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Sciatica vs. Sacroileitis

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Rheumatoid Arthritis
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Posted 11/20/2011 8:30 AM (GMT 0)
I've been being treated for inflammation of my SI joints for years so I know well what that pain generally feels like. Over the last few months, I've had some really severe pain in the left SI joint. Much, much worse than I've ever had before. The strange thing is that the right side was always worse but recently the left has been unbearable. I'm scheduled for the 3rd injection in the left joint on Monday.

Suddenly yesterday I couldn't even stand from pain on the right side. This pain literally went from my spine, down the back of my leg to my knee and then down the outside of my leg to my ankle. I was standing when it started and it hur to stand, I couldn't walk and I couldn't bend. Trying to sit was excrutiating. I eventually had to bend my left side while keeping my right leg straight. I got my left cheek onto the seat and was then able to sit. The pain almost completely disappeared once I was sitting. 

I've never had pain like this before and can't help but wonder if it's sciatica. Everyone I've ever known has told me that the only comfortable position with sciatica was laying down, but I got relief from sitting too.

Although the terrible pain seems to come and go, I'm still having a lot of pain in my knee. I'm wondering if anyone has had similar experiences with either sciatica or SI problems. Thanks for your input.

Posted 11/20/2011 2:49 PM (GMT 0)
Sciatica and SI joint arthritis go hand-in-hand in my experience.

The sciatic nerve runs through a small muscle deep in your glute called the piriformis. The piriformis muscle can go into a spasm and squeeze the sciatic nerve - this is called piriformis syndrome. You can read all about it and the stretches you can do to relieve the pain, plus using alternating ice/heat. Since I know you have gut troubles too I will not recommend NSAIDs, but they are an option if you are willing to take the risk. I will use one Aleve if I have terrible pain. But not more than one.

The dysfunction of your pelvis that causes piriformis syndrome is directly attributable to your SI joint problems. In my experience the best way to manage this is to keep your core strong, make sure you're stretching (but not overstretching!) and maintain good posture when sitting/standing/walking.
Posted 11/20/2011 6:16 PM (GMT 0)
Thanks Kaz. I do stretch regularly since it's expected that I will eventually develop Akylosing Spondylitis. I have some calcification at my facet joints already and it's really a case of use it or lose it for me. There's already some straightening of my lumbar spine and I'm working hard to try and regain some of that ROM. Since a lot of my problems are inflammation of the soft tissues, especially at the insertion points where they are most likely to begin calcification, I have a lot of muscle spasms. In order to try and relax them I spend quality time in hot showers and then do my stretching under the hot water. What a difference that makes!

I'm sure you're right that it's a muscle spasm creating the problem down my leg and it's likely the sciatic nerve involved. I just find it unusual that I get relief from sitting. Luckily I have an apt with my Pain Doc tomorrow. I'll let him figure out what to do about it.

Posted 11/24/2011 12:53 PM (GMT 0)
Hello Keah,

I'm sorry you're in so much pain.  What you describe sounds exactly like what I experience.  It's like this shooting pain when trying to move, and cannot put any weight on the side/leg.  I've been diagnosed with sacroilitiis.  one sciacita symptom I don't have is numbness, although the pain is very sciatia-like.  After all these years of not understanding what this pain is, my physiotherapist explained it.  It has to do with the piriformis muscle, which is irritated due to the SI inflammaion, pinching on the nerve.  I hope you feel better real soon and have limited experiences of this.

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