Jesi Payne, an Oregon mother of three, suffered from mysterious back pain long before she had kids. In her teens, she avoided sitting on couches or anything soft because it was too uncomfortable. An avid athlete, she found that running worsened her symptoms, but it wasn't until the birth of her first child when she was 25 that the pain started to spiral out of control. After a very long labor, her back felt destroyed.
"If I sat down and leaned back at all, I got a pinching pain," she recalls. "Running got so painful I stopped doing races. The pain would be in my lower back muscle, or shoot down my leg, or be in my hip area."
She coped as best she could with an infant, but three years later, her second child was born and exacerbated her symptoms again. She couldn't sit anywhere for more than half an hour at a time or she'd get a pinching pain. Her family moved out of their two-story house because she couldn't deal with the stairs.
Even shifting weight from one foot to the other caused muscle spasms in my back and sudden pain.
"I stopped anything athletic at all, since even shifting weight from one foot to the other caused muscle spasms in my back and sudden pain," she says.
That's when she finally started going to doctors, but none could find anything wrong with her. After one X-ray, a doctor told her she had mild scoliosis — a condition in which the spine is abnormally curved — but not enough to cause her degree of symptoms. She tried physical therapy, wearing a brace on her lower back, acupuncture, and a special diet to reduce inflammation, but nothing worked. "All the doctors had their hands up in the air saying, 'We don't know what to tell you, there's nothing we can do,'" she says.
Still lacking a diagnosis and any relief, she gave birth to her third child at age 31. Again, the severity of her pain ratcheted up, and she had to limit her activities even further. She couldn't unload the dishwasher for fear of triggering spasms in her back, nor could she pick up and hold her own baby. She finally became so uncomfortable sleeping that she bought a hospital bed off Craigslist so that she could adjust the legs and keep pressure off her back.
Meanwhile, she was missing out on her family's fun activities, like paddle boarding and swimming. While her husband played with the kids, she had to sit on the sidelines and watch. Her sisters ran a half marathon and pushed Payne half the way in a wheelchair.
Her emotional well-being plummeted along with her physical health; at one point, she was on nine prescriptions, including muscle relaxants, painkillers, and antidepressants. "To have this active part of my life taken away was very psychologically difficult without a direction to fix it," she says. But she wasn't about to give up looking. If anything, the severity of her symptoms pushed her to find real answers.
To have this active part of my life taken away was very psychologically difficult.
At age 33, frustrated and desperate, Payne started to read medical journals in Europe and the U.S. about back conditions and misdiagnosis. "My ambition and curiosity exceeded that of my doctors," she says.
Reading about the sacroiliac, or SI, joint piqued her interest. Located in the pelvis, it links the pelvic bone to the sacrum, which is the lowest part of the spine above the tailbone. Because it's the junction between the lower and upper body, it's crucial for shock absorption while walking. Normally it's held together by ligaments and is not supposed to move very much — no more than a couple of millimeters in any direction.
But in women, SI joints are more flexible to allow for childbirth. Payne learned that many women who struggle with undiagnosed back pain after a long or difficult childbirth are actually suffering from an unstable SI joint, but because a lot of doctors are unfamiliar with this little-recognized joint, the women might never discover the root of their pain. In fact, up to 25 percent of lower back pain is caused by the SI joint, according to a November 2005 study; risk factors besides pregnancy and childbirth include smoking, poor physical health, family history, and repetitive trauma to that joint. The condition is more common in younger and middle-aged women.
Payne recognized her own symptoms in the description of SI joint dysfunction: popping sensations and bone movement in her pelvis, pinching pain and muscles spasms in her lower back and hip, inability to sit and sleep well, shooting pain down her legs. She visited several orthopedic surgeons to confirm her suspicions, but each one gave her various unsatisfying responses. One recommended she have surgery to implant a metal rod from her tailbone to her mid-back, which she declined. Another suggested she have several vertebrae in her spine fused together.
She kept looking until she discovered a procedure from a company called SI-Bone, which innovated the tools behind a minimally invasive approach: With the aid of cameras, a surgeon drills holes into the connections between the pelvis and the sacrum, and then hammers in three titanium bolts to stabilize the joint. It takes one hour, does not require a bone graft, and patients can walk the same day.
Excited, Payne drove two hours from her home near Portland to the NeuroSpine Institute in Eugene, Oregon, where doctors were experienced in the procedure. There, a neurosurgeon examined her by manipulating her SI joint and confirmed that hers was unstable, probably as a result of her kids' births, her athletic background, and a slight difference in the length of her legs. Four weeks later, her surgery was scheduled, and the possibility of getting her life back actually seemed real.
First, Payne had her left side stabilized. The procedure was brief, and she was able to go home the same day.
I felt I'd been in this cage of not being able to live my life and this was me starting a new chapter.
"I saw a huge improvement immediately," she says. "I had a walker to lessen the weight on my leg, but I was in less pain after having them drill into my bones because I could actually sit." She also found that the constant pressure on her lower back lessened. The shooting pain down her leg never happened again. A month later, she went back to get her right side fixed.
Just four weeks after that, her family was having a reunion by the water and she asked her doctor if she could wakeboard again. He did a CATSCAN and told her everything looked good. So she did. To this day, two years later, it's one of her fondest memories.
"I carved back and forth in the wake," she remembers. "Everyone was looking at me like I'm this broken doll, but it didn't hurt. It was this moment of joy — I felt I'd been in this cage of not being able to live my life and this was me starting a new chapter."
Back at home, Payne's life normalized. She was able to do dishes and laundry again. She sold her hospital bed. Best of all, she could pick up her kids again. Rather than being leery about them running into her arms, she welcomed them.
One year after the surgery, she ran a half marathon that "didn't hurt at all." Since then, she's also been bridge-jumping, completed a triathlon, skied, hiked, and gone rock climbing and paddle boarding with her kids. "I'm back to my normal self," she says.