Sacroiliac fun
Aug. 17th, 2010 01:55 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
urocyonYesterday was pretty rough, but I'm doing better today.
Sunday night, I got what would have to qualify as the opposite of a useful chiropractic adjustment, quite unintentionally.vatine was having a look at something on my shoulder blade, and leaned on his forearm in just the wrong way on my behind: CRUNK! goes my left sacroiliac joint.
I think he's been concerned about unintentionally hurting me anyway, and that didn't help. *wry smile* It wouldn't have been a problem, if not for the unlucky combination of hypermobility, previous injury, and a bunch of tight muscles already putting strain on the joint.
Good thing we had a new bag of frozen peas. I woke up in the morning with room temperature peas still there, which was a little disconcerting, but it brought a lot of the swelling down. :) I will probably lie down with an ice pack again later, since there's still active inflammation, and it really helped yesterday. Things are less stabby today, but that's probably a good idea anyway. For some reason, I tend to forget about icing things. Probably because it involves slowing down long enough to do it. :-| Resting things? Not so good at that.
One disconcerting thing about this, which I also noticed with the severely sprained ankle a while back? A sacroiliac injury like this is considered to cause severe pain, and after the first night, it's striking me as annoying but manageable. Even on top of the other chronic pain. A good demonstration that I'm scarily accustomed to dealing with pain by now. "Scarily" because that's exactly how my mom missed that she had bone cancer until it was way too late.
On the brighter side of things, applying Occam's Razor, the pain I'd been suspecting was coming from endometriosis may well be from the chronic sacroiliac weirdness. There's an awful lot of symptom overlap, including chronic pelvic pain, the way so much stuff is all packed together in the pelvis with so much potential for one thing going wrong and messing with other things around it. E.g., an inflamed appendix irritating adjacent muscles to the point that the psoas sign is used to diagnose appendicitis. The misplaced bits of endometrial tissue will do the same thing.
The problem probably gets so bad at certain times of the month because of the already-knotted-up muscles going wild from prostaglandins so that everything goes into spasm, and it also turns out that relaxin which causes pregnancy back and pelvic pain is also released during the menstrual cycle and makes women more prone to soft-tissue injuries. Ligaments loosen, sublux goes the sacroiliac! In another lovely musculoskeletal vicious circle, an out-of-whack sacroiliac will set off all kinds of muscle weirdness, which will keep yanking on the joint.
What tipped me off, besides just doing more reading on how to deal with an acute sacroiliac ligament strain? The muscle weirdness I've been having anyway, including the "menstrual cramps from Hell"-feeling part, went absolutely wild after the CRUNK! Very encouraging, actually, since while unpleasant that's easier to work on (and easier to treat on my own!).
I mentioned a previous sacroiliac injury. That got me thinking again about the ballistics gel dummy model of anatomy: "It bears an eerie and unfortunate resemblance to the usual medical model, where pain is concerned: there's the skeleton and internal organs--where the Real Problems lie--and then there's this ill-defined fleshy mass encasing them." An excellent example? When I probably tore at least one ligament there (not just CRUNK!, but SNAP!), and the continuing pain was honest-to-goodness 'splained away as a special invisible bone abscess in my coccyx, which broke in the same fall. Never was soft tissue mentioned, at all.
In 1990, I was out hiking around and fell on my ass on a huge rock, hard. Twice in a row. The first time, the coccyx went. The second fall, with added torsion since I was in the process of getting up from the first fall, was when the SNAP! happened. I've torn other ligaments since then, and am fairly sure that at least one ligament at the sacroiliac tore then, besides an awful lot of muscle injuries which helped set up trigger points.
I haven't been able to sit down comfortably for any length of time since then. Which is apparently not unusual after injuries or childbirth.
The usual ER trip happened, and a coccyx fracture (may have really been dislocated) showed up on X-ray. I saw it; the tailbone was bent at a really funny angle, very much like the first diagram on that linked page (only I've got a really long one, too, for extra fun). So, I'm sure there really was coccyx damage.
Only, the pain didn't go away. At least they did believe me; though I had a lot better luck with that when I was 15 than at 25 or 35. (Not to mention pain medication, which somehow I was considered less likely to misuse or become dependent on. As a teenager. *scratches head* I kinda miss the 100-tablet bottles of Darvocet sometimes.) I had continuing severe sacroiliac-pattern pain; falling on your butt is also the most common cause of sacroiliac injuries, not surprisingly.
So, after a couple months of the pain continuing, they suspected that my coccyx had abscessed instead of healing properly. Since I had good dual insurance coverage then, they sent me off for some kind of dye-contrast scan. In spite of the fact that no evidence of anything of the sort showed on the scan, the only possible explanation was some kind of special invisible bone abscess. Seriously.
Never was a word said about the possibility of any kind of soft tissue injury. In spite of my obvious hypermobility#, and all the ligaments and muscles around the pelvis.
I got months of increasingly stronger antibiotics; the pain continued, proof of a really persistent infection in the bone. *headdesk* I also got sent for useless (and painful##, and expensive--note good insurance) ultrasound treatment, to try to get the bone healing better. After several more months, they started mumbling about nerve damage from the abscess. And sent me to a neurologist with electrified needles.
After that, I stopped complaining about it. And have had chronic pain, to varying degrees, since then. No connection was ever drawn between that injury and my recurring (and increasingly worse) lower back pain until I had the sense to see an osteopath during a particularly bad flare-up. Imagine that: "Sacroiliac joint pain can become severe and disabling if not treated." I've been concentrating on putting out fires with the muscle problems, but am starting to suspect that trying to get the joint stabilized will help the muscles calm down.
This is a bit extreme, but fairly representative of my dealings with orthopedists. Sometimes I feel a bit silly for not having made connections earlier, but then I think of the magic invisible bone abscess--and don't think I'm doing so badly anymore, with the information at hand! It's more than a little frustrating that you have to search so hard for the information to form reasonable working hypotheses about what might be going on with your health, in so many cases.
_____________
# The year before, I separated my ankle in a way that required much heftier casting and at least three times longer to heal than a plain old fracture. When I got sent to PT, they absolutely freaked and decided that I couldn't continue to use crutches without destroying other hypermobile joints, including but not limited to my hyperextending knees. (Which has not proven to be a problem.) Orthopedists have commented on the hypermobility, but apparently not considered it relevant. Fail.
## Since this was through the PT department, I assumed it was supposed to hurt. (Having already done some of the "no pain, no gain" style PT which did more harm than good. Questionable enough anyway, but when you've got hypermobility and knotted-up muscles in spasm? Faily fail fail.) Nope, they had the machine turned up way too high, assuming my rump had a lot more padding than it did. As I found out during the third session, when they noticed I looked like I was in pain. :-|
Sunday night, I got what would have to qualify as the opposite of a useful chiropractic adjustment, quite unintentionally.
vatine was having a look at something on my shoulder blade, and leaned on his forearm in just the wrong way on my behind: CRUNK! goes my left sacroiliac joint.I think he's been concerned about unintentionally hurting me anyway, and that didn't help. *wry smile* It wouldn't have been a problem, if not for the unlucky combination of hypermobility, previous injury, and a bunch of tight muscles already putting strain on the joint.
Good thing we had a new bag of frozen peas. I woke up in the morning with room temperature peas still there, which was a little disconcerting, but it brought a lot of the swelling down. :) I will probably lie down with an ice pack again later, since there's still active inflammation, and it really helped yesterday. Things are less stabby today, but that's probably a good idea anyway. For some reason, I tend to forget about icing things. Probably because it involves slowing down long enough to do it. :-| Resting things? Not so good at that.
One disconcerting thing about this, which I also noticed with the severely sprained ankle a while back? A sacroiliac injury like this is considered to cause severe pain, and after the first night, it's striking me as annoying but manageable. Even on top of the other chronic pain. A good demonstration that I'm scarily accustomed to dealing with pain by now. "Scarily" because that's exactly how my mom missed that she had bone cancer until it was way too late.
On the brighter side of things, applying Occam's Razor, the pain I'd been suspecting was coming from endometriosis may well be from the chronic sacroiliac weirdness. There's an awful lot of symptom overlap, including chronic pelvic pain, the way so much stuff is all packed together in the pelvis with so much potential for one thing going wrong and messing with other things around it. E.g., an inflamed appendix irritating adjacent muscles to the point that the psoas sign is used to diagnose appendicitis. The misplaced bits of endometrial tissue will do the same thing.
The problem probably gets so bad at certain times of the month because of the already-knotted-up muscles going wild from prostaglandins so that everything goes into spasm, and it also turns out that relaxin which causes pregnancy back and pelvic pain is also released during the menstrual cycle and makes women more prone to soft-tissue injuries. Ligaments loosen, sublux goes the sacroiliac! In another lovely musculoskeletal vicious circle, an out-of-whack sacroiliac will set off all kinds of muscle weirdness, which will keep yanking on the joint.
What tipped me off, besides just doing more reading on how to deal with an acute sacroiliac ligament strain? The muscle weirdness I've been having anyway, including the "menstrual cramps from Hell"-feeling part, went absolutely wild after the CRUNK! Very encouraging, actually, since while unpleasant that's easier to work on (and easier to treat on my own!).
I mentioned a previous sacroiliac injury. That got me thinking again about the ballistics gel dummy model of anatomy: "It bears an eerie and unfortunate resemblance to the usual medical model, where pain is concerned: there's the skeleton and internal organs--where the Real Problems lie--and then there's this ill-defined fleshy mass encasing them." An excellent example? When I probably tore at least one ligament there (not just CRUNK!, but SNAP!), and the continuing pain was honest-to-goodness 'splained away as a special invisible bone abscess in my coccyx, which broke in the same fall. Never was soft tissue mentioned, at all.
In 1990, I was out hiking around and fell on my ass on a huge rock, hard. Twice in a row. The first time, the coccyx went. The second fall, with added torsion since I was in the process of getting up from the first fall, was when the SNAP! happened. I've torn other ligaments since then, and am fairly sure that at least one ligament at the sacroiliac tore then, besides an awful lot of muscle injuries which helped set up trigger points.
I haven't been able to sit down comfortably for any length of time since then. Which is apparently not unusual after injuries or childbirth.
The usual ER trip happened, and a coccyx fracture (may have really been dislocated) showed up on X-ray. I saw it; the tailbone was bent at a really funny angle, very much like the first diagram on that linked page (only I've got a really long one, too, for extra fun). So, I'm sure there really was coccyx damage.
Only, the pain didn't go away. At least they did believe me; though I had a lot better luck with that when I was 15 than at 25 or 35. (Not to mention pain medication, which somehow I was considered less likely to misuse or become dependent on. As a teenager. *scratches head* I kinda miss the 100-tablet bottles of Darvocet sometimes.) I had continuing severe sacroiliac-pattern pain; falling on your butt is also the most common cause of sacroiliac injuries, not surprisingly.
So, after a couple months of the pain continuing, they suspected that my coccyx had abscessed instead of healing properly. Since I had good dual insurance coverage then, they sent me off for some kind of dye-contrast scan. In spite of the fact that no evidence of anything of the sort showed on the scan, the only possible explanation was some kind of special invisible bone abscess. Seriously.
Never was a word said about the possibility of any kind of soft tissue injury. In spite of my obvious hypermobility#, and all the ligaments and muscles around the pelvis.
I got months of increasingly stronger antibiotics; the pain continued, proof of a really persistent infection in the bone. *headdesk* I also got sent for useless (and painful##, and expensive--note good insurance) ultrasound treatment, to try to get the bone healing better. After several more months, they started mumbling about nerve damage from the abscess. And sent me to a neurologist with electrified needles.
After that, I stopped complaining about it. And have had chronic pain, to varying degrees, since then. No connection was ever drawn between that injury and my recurring (and increasingly worse) lower back pain until I had the sense to see an osteopath during a particularly bad flare-up. Imagine that: "Sacroiliac joint pain can become severe and disabling if not treated." I've been concentrating on putting out fires with the muscle problems, but am starting to suspect that trying to get the joint stabilized will help the muscles calm down.
This is a bit extreme, but fairly representative of my dealings with orthopedists. Sometimes I feel a bit silly for not having made connections earlier, but then I think of the magic invisible bone abscess--and don't think I'm doing so badly anymore, with the information at hand! It's more than a little frustrating that you have to search so hard for the information to form reasonable working hypotheses about what might be going on with your health, in so many cases.
_____________
# The year before, I separated my ankle in a way that required much heftier casting and at least three times longer to heal than a plain old fracture. When I got sent to PT, they absolutely freaked and decided that I couldn't continue to use crutches without destroying other hypermobile joints, including but not limited to my hyperextending knees. (Which has not proven to be a problem.) Orthopedists have commented on the hypermobility, but apparently not considered it relevant. Fail.
## Since this was through the PT department, I assumed it was supposed to hurt. (Having already done some of the "no pain, no gain" style PT which did more harm than good. Questionable enough anyway, but when you've got hypermobility and knotted-up muscles in spasm? Faily fail fail.) Nope, they had the machine turned up way too high, assuming my rump had a lot more padding than it did. As I found out during the third session, when they noticed I looked like I was in pain. :-|
no subject
Date: 2010-08-18 12:48 am (UTC)I'm impressed by all the things you now know about your body, and infuriated that the people who, you know, we pay to do this stuff haven't been paying attention.
I've had better pain relief from hands-on body-smart healers than decades of narcotics, NSAIDs, etc. Because the healers pay attention to the soft tissue.