Chiropractic for Sacroiliac Pain

Chiropractic for Sacroiliac Pain

            Chiropractic treatment for sacroiliac pain is effective, and is a type of pain that licensed chiropractors are well acquainted with. Depending on the setting, the prevalence of sacroiliac pain can range between 10% and 62%, but overall around 25% of the population have Sacroiliac pain. There are a variety of chiropractic procedures that can be implemented for sacroiliac pain, and in many cases is considered a first line of treatment.

What is Sacroiliac Pain?

            The ability for a patient to move around and stand relies on a group of muscles, bones, and joints near the pelvis, but the two sacroiliac joints are mainly involved in preventing the pelvis from locking up over time, and help to facilitate movement. Since the sacroiliac joints are held together by cartilage, when these joints misalign, swelling occurs in the cartilage causing sacroiliac pain. Primary care doctors will often refer to this inflammation as sacroiliitis which can result from chronic sacroiliac joint misalignment. There are multiple reasons sacroiliac pain can occur, not least of which being too much or too little movement.

Signs & Symptoms of Sacroiliac Pain:

  • Being overweight

  • Having an anatomically short leg or one leg shorter than the other

  • Improper gait after foot or knee surgeries

  • Traumatic event, such as a fall

The pain can be dull or sharp, and can move to the upper back, buttocks, thighs, and groin. There are also some chronic conditions that can cause sacroiliac pain.

Conditions that can Cause Sacroiliac Pain:

  • Ulcerative Colitis

  • Osteoarthritis

  • Infection

  • Severe lower back injury

  • Inflammation during pregnancy

  • Inflammatory bowel syndromes

  • Arthritis-related conditions

Sacroiliac pain often gets worse when the patient climbs the stairs, puts more weight on one leg than the other, stands for a long time, runs, and/or gets out of a chair.

Chiropractic & Sacroiliitis

            The ultimate goal of chiropractic treatment for sacroiliac pain is to make use of the technique that is best tolerated by the patient while delivering the best outcome. Needless to say, each patient responds better to different treatment approaches, so it is vital that you as the chiropractic provider are able to implement multiple manipulations in your practice to address sacroiliac pain.

Chiropractic Techniques that, in general, work well for sacroiliac joint dysfunction:

  • Spinal manipulation – HVLA (high-velocity, low-amplitude) thrust

  • Spinal mobilization – low-velocity, low-amplitude thrust

In addition to these methods, adjunctive therapy such as heat and massage therapy are also used in addition to tools such as the activator. Again, this is all depending on what the patient can tolerate, and the severity of their sacroiliac pain. While there are some patients that can tolerate traditional spinal manipulation, often times with sacroiliac pain, it requires a gentler technique.

Low-Velocity Chiropractic Techniques:

  • Activator tool – spring loaded instrument providing a low-force impulse directed at specific locations on the spine.

  • Drop-table – table sections are dropped at the same time as the thrust leaving room for gravity to assist in the adjustment.

  • Adjusting blocks – these are padded blocks which vary in size and shape placed under the body at certain places to aid in treatment. Using gravity from the block instead of relying on force alone allows for a gentle treatment of the sacroiliac point.

  • Long-axis leg traction technique – the patient takes deep breaths at the same time as the chiropractic provider gently pulls on the leg at a certain angle in order to facilitate the adjustment.

  • Cox technique – flexion distraction involving a cox chiropractic table gently stretching the spine allowing the chiropractic provider to isolate the pain point.

The chiropractic provider treatment for SI joint dysfunction is to improve mobility overall.

Research & Certifications

            If you are a chiropractic provider interested in specializing in conditions such as sacroiliac joint dysfunction, there is a certification that can be obtained to offer the latest evidence-based rehabilitation techniques and treatments. Having a certification such as this would allow for patients to achieve their best version of health and mobility. A program with the American Chiropractic Rehabilitation Board (ACRB) is a great program that would be worth getting certification at if you want to highlight your back pain expertise along with your credentials.

Chiropractic Research on Sacroiliac Pain:

Evaluation of the Effect of Chiropractic Manipulative Treatment on Oxidative Stress in Sacroiliac Joint Dysfunction, 2020:

  • The goal of this study was to evaluate the effect of chiropractic treatment on sacroiliac joint dysfunction and the relationship it has to oxidative stress.

  • This study included 20 males and 13 females ranging from 18 – 60 years of age diagnosed with sacroiliac joint dysfunction as well as 30 healthy volunteers including 20 males and 10 females ranging 20 to 57 years of age. Manipulation was performed on these patients once a week for 4 weeks. Patients were evaluated prior to treatment and one month after.

  • This study found that manipulation was considerably useful in sacroiliac joint dysfunction.

The Effect of Sacroiliac Chiropractic Adjustments on Innominate Angles, 2020:

  • The goal of this study was to figure out whether or not there was significant change in the angle of the innominate bone after chiropractic sacroiliac joint adjustment, and what the degree of change in the angle of the innominate bone.

  • This study included 100 patients who met the study criteria that were placed randomly in either the treatment or control group. The chiropractic treatment group were given adjustments based on their sacroiliac joint dysfunction, and the control group was treated with a sham treatment (detuned ultrasound therapy).

  • This study concluded that specific chiropractic adjustments yielded significant change in the angle of the innominate bone. Although the changes were evident bilaterally, the side that was adjusted shows the greatest degree of change.

Chiropractic & Sacroiliac Joint Pain

            When it comes to treating sacroiliac pain, the chiropractic provider should rely on the history of the current complaint, the physical exam, and the patient’s medical history. Additionally, an x-ray may be in order if the patient shows signs of scoliosis or 1 side of the pelvis is higher than the other. A good way to diagnose sacroiliac joint disorders is using Patrick’s test, also known as the FABER test, and if this test isn’t clear, then things like localized pain in the area, leg length inequality, trauma history, and change in gait will help in making a clear diagnosis. Chiropractic treatments make a big difference to those who suffer from sacroiliac pain.