sacroilliac pain

[ducktails]

Could I please hear your stories on sacroilliac pain, what were the symptoms, I know it is hard to diagnose and even harder to treat but any info would be greatly appreciated. Although there is lots on the net there is also not that much that tells you how it is.

Cheers in advance.

 

[sye777]

OOOh just posted below about bone changes in my boys stifles which vets were worried about being sarcoilliac damage until the stifles were checked. His main symptons are on my post.
Hope it helps!

 

[seabiscuit]

Usually secondary to another problem/aliment ( i.e PSD, k.s, spavin etc)
Very very hard to settle down and get rid off/cure completly
good shoeing helps
H wave therapy really helps
Working them really long and low helps
Cortisone offers temporary relief but is NEVER the long term solution, it fools you into thinking the horse will be ok but the problem always comes back after a few months even worse

 

[keeperscottage]

Hi, Ducktails! One of our horses, a very "hot" 18 year old ex-pointer, had what we thought was muscle wastage on one side of her quarters and her sacroilliac was definitely unlevel when viewed from behind. She'd been hunted regularly and was never lame.......so we thought! We use an amazing veterinary osteopath (PM me for details - he travels the country, more or less!). Osteopath took one look at her from a walk and declared her to be 4/10th lame!!!!!! I was speechless! Anyway, he manipulated her and lo and behold, her pelvis was level and my daughter declared (when she rode her two days later) that it was like riding a different horse.....she didn't throw her head about, she didn't keep changing legs at the canter, jumped beautifully and was just bascially DIFFERENT! Feel really awful now that we may have been riding her unaware that she was in pain!

 

[ducktails]

thank you for the replies,

what about symptoms? How did your vet diagnose?

toe dragging?
un rideable on one rein
bucking?

Are there any other things i could look out for?

 

[chestnut cob]

Usually secondary to another problem/aliment ( i.e PSD, k.s, spavin etc)
Very very hard to settle down and get rid off/cure completly
good shoeing helps
H wave therapy really helps
Working them really long and low helps
Cortisone offers temporary relief but is NEVER the long term solution, it fools you into thinking the horse will be ok but the problem always comes back after a few months even worse

Echo this. My horse had bad SI pain (muscular) due to spavins in both hocks. He also has shivers so tends to get tight over that area. Spavins have been treated successfully (cortisone jabs, Adequan, joint supplement) and he had a course of osteopathy and physio for the muscular pain. As above, lots of working long and low, I also work in hand a lot, lunge and long rein. I spoke to my vet about cortisone for SI pain; he said it should only be done for SI joint pain and it's such a nightmare to attempt that the risks tend to outweigh the benefits. He doesn't believe there is anything to be gained from cortisone injections in to the muscle and muscular pain across the SI area should be dealt with in other ways.

 

[Sam22]

Symptoms include short striding behing, poor quality canter especially transitions, loss of performance - particularly jumping (knocking poles/refusals), difficulty going on the rein on the effected side/poor bend that way. Acute SI injuries are usually caused by a fall and treatment is often successful. chronic degenerative injuries as said before are often secondary to other conditions or may be primary arthritis of the SI joint. Diagnosis is by nerve blocking the area. The main sciatic nerve lies very near the SI joint and there is a small risk of this being numbed and the horse not being able to weight bear on that limb for a couple of hours. If they are blocked one at a time it ensures if this happens they won't fall over. It is a low risk and the joint is very deep which is why the block is a highly skilled procedure and very few vets in the country will do it. Any vet who sais it is too risky is one who doesn't do it! the block will cause some inprovement in most older horses and therefore lower limb blocks must have been done first to enable accurate interpretation. Scintigraphy is positive in some cases and can help determine if a positive block is clinically significant. Treatment is with steroid injected the same way as the block and intensive physiotherapy/chiropracter. If horse has SI pain the prognosis is improved with steroid injections as they reduce the inflamation and allow the body work to have maximum effect.

 

[Puddles]

Hi,

My horse has SI and has probably had it for a long time - various vets had always written it off in the past as 'more likely to be behaviour' as he was never lame. But symptoms that I experienced were unwilling to go forward - far more noticeable in the school, poor canter - his was almost 4 time much worse on one rein and very un willing to go foward, bucking in transitions. Reluctance to turn on tight circle, drags toes. When pushed in the school the reaction was very violent bucking.

Jumping - he went from being a pleasure to jump to dangerous - he would rush his fences then fly buck several times on landing, reluctant to canter into fences, refusing or last minute run outs. A grid of jumps was not pleasant to ride at all!

Lunging, again very violent out bursts of what can only be described as rodeo behaviour.

I expect these could also be the symptoms for many other problems but I would suggest that if you have any of these then its worth getting them checked.

 

[BeckyD]

We have a bit of a chicken and egg scenario re SI. Ron had a slightly unlevel tuber sacrale area when I bought him (april 2007), which caused him no problems for at least a year. His canter was always poor, canter transitions poor, had a great jump but was lazy behind over smaller jumps, usually knocking them down unless bigger than 3 foot. He then started bucking when excited/stressed (april 2008), which I put down to spring grass and him being 4/5. In the autumn, he had a couple of crashing falls in the field, and was then 3 or 4/10ths lame on left hind. Presented to vets like a fractured pelvis, which necessitated an urgent trip for a bone scan. Bone scan showed SI issues. He was medicated twice in to the joint with corticosteroids, came sound, and then started work.

Then went lame on both hinds (and one fore). Again 3-4ths lame both hinds. PSD then diagnosed, and surgery recommended. Neurectomy and fasciotomy only it went a bit wrong as the wounds broke down, so he couldn't do the gentle exercise, so adhesions have formed. Lots of physio later, as his back was in a lot of pain.

He is now in work, is intermittently very mildly lame on all 4 legs (!) - thought to be mechanical behind (and isn't noticeabe to my excellent instructor) and they have no idea what's wrong in front (possibly nothing - referred lameness). I *think* we have come out of the other side of the SI pain. He works better now than he ever did, doesn't buck, and the canter is a totally different, *great* canter, compared to what he was like before all this. So I wonder whether he had something wrong all along. I now do most work long and low, some time in deep and round, and have started to ask for more "up" work, which he is finding fairly easy, thankfully. Hopefully this is all strengthening his back and SI region. I am hopeful he will be a hack/low-level dressage horse now.

 

[ducktails]

Puddles..

Hello :O)

How was it managed / treated ..?

My mare is going into the vets on monday for another assesment after treating what they thought before was poorly shod feet and infflammation in the hock joint. They would be happy to write her off as naughty but i know she isnt and that they have missed something. We have no lameness but occasional dragging of the right toe plus uncomfortable on the left rein, bucking when being asked to use the right hind and just generally looking miserable. I just hope my vets do her justice this time and keep looking till they find what it is.

 

[loopylucifer]

Will be quite intrested to here if theyfind anything else as it sounds quite simmilar to mine at present. has had few other issues but now just well not right genrally look uncomftable behind occasionaly toe dragging left hind (dispite other problems being right hind) not happy right rein in general and right canter very crocked when strighten up bucks and seems to findit imposiable to engage when always used to. Vet did think back in jan it could be hock related but x rays very clean feet showed quite major imbalance dispite externaly looking good worse right hind. put pads on but they seem to aggrivate the problem!? so in three months I seem to have gone round in a very big circle and feel I am having to convice people my horse is not normally like this!! so good luck I hope you can take some steps in the right direction i know how frustrating it is

 

[Puddles]

Hi Ducktails,

I am in the rather unfortunate positon of having a 17 year old horse who is not insured for vet bills! As I think I mentioned this had been going on for what I think has been a long time - all the behaviour I mentioned earlier. Despite getting several vets and back people to look at him none could find anything wrong as such and so all said likely bad behaviour. So with my instructor we worked through it trying to get him to stretch work long and low etc etc. which did work( did take a long time! ) He was competing succesfully at elementary dressage all the bad behaviour had pretty much disappeared. 3 years he had a trailer accident (came out through the grooms door) and slowly all the bad behaviour returned. I went back to physio and vets and at least now I had something to justify making them take a closer look - first diagnosis was fractured pelvis which thankfully was negative the next option was soft tissue damage physio convinced SI so went onto rest then restricted turn out followed by a very careful back to work programme - lunging would have been good but he doesn't lunge. About 9 months later he was back to competing at Novice level but I knew he wasn't right - sadly he has deteriorated over this cold winter and my thoughts are at his age I will just retire him to hacking which he is perfectly happy to do - the minute I put him in the school he is just not interested and I don't want to fight with him any more.
If he were younger I would go back to the start and try again because it did work and if I listened to what he was telling me he could do and not do and push and back of in the right places we managed it. From my research SI is often twinned with other problems such as PSD so it does need careful management but it can be done! Best of luck.