ATLANTA - For the first time in a long time, Ryan English can exercise without being dogged by back pain. The now 43-year old former Marine and Army soldier turned military contractor hurt his back the first time in 2010 while in Iraq on a security detail protecting U.S. diplomats.
"So I get up on the roof, and I was providing overview support," English says.
Heading back down, the stairway collapsed.
"I'm wearing all my gear, body armor, radio, weapon, and I landed right on my butt," recall English.
English thought he'd re-injured an old back injury. But, with intense physical therapy, he got better. So went back to work, and two years later, back overseas, English fell, hurt his back again. This time, the low back pain was constant, sending pain and tingling down into his leg.
"I knew it was really bad when my leg would just collapse," He remembers. " I would be wearing all my kit, get out of the vehicle, I didn't know that my leg had fallen asleep because of the pressure on that nerve. And I'd get out of a vehicle and just hit the deck. It would be like not knowing you only had one leg."
Ryan's orthopedic surgeon, WellStar Atlanta Medical Center's Dr. John Keating says the problem was Ryan's sacroiliac joint, at the very bottom of his spine.
"The sacroiliac joint is the joint in your pelvis that joins the top half of your body, your trunk, to the bottom half of your body, your hips, and legs," Keating explains.
The joint is surrounded by nerves, so when it's injured or becomes unstable, Dr. Keating says, it can be really painful. He sees this type of injury pretty commonly in pregnant women, and people who've suffered an injury.
Typically, Keating says, the pain is in the lower back and is one-sided.
"It's made worse when you sit," he says. "It's frequently made worse when you do jarring activities, aerobics, running, long standing. It's prolonged postures that bother it."
Dr. Keating says 73 percent of SI joint injury patients like Ryan get better with physical therapy, chiropractic care, or rest, but Ryan English didn't get better.
"He had a very bad situation," Keating says.
To prove Ryan's SI joint was the problem, Dr. Keating numbed it with lidocaine.
"Frequently, these patients will come in, they've had 5 to 10 years of pain," Keating says. "They've lost all hope, they're totally depressed. You inject that joint. They come back all tearful, 'My pain is gone, you've helped me!' But, then it comes back when the pain medicine wears off."
That is what happened to Ryan.
"So what do you do," Keating asks. "The answer is you stabilize that joint by putting an implant across the joint that stops the motion."
The surgery worked for Ryan. He needed months of physical therapy to build back his strength and muscle tone in his back and core. But the pain disappeared, and he can now sleep, and drive down to visit his parents in Florida. And today, Ryan English says he is finally back to living his life, without pain.