As my readers know I have been suffering from bilateral sacroiliac joint dysfunction problems for quite some time and last year had some steroid injections into both sides which gave me some amazing pain-free time, although short-lived.
It was then decided that the next option was Radiofrequency Ablation which I had done on both sides 13 weeks ago.
My diary on my pain relief after the procedure went something like this –
DAY 3 MINIMAL PAIN – ONLY NEED PARACETAMOL.
ONE WEEK FROM THE PROCEDURE – JUST PARACETAMOL.
3 WEEKS FROM THE PROCEDURE – AFTER A LONG CAR JOURNEY SEVERE SPASMS AND LOW BACK PAIN NEED STRONGER PAINKILLERS.
STARTED WITH PHYSIOTHERAPIST ON WEEK 4 – GIVEN LOTS OF EXERCISES.
LOTS OF REGULAR VISITS TO PHYSIO AND ALSO GIVEN ACUPUNCTURE AND MASSAGE TO THE RIGHT SIDE OF LOW BACK TO HELP EASE SPASMS.
FROM WEEK 8 ONWARDS PAIN GRADUALLY CAME BACK INCLUDING PAIN AFTER WALKING/STANDING/VERY STIFF FIRST THING IN THE MORNING AND SITTING FOR A WHILE.
RESTLESS NIGHTS WITH PAIN IN BOTH HIPS WHEN I LIE ON THEM.
GOING UPSTAIRS SOMETIMES BRINGS THE PAIN ON AS WELL AS WALKING DOWNSTAIRS.
THE MAIN PAIN IS IN THE LOWER BACK, WHICH IS ACHING, SHARP AND DULL (LIKE TOOTHACHE) AND VERY PAINFUL TO TOUCH WITH A LOT OF NUMBNESS UNDER THE LEFT FOOT.
Obviously, I have been quite disappointed and felt quite low about the outcome especially as I also caught COVID on week 9 which completely knocked me sideways. The pain in my muscles was really severe.
I have now been back for my follow-up consultation with my Neurosurgeon who has come up with some options for me. First I am going to be booked in for a CT lumbar/including pelvis scan.
There is obviously a wait for this which is giving me time to think about the options available. Initially, I will continue with a conservative approach with oral analgesia. Then if things do not improve by the time I see my consultant again I will have hopefully decided to either consider a SI joint fusion or a spinal cord stimulation. Both are quite big things for me to decide upon so it is better that I have this time to see how I can manage without any further operative procedure as there are always risks involved in any type of surgery and no guarantee of complete pain relief.
In a fusion surgery, a bone graft and/or instruments are used to encourage bone growth over the sacroiliac joint and create one immobile unit. Joint fusion can effectively reduce pain and instability caused by sacroiliac joint dysfunction or inflammation (sacroiliitis).
Dysfunction in the sacroiliac joint (also called the SI joint) can produce significant lower back pain, as well as pelvic, groin, and hip pain. Sacroiliac joint dysfunction can be the result of too much motion, too little motion, or inflammation of the joint.
Spine Health writes that “Sacroiliac joint fusion is always an elective procedure, meaning it is the patient’s decision whether or not to have surgery. There are many factors to consider when deciding to have surgery, including the effectiveness of nonsurgical treatments, if fusion surgery is likely to improve one’s quality of life, and the recovery process necessary after surgery.”
Spinal Cord Stimulation is an advanced pain-relief procedure that is often recommended for an increasing number of medical conditions such as complex regional pain syndrome, neuropathy, cervical and lumbar radiculitis.
A neurosurgeon will implant the spinal cord stimulator in the patient’s back. It consists of a small battery pack which is surgically inserted beneath the skin and is connected to a lead placed near the spinal cord. The battery sends electric signals to the lead in the epidural space next to the spinal cord altering the long-standing pain signals often reducing the perception of pain and subsequently improving the patient’s quality of life.
A spinal cord stimulator can be trialled for a few weeks to assess its effectiveness or fully inserted at the first sitting. The trial system allows patients to have a test run before committing to a full system but can involve additional delays and further surgical procedures. The decision on the most appropriate for each patient is made on an individual basis by a multidisciplinary team and will be discussed before committing to any procedure.
Spinal cord stimulation is a therapy that has been used for over 40 years to help relieve chronic pain and improve quality of life.
It is a bit of a waiting game for me now.