L.S/S.I Joints Thread

[Captain Nemo]

For layman's, Lumbosacral/Sacroiliac Joints Thread.

Going on from L.L's thread, seems as though a few of us have Lower Back problems.
Please post effective treatments, drugs, stretches etc....
Lets keep this on track and cutout the B.S please!

[simmsy]

Do u mean L5/S1 titty?

[simmsy]

Going through this as you know.
I know Courty has had lots of time with it.

I just had Cortisone inj which seems to be going well.
Before that I was doing Bikram Yoga 2-3times a week and that was very good. A dose of gardening undid my back this time.

Doc has had me on
Naproxyn and Tramadol for about 5 weeks which helped well before the Cort inj and now just use them as need.

[simmsy]

Going to my physio next week to start a new plan on specific exercises. Will let you know what comes of it.

[Captain Nemo]

Do u mean L5/S1 titty?

Just Lumbar/Sacral area in general.....
Let's try compile some good links to stretches/exercises to help everyone.

[simmsy]

Sweet. Sounds good mate.

How's yours coming along?
I had a bad back for years but always managed it the straw that broke this camels back was doing same as you. Lifting my buggy out my car early one morning.

[Ron Burgundy]

Is it safe to assume you guys have already had MRIs to confirm which discs are involved/degree of protrusion/which side etc. If not, that'd be a very good idea.

[simmsy]

Yep. Scan done.

[simmsy]

Bit hard to get a Dr to stick a needle in your spine without one

[Ron Burgundy]

Good stuff. Plenty will do it after a CT instead, which isn't ideal. Out of interest, how long does the symptom relief tend to last for you with the injections?

[simmsy]

No stated time with any assurance.
They tell you anything from 1week to 12months.
So it is somewhat of a lottery.

[Courty]

As a general statement, I have found that painkillers don't work. I guess it's due (in my case) to the symptoms being referred pain. I have had much greater success with various types of anti-inflammatories. And when it gets real bad, Endep also provides some relief.

As I've mentioned elsewhere, the stretches that work best for me are:

Piriformis stretch
http://www.thehealthybackblog.com/wp-content/uploads/2012/09/piriformis-stretch1.jpg

Tennis ball variation (for that extra intensity)
http://i1.ytimg.com/vi/dm4EBzxpPRI/hqdefault.jpg

Piriformis muscle
http://www.clinicalexams.co.uk/images/Musculoskeletal Medicine Resource-images/Piriformis-syndrome-web-large(800x600).jpg

followed by the Psoas stretch
http://dcinjuryclinic.files.wordpress.com/2012/04/psoas-stretch.jpg

Psoas muscle
http://images.elephantjournal.com/wp-content/uploads/2013/01/psoas.jpg

[Captain Nemo]

Despite having regular Chiro as maintenance, my backs flared up again.
Anyone had any success with Acupuncture/Dry Needling in this area....?

[3Puttpete]

Despite having regular Chiro as maintenance, my backs flared up again.
Anyone had any success with Acupuncture/Dry Needling in this area....?

What about remote healing? I'll treat you for 75% of whatever your chiro charged

[Captain Nemo]

Mate, if you could fix me id pay you 80%...

[3Puttpete]

50% if I promise not to make it worse?

[Monsta]

Not sure if its the same, but after crushing 3 vertebrae in lower back (L3,4 &5). Surgery to install pins and screws......

My physio had me in the pool doing exercises to rehab my spine. Seemed to work, can play 3-4 games in 3-4 days and still be able to walk.

Physio said that pool walking/streching/exercising is the best thing for spine/back injuries. Maybe worth a try????

[Captain Nemo]

Can only try.
I think i need 2-3 weeks off rest, no golf/cycling etc

[Courty]

I've been told by more than one doctor/ physio that cycling is no good for lower back problems.

[Captain Nemo]

It prob isnt, but its my only real way to commute to work.... :(
Sitting in the car for 20-30 mins isnt much good either!

[simmsy]

yeah cycling not good for back pain in that area mate, the joints are always flexed in that hunched over position.

[Hux]

yeah cycling not good for back pain in that area mate, the joints are always flexed in that hunched over position.

You reckon? If your back is sore you generally hunch over to relieve the stress on your muscles. Standing upright is your back and stomach muscles in tension.

Now have you had a test for Ankolysing Spodylitis? Get a HLA-B27 blood test.

I have a specialist appointment next week with a rheumatologist as I am HLA-B27 positive, have a night back pain, pain in the lower butt like a sore hammy, back generally feels better after I get up and start to move around etc. Little brother has fairly advanced AS as well.
Over 12 months now with no more than 5hrs continuous sleep.....did I mention I am more tired than I have a sore back :-)

[wazandnic]

It prob isnt, but its my only real way to commute to work.... :(
Sitting in the car for 20-30 mins isnt much good either!

Could you get your hands on a mountain bike or something hat has you sitting more upright, for a bit??

The other thing that I would recommend is stretch those hammies and calves. As simple as even just standing up put one foot back and push your hands against a wall. the foot back you should feel the stretch up your calve. Simple stretch and while it is for the calve I find it actually helps the lower back a bit. My pysio has me doing these and my mum actually got shown a similiar by her physio. May not work for you but worth a try??

Good luck with it mate...

[golfbound]

I get botox injections in my legs for pain haven't tried it in my back not sure if it would work or not.

[3oneday]

http://www.thehealthybackblog.com/wp-content/uploads/2012/09/piriformis-stretch1.jpg
gee County, you've lost weight mate!

[Captain Nemo]

You reckon? If your back is sore you generally hunch over to relieve the stress on your muscles. Standing upright is your back and stomach muscles in tension.

Now have you had a test for Ankolysing Spodylitis? Get a HLA-B27 blood test.

I have a specialist appointment next week with a rheumatologist as I am HLA-B27 positive, have a night back pain, pain in the lower butt like a sore hammy, back generally feels better after I get up and start to move around etc. Little brother has fairly advanced AS as well.
Over 12 months now with no more than 5hrs continuous sleep.....did I mention I am more tired than I have a sore back :-)

Worth a shot, at this point ill try anything.
As i told Simmsy in a pm, yesterday here at work was the worst day i have had pain wise since i did it by far.
Ive been having regular chiro/massage since i injured it,in fact i had treatment on it last friday.
Im at a point where yes, the next step is an MRI.....
Last night i went to the soccer on 2 Voltaren 25's, and when i got home i was in so much pain i took an Endone....!
Im off to the doc soon, try get a referral for an MRI.....





Could you get your hands on a mountain bike or something hat has you sitting more upright, for a bit??

The other thing that I would recommend is stretch those hammies and calves. As simple as even just standing up put one foot back and push your hands against a wall. the foot back you should feel the stretch up your calve. Simple stretch and while it is for the calve I find it actually helps the lower back a bit. My pysio has me doing these and my mum actually got shown a similiar by her physio. May not work for you but worth a try??

Good luck with it mate...
My commuter is very rider/cruiser friendly, i have no probs riding it.
Im stretching daily, but im at a point where i need further investigations....

[Captain Nemo]

Ok, today was extremely productive....
Went to the medical centre near work.
Saw a GP, who ordered full blood count (may as well get it all done while I'm there I thought) and the HLA-B27 test recommended by Hux, GP thought that would be a good idea as well...seeing as though it was bulk billed.
Got full set of pelvic X-rays done as well (not that they will be that useful)
Got one of my treating specialist to write me an MRI referral.
As I went to uni (and was close to her back in the day..) with the chief radiographer at the private hospital, she's booked me I to have an MRI done tomorrow arvo, bulk billed!
So I suppose by fri I'll have all the info I need to determine the next course of attack...
Question will be whether I see a Musculoskeletal specialist http://www.musculoskeletalgolfinjury.com.au/about-dr-oei.html or sports/ortho specialist perhaps at the footy stadium clinic????

[MegaWatty]

I have found acupuncture to be extremely effective in my lower back.

I think Yoss is the best to discuss dry needling in the lower back area though.

[Captain Nemo]

Please, please let's keep Yoss out of this thread....

[MegaWatty]

Please, please let's keep Yoss out of this thread....

Apologies. ;)

[Yossarian]

Hi. I'm super thanks for asking.

[Hux]

Hopefully you only have a pinched nerve or bulging disc.

The microdiscetomy (sp?) they do these days at some of the top places is basically day surgery. Probably still a bit of rehab but its not 4 hrs on the slab.

[simmsy]

yep friend of mine had this done a couple of years ago, up walking the next day, out of hospital day after then physio for a bit of time from there. very successful it was.

[Courty]

Early days to be talking about surgery. Should be the last option, IMO.

CT-guided Cortisone injections have worked well for me.

[simmsy]

Mine lasted 6 weeks. Was good while lasted though.
Good chat with surgeon yesterday. Got good news about my back. So hopefully it's manageable.

[Courty]

Good chat with surgeon yesterday. Got good news about my back. So hopefully it's manageable.

Good to hear, mate.

[Captain Nemo]

Ok, not all doom and gloom, but golf will be on the backburner for a few weeks....
I'll keep the findings brief!

L4/5 right lateral annular tear and disc protrusion with nerve displacement.
L5/S1 diffuse disc bulge small post central annular tear.
L3/4 minimal disc bulge left anterolateral annual tear.

So at least now I've found the cause of the pain....
Some rest and stretching.
Stop Chiro for a while.
Well see what happens?

[simmsy]

yeah, like you have said mate, good and bad news there.

atleast you have a cause and direction to head in.

hope it settles down for you soon.

[jimandr]

I'm bumping this thread because it describes my situation accurately, and is less alarming than other back pain threads from 2009 and 10.

I had some minor back and hip pain after golf for a while, but it always went away after a day or so. 7 weeks ago, my back 'went', and by the time i got home my back was sore, but my right hip and down my leg was agony.

The diagnosis was an L5 nerve compression problem, which somehow caused a tear in the gluteous medial tendon in my right hip. Most painful thing I've ever suffered.

I've had a number of encouraging improving signs and discouraging setbacks with the tendons and muscles in my right hip and groin, but finally I'm recovering.

I'm allowed to make 20 half swings a day on top of my other rehab exercises. I'm guessing it'll still be a while before full 18 hole golf rounds, though.

I note some of the posters on this thread and the earlier ones are still active and not reporting further back problems. Any tips on how to prevent this occurring again?

[Captain Nemo]

I’ll report back, I’m ****ed, still sore and now hips are rooted too….
Although I’m managing..

[AndyP]

Good luck with it, Jim. I assume you've got lots of strengthening work to do.

[simmsy]

I'm bumping this thread because it describes my situation accurately, and is less alarming than other back pain threads from 2009 and 10.

I had some minor back and hip pain after golf for a while, but it always went away after a day or so. 7 weeks ago, my back 'went', and by the time i got home my back was sore, but my right hip and down my leg was agony.

The diagnosis was an L5 nerve compression problem, which somehow caused a tear in the gluteous medial tendon in my right hip. Most painful thing I've ever suffered.

I've had a number of encouraging improving signs and discouraging setbacks with the tendons and muscles in my right hip and groin, but finally I'm recovering.

I'm allowed to make 20 half swings a day on top of my other rehab exercises. I'm guessing it'll still be a while before full 18 hole golf rounds, though.

I note some of the posters on this thread and the earlier ones are still active and not reporting further back problems. Any tips on how to prevent this occurring again?


Hey mate.
Yep still playing golf but have never swung the same way since hurting my back and going through a couple of years of trying to get back to golf.
I'd say i manage it pretty well. Lots of "girly" things helped me get back to being able to play and learn when my SI was not liking me.
Pilates was the best thing I did for learning how to breathe and support my lower back.
Yoga (bikram and Adriene) are something i continue to this day.
My GP is a golfer and understands what i'm doing which has helped and always has fed me a good supply of anti-inflamms and forte when things go wrong.
My physio knows exactly how to treat my issues with needle point and massage and I now go and see him prior to my back playing up as i feel the tightness coming on.

I don't know of an easy fix, but the above things have all helped me. Cortisone helped at my worst time and allowed me to get through a Vic Champs wend but i wouldn't do that again.

[Slug]

Good thread this one

My back is still killing me, has been for years.

Im pre ankylosing spondylitis, officially have inflammatory spinal arthritis.

My inflammation markers are high, have inflammation on mri and X-rays, but not graded high enough on left side to be classed as ankylosing spondylitis.

I struggle in mornings and nights mostly, once up and about not so bad.

Doesn’t affect golf whilst playing, but back to back days are near on impossible.

Was on anti inflams daily, but had to come off as stomach issues flared up.

Fun and games….not

[jimandr]

I’ll report back, I’m ****ed, still sore and now hips are rooted too….
Although I’m managing..

Gees, Nemo

You were supposed to tell me how carefree and painfree your life was since you discovered the cure.

Maybe I can get Courty to give me some encouragement.

[AndyP]

Gees, Nemo

You were supposed to tell me how carefree and painfree your life was since you discovered the cure.

Maybe I can get Courty to give me some encouragement.
Hmmm, I think it is something that he still manages. I can't think of any other reason why someone would willingly swim laps of a pool.

[Courty]

Hmmm, I think it is something that he still manages.

Absolutely. Aside from the original injury I have degenerative changes, so it's never going to miraculously heal up. The L5/S1 disc is properly buggered but over the years I have developed a routine that mostly keeps me out of the doctors surgery. I don't even take any regular medication.


I can't think of any other reason why someone would willingly swim laps of a pool.

The swimming is two-fold. One, I'm in a team for next years Ironman again. Second, it's just a great general wellbeing activity (physical & mental).
I can honestly say that my back has responded well and feels better for it. But that would probably apply to any regular activity.

2 years ago I had a setback and was suffering referred pain from a slightly different site that the cortisone injections didn't help. I ended up getting a procedure called a radiofrequency neurotomy (https://www.mayoclinic.org/tests-procedures/radiofrequency-neurotomy/about/pac-20394931) which worked really well. Even though the nerve in question would have well & truly grown back by now the pain has not returned.

If I was asked to recommend one thing it would be to find the Piriformis & Psoas stretches that work best for you.

[rickie prowler]

First sign of bursitis and I went to clinical Pilates and then regular Pilates. Small muscles are the answer.