If you have stumbled across this blog I know you’ve experienced all it takes to bring a special life into this world. Kudos, your resilience, and determination will serve you well in motherhood! Pregnancy and delivery are not for the faint of heart and often come with battle scars. I personally have brought babies into the world resulting in two fantastic kids (if I do say so myself). My first pregnancy was the stuff of fairytales. No morning sickness, no trouble sleeping, and no back pain. My second, not so much! I had trouble sleeping due to postpartum back pain and intermittent sciatica.
I too have tried everything ranging from stretching, massages, to those fabulous pregnancy pillows, and nothing seemed to work. Experiencing back pain during and after pregnancy is quite common and fortunately for me and the vast majority of cases, the pain is temporary. Which begs the question, what can do you do when the pain doesn’t resolve?
The best way to find long-lasting relief is to identify the source of the problem. For many women suffering from chronic back pain after pregnancy, the workup is negative: X-rays look good, MRI no issues. Although in some ways it’s likely a relief to hear nothing is “wrong” but also frustrating having no explanation as to what is causing this awful pain.
Sacroiliac (SI) joint dysfunction is common and is often under or misdiagnosed. The SI joints are non-mobile joints where the spine meets the pelvis. Degeneration or disruption of the joint(s) can cause lower back pain often described to be in the buttock/hip region. This pain can radiate to the groin or even down the leg. You can imagine how carrying and delivering children can stress or disrupt these joints.
How is SI joint dysfunction diagnosed? A detailed physical exam will typically guide your physician/provider. There are several provocative tests that can be done in the office. This means we manipulate your body in a way that stresses the SI joint. If these maneuvers reproduce or aggravate your pain we know we are on the right track. We then confirm our suspicions by sending you for a diagnostic block. This involves x-rays guided injection of numbing medication and a steroid into the joint. If your pain is relieved even for a temporary period of time we have confirmed our diagnosis. A CT scan of the pelvis is also a helpful study for evaluating the integrity of these joints.
The good news is SI joint dysfunction is treatable. The most conservative treatment is a physical therapy which focuses on building strength within the core and pelvis. If this fails the diagnostic injection can also provide therapeutic relief for pelvic pain. The steroid medication provided via the injection can reduce inflammation and improve pain.
A pain management specialist can also attempt radiofrequency ablation. This involves using heat/cautery “laser” intended to target the nerves that supply the SI joint(s.) If conservative treatments fail, minimally invasive surgery to stabilize the joint(s) is an option. This operation is commonly done with a high success rate! Surgery typically takes 30 minutes and is done in outpatient. We do not require our patients to restrict weight-bearing, so this means no crutches. Surgical pain on average will resolve 2-6 weeks after surgery.
Let’s face it, our babies are only getting bigger and harder to keep up with their physical activities. If you are suffering from back pain months after delivery, schedule a consultation. Pain relief is possible! For more information visit SIjointcenter.com or drmesiwala.com.