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Can a Chiropractor Help my Sacroiliac Pain?

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Sacroiliac pain is that nagging pain in your lower back and hips. It can worsen during weight bearing activities such as walking.  The pain is a result of inflamed sacroiliac joints, which are located in the “dimpled” area at the base of your spine.  This is where your sacrum connects to your pelvis.

3D illustration of sacroiliac joint pain in the hips

These sacroiliac joints are connected by cartilage.  This cartilage is prone to swelling if there is a misalignment of either one or both of the sacroiliac joints.  This can cause the joints to become painful and inflamed, a condition your doctor refers to as sacroiliitis.

Causes of Sacroiliac Joint Pain

Sacroiliac joint pain is caused by a number of conditions, such as:

  • Uneven Gaits caused by foot or knee surgery
  • Anatomically uneven legs (one leg shorter than the other)
  • Obesity causing strain to the joints
  • Hip pathologies that affect the gait
  • Trauma, such as an accident or a fall

The majority of these issues result in improper gait. Improper gait is the main culprit in a misaligned sacroiliac joint. This causes inflamed cartilage, swelling and lower back and hip pain.

Your chiropractor can relieve both the symptoms and causes of sacroiliac dysfunction.

Diagnosing Sacroiliac Joint Pain & Problems

Your chiropractor will perform an evaluation of your pain. A normal evaluation includes your medical history, length of time with pain, and a thorough physical examination.  If you’ve had a trauma or display signs that one side of your pelvis is higher compared to the other side (an indicator of potential scoliosis), your chiropractor may order x-rays as a diagnostic tool.  The damage of sacroiliitis is apparent on films due to the extra calcium that deposits on the joints as a result of chronic inflammation.

Another diagnostic tool used by chiropractors is the Patrick’s test. This test is also known as the Flexion, Abduction and External Rotation test (FABER).  The test begins while you are lying on your back. The chiropractor will have you place your foot on your opposite knee and press downwards. They will measure the amount of pain experienced in the SI joint during the evaluation.  If you experience pain from this test, you have a positive finding for sacroiliitis.

SI joint pain will typically worsen when doing weight bearing activities like walking. Symptoms will lessen when sitting down.

Chiropractic Treatment of Sacroiliitis

Chiropractic treatment of sacroiliitis involves targeting and manipulating the sacroiliac joint directly:

  • You will flex your knee and raise it towards your chest
  • Your bottom shoulder will be positioned forward to stretch the lower back and pelvis
  • Your chiropractor will place his hand on the sacroiliac joint. He or she will apply pressure using your shoulder. This creates a tension called traction. Simultaneously they will push the knee towards the floor
  • If you are comfortable and your back is gently stretched, they will perform a low-amplitude high-velocity thrust

This adjustment will result in cavitation. That’s an audible release that sounds like the “crack” from your knuckles.  This pop or crack is the result of released gases. These gases include carbon dioxide, oxygen, and nitrogen. A joint releases these gases when it is flexed safely past its passive range of motion.

Some patients are initially frightened by the idea of “cracking.” But don’t worry. It isn’t an uncomfortable sensation.  In fact, patients report that they feel immediate relief. They often will ask for the procedure to be repeated in future visits. If you feel that you can’t get past the “cracking” sensation or the twisting and pulling involved with traditional chiropractic approaches, your doctor can recommend other courses of treatment that are less forceful but still effective at treating your sacroiliac pain.

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