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forty8
03-30-2004, 12:39 PM
My wife suffers from arthritis of the SI joint that started as the result of an injury five years ago. This makes hiking unbearably painful, and she can only go short distances before she has to quit. Backpacking is out of the question. She has been to many different doctors and received many treatments for managing pain, including acupuncture, but nothing seems to help. Would trekking poles help? Is there some other equipment that we can try that would help take pressure off the back/hips?

Stan
03-30-2004, 02:32 PM
What is the SI joint?

Whatever it is, my general philosophy for preventing pains of vulnerable joints is this:

1) cushion and/or immobilize the joint as much as possible (that could mean orthodics, taping etc.),
2) try to minimize the stress on the joint (could mean poles, to me it means watching my weight),
3) take anti-inflammatories before the pain sets in, not afterwards,
4) stretch impacted areas before AND after the exercise/hike,
5) strengthen muscles around vulnerable joints, and my favorite, 6) a couple ounces, more or less, of tequila after a hike (made from the agave plant which looks a lot like the yucca plant from which an ancient arthritis recipe derives ... what the hey, it works for me).

If this doesn't work, and your doctors have been unsuccessful, try another doctor.

Dr. Stan

Skyclimber
03-30-2004, 08:42 PM
Has she tried Aqua Therapy (swim exercise)? Therma Care heat wraps are helpful too, on the painful area to keep the joint warm and a little more flexible.

daxs
03-31-2004, 07:43 AM
Has she tried an SI joint belt? Its like a brace for the joint. The belts are a little cumbersome but it may be helpful. Maybe a Lidoderm patch over the area? I would also seek out a pain management doctor who does injections. There are doctors who have special certification in pain management and doctors who have done special fellowships in injections. I would look for someone who has a background in orthopedics or physical medicine and rehab versus an anesthesiologist who does injections. Often a cortisone injection into the joint can be helpful. You want to find someone who injects directly into the joint (ie they need to do this under xray flouroscopic guidance) and does more than a "trigger point" injection into the soft tissue over the joint. Also, are the doctors sure its an SI joint problem? Often disc herniations and tears in the annulus of the disc can cause referred pain into the SI area.

On a less medical note, I would think that level trails versus trails that climb and have significant elevation changes would be easier to handle. I would also avoid trails with looser or sandy type soils and hike on trails that are firm. I hope your wife can can hit the trail painlessly soon!

Dugan
03-31-2004, 07:48 AM
SI joint: sacro iliac If you put your hands behind your back such that the palms are facing your back and your finger tips are touching your spine, the SI joints (one to each side) are found below the waist, above the hips, a few inches to the side of the spine. It feels like a small bony lump.

I've had mild rheumatoid arthritis for years (affecting mainly knees and wrists) and recently learned of some osteo arthritis in my lower back.

I agree with everything Stan said, though it would be difficult to tape an SI joint. I would add regular, low impact exercise. It also might not hurt to find a book with exercises specific to the lower back, or to consult with a physical therapist to find some exercises to add/begin a daily regimen.

I began taking Cosequin (the dog version of Cosamin), a glucosamine/chondroitin supplement last year. I find it helps immensely. A couple of years ago I was using neoprene braces with splints on both knees and hiking poles going down hill on real hikes (like in the Whites, but not Mass hills). At the end, I would feel some pain. Since beginning the Cosequin I no longer need braces or the poles, nor am I in discomfort. I've stopped taking the Cosequin twice, to see whether it really works. Within two weeks I begin to have achy knees again. Cosequin and Cosamin are made by Nutramax. I chose it over other similar supplements because it's the only one for which I can find clinical research.

bobmak
03-31-2004, 12:55 PM
I began taking Cosequin (the dog version of Cosamin),

Interesting Dugan.... I have knee pain I am dealing with as well. Tell me, why Cosequin over Cosamin? Or is that really your picture in the avatar!!! :D

Barb Harris
03-31-2004, 03:56 PM
I can understand your wife's pain as I have osteoarthritis, more of arthur in hands, feet and knees too. What works for me is taking Advil the night before a hike, again the morning of the hike, on the summit before heading out and sometimes more at the car! Everyday I take 1500 mg of glucosamine and Chondroitin along with 200 mg of Celebrex. Drugs!! Exercize everyday and an attitude of I'm not giving up:) An interesting fact for me is when I backpack and winter hike the weight of the pack puts more pressure on my lower back and actually helps. Weird but works for me. Just hurts like hell when I take the pack off!

Orthodics in a good pair of hiking boots is a must along with 2 hiking poles.

Ain't the golden years fun:)

Happy Trails!
Barb

Dugan
04-03-2004, 07:22 AM
<laughing> Yah, isn't he great with a keyboard?! Now if I could just get him to do some coding...

I'm taking Cosequin because I'd bought a 250 count bottle for a dog I've since lost. I'd been intending to try Cosamin, but it seemed a shame to let the remaining Cosequin go to waste. Since then, I've priced both and find that Cosequin tends to be a little less expensive. According to Nutramax, the difference between the two is the quantity of manganese ascorbate. Cosequin contains about double as Cosamin. I checked with three pharmacists to ensure the level was safe. The body stores some vitamins/minerals, the excess can build to toxic proportions. According to the pharmacists, excess manganese ascorbate is eliminated, not stored.

I haven't done any research for about a year, so the following may have changed. www.cosequin.com will lead you to both products, there is literature and research available on the site. I've also done some research to confirm results through non-Nutramax sources. The reasons I chose Cosequin for my dog were that they guarantee the purity and content of the product - they do for Cosamin as well. Since glucosamine/chondroitin fall under the category of nutrition rather than drug, they are not regulated by the FDA, nor does the manufacturer have to follow rigid guidelines. None of the manufacturers HAVE to follow pharmaceutical guidelines, Nutramax does it because they want to. I couldn't find any similar products that did this. I know people taking some of these other products who do see a benefit from them, but I prefer to have a little more assurance about non-food items that I put into my body.

Besides, the beef/cheese/garlic flavored tabs are sooo yummy! Next purchase, it's capsules.

campsite
04-03-2004, 08:06 AM
forty8
I started having SI pain about 4 years ago - certainly not as serious as your wife's though.
Doctors did nothing, the chiropractor helped a little, and pumping ibuprofen helped a lot - but I'm leery of taking medications constantly.
Then I stumbled upon MSM. The actor, James Coburn took this for his rheumatoid arthritis. I heard that he promoted the product for free.
All my internet research showed that this product has no KNOWN (important point here) deleterious effects, even when taken constantly - I realize I'm contradicting myself here, I told you I don't like to take medications constantly.
My condition improved tremendously within a month.
Does it really work?
Was the positive result only a placebo effect?
Good luck.