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New research suggests the chiropractic approach is most effective for sacroiliac pain
If you have had sacroiliac pain, and the back and or leg pain that goes with it, you know how frustrating it can be to find the right kind of help for the condition. 25% or more of those suffering from the condition of lower back pain, have significant sacroiliac involvement, in which the pelvis distorts, straining the sacroiliac joints and the lower back joints, causing the pain.
Since this is a mechanical problem, it requires a mechanical approach to get pain relief. Many of the approaches that use primarily exercises, injections or medications have significant limitations because they do not work directly on the distortion of those joints, or the mechanical basis of the pain itself.
The chiropractic approach involves manipulation, exercises, manipulation of the extremities and the myofascia, which all contribute to the creation of sacroiliac pain. Chiropractors who use this combined approach are most likely to get you relief quickly. Manipulation alone, which can offer fast relief and is used by some doctors of chiropractic, is not as effective since the tissues surrounding the pelvis including the core and the leg muscles contribute to the distortion of the sacroiliac joints, causing the back and leg pain.
This is why many treatments often fall short of the goal of pain relief; they do not fully address the problems mechanical origins.
A 2013 study reinforces this notion showing that chiropractic manual therapies had a 72% success rate for patients with SI joint problems, compared to a 20% success rate for physiotherapy and a 50% success rate for injections of corticosteroids. Plus, chiropractic patients didn’t have to deal with the side effects or risks associated with injections.
While many professions offer treatments for sacroiliac pain, if they do not properly address the underlying problem causing the pain, they cannot all work and be equally effective. Unfortunately, many health care providers are taught to treat the pain, rather than the problem and then are unable to offer a reliable long term resolution for the sacroiliac problem.
One of the things all healthcare practitioners should evaluate is your feet, since a gait (the way you walk) asymmetry due to an asymmetrical build is quite common in those who suffer from sacroiliac pain. Often, a pair of either off the shelf or expertly casted custom insoles can make a huge difference in your comfort level, since it levels the pelvis out and decreases the distortion in the hips responsible for sacroiliac pain. The feet and your gait are a large part of the appropriate diagnosis and management of sacroiliac pain.
Other procedures that can be helpful in the management of the condition are active evaluation methods, which involve test- treat-test protocols that are used by the most effective healthcare practitioners today and passes scientific scrutiny. These active protocols assure care is not wasteful, since treatment by protocol rather than treatment by discernible improvement which is what active evaluation does is infinitely less effective and reliable.
Myofascial release or instrument assisted soft tissue methods is also essential, since these methods help restore flexibility to the myofascial, an exoskeleton under the skin that helps with the way we move and is always part of a sacroiliac syndrome. When combined with manipulation, flexibility and mobility are markedly improved.
Hansen H, Manchikanti L, Simopoulos TT, et al. A systematic evaluation of the therapeutic effectiveness of sacroiliac joint interventions. Pain Physician 2012;15(3):E247-78.
Visser L, Woudenberg N, et al. Treatment of the sacroiliac joint in patients with leg pain: a randomized-controlled trial. European Spine Journal 2013 [online]. doi: 10.1007/s00586-013-2833-2.