Question
I have moderately severe arthritis in my L-S spine, and have had a fusion on L3-4.  I currently have herniated disks above and below my fusion. Along with moderate right hip arthritis, I have stenosis in my sacrum.  Whenever I bend over, squat, kneel, or whatever, and then start to get up, I get a stabbing, knife like pain right in the right SI joint.  It is the exact same spot every time.  I have previously had both SI joints injected with cortisone but this was unsuccessful.  Occasionally this pain will come when I am pushing a shopping cart also.  It takes my breath away it's so painful.  Any ideas?  I just turned 50 and am trying to stay active.

Answer
Hi Lori,

'Sorry that you're having such difficulty.  What you have is quite common.  It sounds like your pain is coming from the discs.  If the forward bent position, leaning on a shopping cart provided relief, then I would guess that your arthritic spine is causing narrowing of the spinal canal.   This is called central canal stenosis, and forward bent postures, e.g. leaning on the shopping cart or being bent forward with hands on knees is alleviating.   When the forward lean or bending down provokes the pain, odds are it's an irritated disc.  Irritation can come from bulging, tears, or simply pressure against the damaged portion.   I would chat with the doctor about epidural steriod at the disc.  You can also try decompressive manipulation with a chiropractor that has a distraction-type table (see the services tab on my web site www.drgillman.com).   You also should be tested for instability.   Google:  Prone Instability Test for Lower Back.  It should come right up.  If you have a positive test, then you need to do stability exercises (e.g. www.fixyourownback.com shows the big three).

'Hope this helps.

Dr. G