Sacroiliac joint problems postpartum

[Lizard]

Has anyone else dealt with Sacroiliac (SI) joint issues after having their baby? DD is 7 months, and I've had pain since her birth. :( So far I've seen a doctor, who referred me to a physical therapist, who has done as much as she can. She offered me referrals to a chiropractor and an osteopath, but I haven't decided what I want to do yet. I'm just looking for people that have gotten through this and any tips they might have.

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My DH is a chiropractor, so I'm biased, but as soon as I saw your title I thought "She should see a good chiro."

If you have questions about chiro, I'd be happy to try to answer them.

[stevesbabygirl]

I'm currently 21 weeks pregnant, and I'm having the same issue! I don't have sciatic pain, but I do have sacroiliac joint pain.

[TracieB]

I'm not pregnant, nor have I ever been, but I popped by SI joint out of place a few months ago. What worked for me was going to a "bone doctor," (NOT a chiro... the chiro made it a lot worse, actually) and he pulled my leg and popped the joint back into place. I had to go three times before it was completely back in the right location. My thoughts are with you because I know how much it hurts! I ended up in the ER the night I pulled mine out (while running) because of the excrutiating pain I was in. I don't frequent the pregnancy boards often, so if you have any questions, just send me a PM.

edited to say that I'm sure a chiropractor could do what the guy at my doctor's office did for me, but the chiro I went to really made it worse. If you do choose to go to a chiropractor, make sure you get a lot of referrals and references from friends and your doctor.

[carrie9142]

Not pregnant, but I have had SI joint problems for a little over 2 years. I am understandably terrified to get pregnant!

First, it took me two years to even find out what exactly was wrong with my SI. Multiple drs., chiros, PTs and every imaging test you can think of. Turns out, my ligaments suck and allow my SI to rotate backwards and out of place. Not a dislocation like Tracie's. Just everyday being out of whack.

What is your pain like? What makes it better or worse? What is it on a 0-10 scale? Since mine is rotated backwards it feels like I always want to have pressure of some kind on it-like a thumb to push on it. Other people's rotate towards the front. Or a combo.

I would wager one or both of two things are going on here: 1.) your ligaments stretched out during pregnancy and no longer hold your SI in place and/or 2.) during birth (assuming you delivered vaginally) your baby kind of smooshed the joint out of place. Most people's SI joint problems happen during pregnancy or through childbirth. I just got lucky, I guess :rolleyes:

First, ice! No heat! In the absence of ligaments (which are stretchy and do not contract back) the muscles in your butt will step up and try to do the ligaments' jobs. Heat relaxes your muscles, which allows your joint to get out of place more, which causes more irritation and pain. I got some soft ice packs from my drug store and they are awesome.

Second, you need to find a good doctor. It took me going to a physical med/rehab dr. to finally find out what was wrong with me. Plus, doctors can give you painkillers! I suffered for 8 months before I finally got some drugs, and boy was I stupid. You might not want to do this for BF reasons or whatever, but you don't have to suffer needlessly. I have had great success with Ultram (tramadol) once I got passed the nausea.

Third, you need to find a good PT. If your problem is similar to mine, you don't have a spinal or bone problem-you have a connective tissue/myofascial problem. A chiro likely won't be able to help you, well, at least mine never could. Or even diagnose me. Sorry, bitter. This PT should NOT focus on massaging the muscles or ultasound heat or anything like that. Like I wrote with the ice thing-the muscles are your body's second line of defense against this problem, not the actual problem themselves. But, most PTs or doctors see these super tight muscles as the pain causing problem, not as the symptom. I am working with a PT now who is focusing on building up the glute muscles so they are able to hold my SI in place better. I go and work out-that's it.

If the pain kind of feels like a backwards pressure when you sit, or if it feels like you need someone to push on it (I used to lie in bed and have my husband push his thumb as hard as he could onto 'my spot') you might benefit from an SI belt. It is just a little belt you wear as tight as you can that holds the joint in place and provides extra support.

I hope you feel better! I have been dealing with this for 2 years, so I know how painful and stressful it can be. I had tons of professionals tell me with certainty they knew what was wrong with me, but they were all wrong. I listened to my body and kept looking. I wouldn't even be this far if I hadn't started working with a girl who had the same thing wrong with her!! I am still doing PT and likely will be for at least another year or so. It is pretty painful going, but the quicker you nip it in the bud the better. Don't be an idiot like me and wait for almost 9 months before even going to the doctor!

Question for you-SI joint dysfunction is common during and after pgcy, and for this reason I have no idea whether I will be able to have kids or whether it will be worth the havok it will wreak on my body. When did your's start to hurt? How bad was it while you were pregnant?

Good luck!

[stevesbabygirl]

Mine only hurts if I'm standing or sitting in one position for too long. I work in surgery, so I end up being on my feet a lot, or sitting on a stool with no back support. That's when it bothers me most, and I think I had the problem before I got pregnant too.

Where can I find these SI belts that you mentioned?

[LexyLou]

I didn't have these issues PP with DD but I did have it really badly in the first trimester.

I saw a chiropractor weekly and I went to one who had physical therapists on staff and I got a deep tissue massage at least once a month there (part of my co-pay) and it REALLY helped.

What also helps is rest-which I realize is not a reality when you have a 7 months old. I also iced the area a lot. heat feels better, but what you really need is ice to bring down the swelling.

[carrie9142]

SBG-you can Google either SI belts or special maternity SI belts like this one:
http://optp.com/media/products/thmb_Family_890.jpg

or this one from Amazon:
http://ec2.images-amazon.com/images/P/B00066CQAU.01-A2L9I0Y7VXFHAH._AA280_SCLZZZZZZZ_V45248784_.jpg
http://www.amazon.com/Maternity-Si-Belt-Sacroiliac/dp/B00066CQAU

I saw a chiropractor weekly and I went to one who had physical therapists on staff and I got a deep tissue massage at least once a month there (part of my co-pay) and it REALLY helped.

I know it feels good to have those tight muscles massaged, but be careful. Those muscles are tight for a reason-b/c the ligaments are stretching and not holding the SI in place. When you relax the muscles your SI can rotate further and cause more inflammation.

I know I sound preachy! Honestly, I have researched the CRAP out of the SI joint. My PT explained all this to me. He did an extra 4 year residency on the spine, and is the only Level II spine master whatever in the country. At any given day at the gym there is at least one other woman working on her SI. He is the SI King, and the only person I have ever met who has fixed someone worse off than me. God willing, I will someday be fixed!!!

[HollyMN]

I tried to google this to see if this is what I had/have. I had pain in my left hip/low back/leg that came on gradually sometime around 4-5 months pp (I don't remember exactly) and by 9 months pp, I was uncomfortable sitting in my car for 10 minutes and limping in to work in the morning. I went to a few doctors and physical therapists, not sure what made the difference because healing took so long and I tried lots of exercises. I feel like I got my life back some time around 12 or 15 months pp or so and at 18 months I feel almost normal. If I were to jump up and down I may still feel something in my left side, but am mostly back together.



BTW, I found this while googling:

http://www.physioroom.com/experts/expertupdate/interview_diane_lee.php

Could you briefly explain the mechanism of SI joint dysfunction during pregnancy?

"During pregnancy the deep abdominal muscles become stretched. If a woman has less form closure and relies on force closure for stability, then she is more vulnerable to developing pelvic pain during her pregnancy. In addition, a hormone called relaxin is released at periodic intervals during pregnancy and this hormone has the effect of relaxing the ligaments of not only the SIJ but the body. This contributes to the loss of both form and force closure and again there is a greater vulnerability to shear."

" During a vaginal delivery the muscles of the pelvic floor are frequently stretched, cut or torn. This further compromises force closure of the pelvis. It is absolutely essential that a postpartum woman address the function of her deep abdominals and pelvic floor if she is to prevent an onset of pelvic and/or low back pain, possible future urinary incontinence and uterine prolapse. For this reason, the program Postpartum Health for Moms (www.dianelee.ca) was developed and I truly believe that all women should take a course like this to learn how to "put their bodies" back together again after having a baby. Prevention is the key! While training these deep muscles a sacroiliac belt (see The COMPRESSOR at www.dianelee.ca or OPTP.com) can help to support the pelvis. The COMPRESSOR was designed to allow an individual to specify where and how much compression is applied to the pelvis. It is a training tool and not meant to replace a proper exercise program."

I did not have urinary incontinence or anything, but I definitely needed to strengthen abdominal muscles to get better. Pre-pregnancy I was in good physical shape, worked out twice a week and was even taking an abs and back class that I quit sometime in the first trimester. When I started doing lower abdominal exercises pp I was surprised at how I couldn't lift myself at all.

[Lizard]

Wow, thanks for all the responses. I have heard this is a really common problem for women post-partum so I was surprised there wasn't a thread about it.

carrie9142 - You asked a lot of questions and hopefully I can answer them. The best way to describe the pain is that I need to "pop" something back into place, in the lower right part of my back. The PT said it's definitely the SI joint. I noticed it within weeks after labor... DD was sunny side up and I had bad back labor which may be the cause. The times that I feel the most pain is when I'm laying on my back on a hard surface, or sitting on the floor. Of course, I'm doing both of those daily with a 7 mo. old which doesn't help things. :( We found that if my right leg's being pushed in or I hold it out at a 90 degree angle from my body (think Captain Morgan, lol), the pain decreases to practically nothing. Walking doesn't hurt at all, but running hurts BAD. I can't even jog with the shopping cart to the car when it's cold outside.

I've tried heat and cold... heat seems to feel the best but I understand where you're coming from with the cold advice. I've tried an SI belt, but it didn't help and actually made the pain worse after a while. I was also given a steroid patch treatment (I forget the name offhand), which helped a little when I was at my most irritated, but we haven't tried it since.

I've also tried several different exercise routines, but no matter what I do and no matter how long I do it, as soon as I lay flat on the floor again the pain's back. The newest routine I was given focuses on the ab muscles - I haven't started it yet. Oh, and I should point out that I do work out at the gym 2-3 days a week (and have for years), but lately I've only been able to go once a week. I need to get back into routine.

Gotta run, thanks for all the advice & thoughts so far. :D