Colorado spine surgeon Dr. Donald Corenman lectures to physicians and therapists on sacroiliac joint pain treatment and the chiropractic treatment techniques. For the laymen, please explore Dr. Corenman’s website to learn more about the clinical terms used.
Dr. Corenman begins his lecture by discussing the anatomy. Sacroiliac joint pain treatment can be very complex in pathology. The sacroiliac joint combines two different types of union of bone one is a diarthrodial joint and the other is a fibrous joint. The sacroiliac joint is stabilized by the symphysis pubis, which allows little motion. The sacroiliac joint is the most heavily ligamented joint in the body.
As the sacroiliac joint matures it begins to stiffen. As the joint loosens it can create wear on the cartilage. Pregnancy can also loosen the SI joint. Longer lumbar fusions increase level arm stress on the SI joint and hip disorders can also increase stress.
The relative rotation of the of the sacroiliac joint can have an “up slip” (posterior rotation) and a “down slip” (anterior rotation). If one side goes up and the other goes down this is known as “sacral torsion”.
There are very few muscles that cross the SI joint and the muscle vector forces are poor to control unstable SI joint or correct abnormal biomechanics. It is very difficult to strengthen muscles in that area to stabilizes the sacroiliac joint.
Dr. Corenman gives an overview of the history of chiropractic. There are different types of chiropractic manipulation for sacroiliac joint pain treatment. Level 1 involves an active range of motion. Level 2 is mobilization this is where a chiropractor can move the joint beyond an active range. Level 3 is manipulation, which bring the joint beyond its passive range of motion and opens the joint up in an adjustment or manipulation. What an adjustment is a release of the suction of the joint as you break the suction you release a gas into the joint, which creates the “pop” of the joint.
There are different chiropractic techniques for sacroiliac joint pain treatment. There is the diversified adjustment, drop table, flexion-distraction, saro-occipital technique, active release, activator and mobilization. Dr. Corenman discusses each technique in detail.