I have been dealing with roaming/various pain since mid-June...sciatic symptoms, SI joint pain, etc.

Sports Med doc initially took x-ray and diagnosed SI joint issue and prescribed NSAIDs and rehab.

NSAID/rehab did little so we went to MRI. Dr. does not think surgery is a viable option given my age (51).

I'm now set to meet with a Orthopedic Surgeon on Monday to discuss steroid injection.

Anyone have experience/advice here?

SI is rarely ever the problem in my experience. Not to say it doesn't happen but is usually a diagnosis of exclusion. Lumbar discs problems are usually the answer. An epidural can be helpful in that area to relief symptom radiating down the leg.

Are you overweight?

How is you core strength?

Probably a disc pushed out and putting pressure on your nerve. My wife had microdiscectomy earlier this fall and had immediate and lasting relief. Pain other wise left her in tears every night.

Hoosegow said:

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Are you overweight?

How is you core strength?

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Not overweight - 5'11", 192 lbs.

But I'm not as strong as I should be. Was squatting 275 and deadlifting the same who the pain started.

I do not believe that this is a weightlifting injury.

Ragoo said:

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Probably a disc pushed out and putting pressure on your nerve. My wife had microdiscectomy earlier this fall and had immediate and lasting relief. Pain other wise left her in tears every night.

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MRI says L4/L5 hitting nerve more on left side while L5/S1 is affecting more on the right.

I've added gabapentin this last week and do believe that helps but not so much that I'm willing to wait on the injection.

For my wife, the relief of the injection lasted 24 hours tops. Hopefully you get more relief than that.

Where are you located?

what did the mri say

aggiederelict said:

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Where are you located?

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NE Houston Kingwood

You're going about it the right way as far as being conservative with PT then injection then go from there. Your comment makes it sound like you are too old for surgery which you are not - the issue is more that most 51 year old backs have a long list of protrusions and potential issues so unless it's blatantly obvious which one is causing the pain, what they decide to cut on may not help your problem and could possibly do the opposite. Yes, there are people helped significantly by disk surgery, but there's only so much of that material there and once they start cutting it away, there's typically less cushion there forever. So unless it's very obvious that it is the source of the problem and there is no relief from PT or a shot, they don't love to go cutting on it too quickly.

Many times getting the inflammation to calm down just a hair is the difference between significant nerve pain and no pain at all.

DannyDuberstein said:

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Many times getting the inflammation to calm down just a hair is the difference between significant nerve pain and no pain at all.

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Agree 200%.

I'm 51. Over the past 20 years I've had pain last anywhere from 4 weeks to 9 months. Zero rhyme or reason. One day I just wake up and it's gone. When it's there pain is 2-5 on a 1-10 scale. So not crippling but certainly annoying.

I was told probably 15 years ago surgery was coming at some point (same area, L4/5/S1). I'm kicking that can as far down the road as I can. I will say when I'm maintaining weight and staying strong (and not doing stupid exercises) it generally stays away.

The doctor says I'm too YOUNG for surgery. He says that surgery benefits degrade after 10-15 years and that I'd need another. He just prefers that we wait as long as possible and try the alternatives before that comes into play.

Lots of 51 year olds here lol. I am too. I've had 3 significant issues in the past 12 years. I couldn't walk from my car in my work parking lot to my office without a quick stop to sit in the break room in between to let the nerve pain calm. From coaching softball, playing golf 1-2 per week, and working out 4-5 times per week to nothing. The first lasted 6 weeks, one lasted 3-4, most recent a few years ago lasted 2. Each time it went from complete debilitating misery to nothing within 1-2 days and I was right back to my activities. And the real kicker is that while there are some "this could be it" items on my spine MRI, the real issue seems to be muscle inflammation and tightness along the nerve path in my hip/side.

Got it. Yes, so to my point on cutting, once they start taking stuff out, it's gone for good. One step closer to degeneration and possible eventual fusion. Now sometimes it's just blown and obvious and surgery is the only option. But yours does not sound that obvious.

I'm 70 and have 2 herniated discs. They began showing themselves about 5 years ago. Doc told me I wasn't yet a candidate for surgery. Really encouraged me to go to PT, get involved in strength training and not adding any new weight gain. Losing weight would help. He gave me 30 days worth of tramadol but encouraged me to use it only if I couldn't stand it. I still have 25 days worth.

I've followed his advice and it has worked for me. The idea of never having to experience that pain again is a strong motivator.

I've kept all of my PT exercises and do those daily. I found PT to be a game changer. It was tough at first but got better every day.

You can do this!

Lots of good advice here.

Even if you have perfect form this could 100% be partially related to your workouts. Age, core strength, flexibility, and any other number of factors are also likely feeding into what you're feeling.

I'm younger than you but was dealing with something very similar at the end of 2024. Low back/SI w/neuropathy.

My thoughts after going through a year of trial and error…

-Buy Back Mechanic and incorporate that advice into your exercise routine. There are a lot of exercises where the risk of injury outweighs the rewards as you get older. There are other ways to stay strong than the lifts your high school football coach told you about when you were 14.

-Find a regular stretching routine that suits you.

-Keep the weight off.

-Really focus on finding ways to reduce general body inflammation. Diet/supplementation was key for me.

Good luck.

Had a badly herniated disc at L4/L5 in 2016.
The inner disc material had ruptured through the outer part of the disc and was laying against nerves. Worst pain I ever experienced.
Had injections… no help. Therapy…. Made it worse.
First doc I went to said fusion. I said no way as I had seen what fusions had done to my sister. Second opinion doc said Discectomy.
I chose that. Pain free instantly but I had nerve damage from letting it go so long.
About 90 days to get back to normal. Must do what doc says to heal.

I just finished the Sunday Funnies thread and this seemed relevant here.