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Forum Name: Spinal problems and back pain

Question: back pain 2 years after pelvis fracture


 kskbabe - Mon Nov 03, 2008 6:15 pm

I'm a 21 year old female who fractured her pelvis from a car accidnet in November of 2006. I was treated at Harborview Medical in Seattle, Washington. The fracture went straight across my pelvis from the left to the right illium, the left side being the worst. I was told me SI joint was completely "blown out". I had surgery 3-4 days after the accident and had 2 screws, a bolt, and a plate in my pelvis. One screw went through my SI joint. After a year, I had another surgery to remove the screw through my SI joint and a plate.

2 years later, I still have pain everyday. Long days on my feet and sitting increase the pain. The pain varies but is worse the busier I am. Laying straight on my back for any period of time hurts the most. It hurts immediatly to run or even walk at a fast pace. The pain seems to orginate from the middle of my lower back but spreads across my lower back.

I've seen numerous doctors and so far the only real solution I have been given is cortison shots or messing with my nerves. I do all my excersises that I was given from my physical therapist. Stretching defiently helps the pain. But it never elimantes it. I don't believe that the only solution to my pain is shots involving my nerves. I've had MRI's and x-rays done, my pelvis has healed the way it should.

Do you know of any reasons of pain after pelvis fracture and surgery? Also could my pain be involved with my SI joints being "blown out"? If so, what are the solutions?

Also do you have any back specialist doctors in Washington or Oregon you would recommend for my case?

Thanks!
 Tom Plamondon PA-C - Wed Dec 31, 2008 12:50 pm

User avatar Thanks for writing and sorry for the delay in response.

It sounds like the pain is from the SI joint area.

Normally, during walking, standing, or running, weight (a vertical force) is transmitted up through the leg bones, through the SI joint and into the spine. What keep us upright and supported is the rigidity of the spine, pelvis, SI joint, and leg bone with their respective ligaments and connective tissue and the muscles surrounding these bones.
When any of these structures are damaged, then normal function (walking, standing, etc) can cause pain.
Since the SI joint is a weight bearing joint which translates a great deal of force, it is important to support the area. This is why our SI area was created with thick, bulking, strong muscles (the gluteals and iliopsoas) and dense and stiff ligaments.

Besides the treatment measures already mentioned, I would focus effort on aggressive strengthening of the muscles which support the SI joint. This will include the gluteus muscles and iliopsoas. Also strengthen all the hip and trunk muscles (abdominals and lumbar muscles). This way not only deal with the SI area but condition the areas above and below the pelvis.
Give yourself 9-12 months to do this. See a physical therapist if needed.

Starting off, aquatic exercises may be best as buoyancy takes weight off the legs and therefore the SI joint.

Land exercise should include deep squats, lunges, and a special exercise for the SI (With both hands, grasp an overhead bar so the feet are dangling off the ground. Bend both knees simulaneously up toward the chest. It is like a reverse sit up. This will strengthen iliopsoas, abdominals and latisimus dorsi. Use a step stool if needed and definitely do not hop down - gentle step down.). Again, the idea is to strengthen the muscles around the SI joint.

Take your time and strengthen gradually.

Keep us posted.

ps I do not know of any SI specialist in the Northwest. See an orthopedic physical therapist may be the best bet.

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