought I should work. She knew my body better than I. So please give a DO another chance. Some trivia - a DO is trained to feel a quarter buried in the bottom portion of a Chgo phone book. That's how sensitive their touch and how well they can "feel" misalignment and so forth of our body. Amazing to me!
The information on PRP is all over the board. If a specific clinic utilizes this pricey treatment (normally not covered by insurance) there are glowing results - success is almost guaranteed. But one must look past the practitioners that are pushing PRP as a wonder procedure and search for the real facts and statistics - which can be difficult to find.
Failures of PRP is seen as lack of standardization. In December 2013, research critical of PRP treatments found a leading cause to be a “standardization of PRP preparation methods.” The research supported that published in Orthopedics Today warned against the high degree in variability among practitioners who use Platelet Rich Plasma.
The article goes on to say: "Unfortunately, like many new and upcoming treatment methods, there are good and not-so-good uses of the technique. Some physicians are rapidly jumping on the PRP bandwagon without having much injection experience or without any knowledge except for a weekend course in use of PRP. Prolotherapy is a specialized medical technique. It not only involves being able to choose the right proliferant for the patient’s particular pain complaint, but it also involves making a proper diagnosis, and then fully treating the injury. This is what we call Comprehensive Prolotherapy."
You may have come across a PMP that was not as schooled in PRP as he should have been. Remember, sadly in many instances medicine has become a money making business. Gone are the old days. That said there are still great medical professionals out there. You just need to search a bit harder.
Please return to your DO or find one of your choice. I encourage you to find another PMP - Good, kind, caring PMP do exist.
As Phil indicated you should be taking an anti-inflammatory - Acetaminophen (Tylenol) does not have those properties. Check with your PCP or trusted Pharmacist and they'll point you in the right direction.
Please let us know how you are doing. I'll be very interested in hearing from you again soon. I'll watch for your updates.
Best of Luck 7 Take Care,
~Tuck
Hello Cee,
Please excuse my tardy welcome and response to your post. We SIJD patients have great difficultly locating a medical provider that is knowledgeable in SIJD and it's treatment. It's an extremely painful condition and my heart goes out to you.
I've had SIJD for 27 years - a very long 27 years. Several years ago SSD recognized my disability and I am officially disabled due to the condition. I've researched it until I'm over loaded with information out there - some great and some not so great and much of it confusing and contradictory. I've consulted multiple specialties. If you have any other questions I'd be more than happy to try to answer them.
First let me say that any provider that attempts to do a SIJ injection blindly is a duck and quacks! Don't walk - run from that practitioner.
It's impossible to be sure that the correct location receives the dose of steroids that can bring relief without the aid of a fluoroscopy (X-ray guidance) for accuracy. Once the needle has entered the SIJ contrast is injected into the joint to ensure proper needle placement and proper spread of medication.
I believe physicians prefer that you have a spinal condition over SIJD - why?? - because it's better understood and there are many more treatments for spinal conditions. This is only my personal opinion.
It was an astute D.O. that diagnosed my SIJD after years of MDs telling me there was nothing wrong with me. When I couldn't ambulate more than 10ft and couldn't sit more than 5 minutes I was faking to obtain drugs! It was a horrible time and I understand what you are experiencing.
T
Please excuse my tardy welcome and response to your post. We SIJD patients have great difficultly locating a medical provider that is knowledgeable in SIJD and it's treatment. It's an extremely painful condition and my heart goes out to you.
I've had SIJD for 27 years - a very long 27 years. Several years ago SSD recognized my disability and I am officially disabled due to the condition. I've researched it until I'm over loaded with information out there - some great and some not so great and much of it confusing and contradictory. I've consulted multiple specialties. If you have any other questions I'd be more than happy to try to answer them.
First let me say that any provider that attempts to do a SIJ injection blindly is a duck and quacks! Don't walk - run from that practitioner.
It's impossible to be sure that the correct location receives the dose of steroids that can bring relief without the aid of a fluoroscopy (X-ray guidance) for accuracy. Once the needle has entered the SIJ contrast is injected into the joint to ensure proper needle placement and proper spread of medication.
I believe physicians prefer that you have a spinal condition over SIJD - why?? - because it's better understood and there are many more treatments for spinal conditions. This is only my personal opinion.
It was an astute D.O. that diagnosed my SIJD after years of MDs telling me there was nothing wrong with me. When I couldn't ambulate more than 10ft and couldn't sit more than 5 minutes I was faking to obtain drugs! It was a horrible time and I understand what you are experiencing.
T
OK, thank you. I'm glad that you defined PRP as platelet rich plasma. Otherwise I wouldn't have known what you meant.
For many who do not understand SIJ, this is the sacro-illiac joint.
You've only had one injection in the spine, so it is difficult to say if you're going to benefit from that mode of treatment. Most pain doctors will want you to try three times, or try different areas.
However, injecting the SI joint without an MRI sounds like bad medicine. If I were you, I'd find another pain doctor.
What kind of different spinal doctor are you going to see? If it is a surgeon, be wary. While microdiscectomy may help this condition, it may cause further disc problems down the road that will cause the loss of the disc.
It is best to exhaust all conservative treatments before opting for surgery.
In the mean time, your pain needs treatment, and tylenol is not the answer.
Incidentally, what was the result of the discogram. platelet rich therapy can accelerate healing of nucleus fibrosis damage. Sometimes discs heal on their own, within 18 months.
Again, find a pain doctor who is not afraid of treating your pain medically. In other words, find a pain doctor who is not afraid of using opioid analgesics, which are called for in your situation.
Look for a board certified pain doctor, with credentials like MD, DABPM (or DO, DABPM). These doctors are trained in pain management and interventional pain treatments (like injections).
Ice is an excellent pain reliever, and a hot soak at the end of the day can help ease sore muscles.
A good chiropractor who is not keen on "adjustment" can help manipulate soft tissue around the injury, reducing pain.
By the way, you should be using an anti-inflammatory medication like ibuprofen, not Tylenol which has no anti-inflammatory properties. Tylenol is great for mild pain and fever.
Best wishes.
For many who do not understand SIJ, this is the sacro-illiac joint.
You've only had one injection in the spine, so it is difficult to say if you're going to benefit from that mode of treatment. Most pain doctors will want you to try three times, or try different areas.
However, injecting the SI joint without an MRI sounds like bad medicine. If I were you, I'd find another pain doctor.
What kind of different spinal doctor are you going to see? If it is a surgeon, be wary. While microdiscectomy may help this condition, it may cause further disc problems down the road that will cause the loss of the disc.
It is best to exhaust all conservative treatments before opting for surgery.
In the mean time, your pain needs treatment, and tylenol is not the answer.
Incidentally, what was the result of the discogram. platelet rich therapy can accelerate healing of nucleus fibrosis damage. Sometimes discs heal on their own, within 18 months.
Again, find a pain doctor who is not afraid of treating your pain medically. In other words, find a pain doctor who is not afraid of using opioid analgesics, which are called for in your situation.
Look for a board certified pain doctor, with credentials like MD, DABPM (or DO, DABPM). These doctors are trained in pain management and interventional pain treatments (like injections).
Ice is an excellent pain reliever, and a hot soak at the end of the day can help ease sore muscles.
A good chiropractor who is not keen on "adjustment" can help manipulate soft tissue around the injury, reducing pain.
By the way, you should be using an anti-inflammatory medication like ibuprofen, not Tylenol which has no anti-inflammatory properties. Tylenol is great for mild pain and fever.
Best wishes.
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