Should I Use A Chiropractor For Lower Back Pain Caused By The Si Joint?

If you’ve been diagnosed with SI joint dysfunction, your doctor may recommend that you begin with a non-surgical treatment plan that includes seeing a chiropractor in addition to a pain management doctor and/or a physical therapist. But is a chiropractor right for you?

Is the (SI) sacroiliac joint the source of your lower back pain?

To understand whether or not a chiropractor can help with your lower back pain, first be certain of what’s causing your pain. A doctor must perform specific provocative tests for sacroiliac (SI) joint diagnosis as a first step in diagnosing SI joint dysfunction. If your doctor is not familiar with these diagnostic tests, consider contacting a physician in your area that has been trained to properly diagnose and treat SI joint pain.

If your healthcare practitioner, including your chiropractor or physical therapist¹²⁷, performed manual tests to evaluate sacroiliac (SI) joint, and they suspect you have SI joint dysfunction, the next step is to confirm the diagnosis. Diagnostic imaging (such as an X-ray, CT scan, or MRI) and/or an SI joint diagnostic injection can help determine whether the SI joint is the cause of the pain and rule out other health conditions.

Here’s a little more information about why and how misdiagnosis of SI joint pain can happen.

Should you see a chiropractor for low back pain?

Once your doctor has confirmed that SI joint dysfunction is what is causing your lower back pain, ask your doctor if a chiropractor might help. Few published clinical studies exist that evaluate the long-term effectiveness of treatments from a chiropractor for SI joint dysfunction, but in specific situations, it might be a valuable step of your treatment journey.¹²⁸

Non-surgical treatments will top your doctors list of recommendations. They may include chiropractic care, pain medication, yoga and stretching, physical therapy, SI joint belts or lower back braces, therapeutic SI joint injections (not to be confused with diagnostic injections), massage therapy, and/or radiofrequency ablation (RFA).

These are considered short-term treatment strategies for SI joint pain. If, after six months, the recommended conservative, non-surgical treatments are not working or the pain has gotten worse, your doctor may suggest you consider minimally invasive SI joint fusion. If you need to talk to a doctor about SI joint fusion, you can find one in your area in this directory.

What does a chiropractor do for lower back pain?

Chiropractors are healthcare professionals who evaluate and treat the neuromuscular system. They adjust or manipulate the spine, primarily, in order to improve joint alignment problems and relieve pain.¹²⁹

Typically, the SI joints should not move too much (no more than 2 mm to 4 mm in any direction¹³⁰). With SI joint dysfunction, these joints do not work effectively to transfer load. The joints may move too much or they move too little, which can cause low back pain and/or pain in the buttocks, legs, and groin.

A chiropractor may perform hands-on adjustments to help ease low back pain caused by SI joint movement. But does chiropractic care really help reduce lower back pain?

With a chiropractor, your goal is to reduce pain by attempting to:

• Improve your posture, balance, and symmetry

• Optimize the sacroiliac joint position

• Improve mobility of the joints and tissue above, below, and surrounding the SI joint

• Manage tension and pain in the tissues that surround and support the sacroiliac joint

• Normalize your gait or the way you walk

Although published research has been limited, some studies are emerging that note chiropractic care may positively contribute to SI joint treatment.¹³¹

Next step, Ask your doctor about chiropractic care as part of your overall treatment plan

A chiropractor may become a valuable part of your SI joint treatment team. SI joint dysfunction is caused by trauma and/or degeneration due to a number of different situations, including accidents, pregnancy and childbirth, other surgeries, and infections. Ask your doctor if your situation may be helped by chiropractic care.

If you have followed a non-surgical treatment plan for six months or more, whether or not it has included using a chiropractor to ease low back pain, and your lower back is still painful, you should consider calling on a trained physician to ask about SI joint fusion.

Additional related resources for low back pain relief

• Nonsurgical SI Joint Therapies
• Sacroiliac Joint Injection: Will It Work for Me?
• Diagnosed with Degenerative Sacroiliitis: Shirley's iFuse Story
• Neil's Story: My chiropractor felt my pain might be coming from my SI joint.