Question
QUESTION: I really appreciate all of your advice and asked my chiropractor to check for soft tissue damage and stability issues.  He did and said that everything looked fine.  I also decided to drive down to Palmer Chiropractic college in San Jose to get someone from the clinic to look at me as well.  I figured that they would have access to professors and all sorts of techniques.  Luckily, I was able to see one of the Professors, he confirmed what my chiro said about not needing soft tissue work (stating that I wasn't a candidate for the graston technique).  He said that my issue was definitely the joint and that was where the pain the coming from.  He also said that my pelvis has a slight anterior rotation.  He did an adjustment on a drop table to both SI joints.  I feel the exact same, except that my pelvis looks tilted forward on the left side, as that bone sticks out a little further when lying down on my back.  However, when standing the left bone seems to stick out more.  Anyhow, I am really anxious to heal up and am worried that this is my life.  I can walk just fine and stretching seems easier.  My problem is sitting and lying flat on my back.  I get a deep ache in the joint and almost have a weird light tingling/burning sensation in the joint too.  I also have a little back stiffness when I bend, but not too bad.  As I told you before, my new chiro wants to see me every 3 weeks as he thinks I am on the road to recovery.  I have a few questions for you.  One, in your experience, how long does it take to heal that joint and do you see people fully recover (My initial adjustment and pain in the joint began August 27th)?  Should I be concerned about the slight rotation in my pelvis?  Both chiros (professor and my new one) adjusted it, but don't seem to think it is that big of deal, as they don't want to keep seeing me on a regular basis.   Again, I really appreciate all of your time.  I think bottom line, I just want to have a normal joint again and be able to sit and lay down without feeling any pain.  Thanks for everything.

ANSWER: Nicole:  Is your professor trained in Graston Technique?  If not, then his opinion doesn't count.   Research shows that the mechanically assisted soft tissue mobilization can change the anatomy of tendons and ligaments.  Changes to ligament anatomy were demonstrated and published recently in a medical journal (JOSPT).   What do you think holds the SI joint together?  Also, there are many unimpressive professors at chiropractic colleges...   Remember the saying, "if you do the same thing over and over, but expect different results, then that's the definition of insanity (or something like that)..."    So my questions to the DC's are:  what is the presumptive diagnosis?  What are the underlying confounders (e.g. an asymmetric overpronation of arches on gait, a previous trauma, loss of core muscle control, or Vitamin-D deficiency)?   What method(s) will affect the tissues or function to most likely improve the condition?   Is the diagnosis valid?   See if you can get a consult/eval with Dr. Thomas Sousa at Palmer West (I think that's where hs is).  

Good luck,

Dr. G

---------- FOLLOW-UP ----------

QUESTION: What are your thoughts on using the K laser on your SI joint?  Apparently it is a light therapy that can help expedite the healing process.  Any thoughts?  

Answer
Low level laser simply increases the ATP (energy) of the cells that are being photo-irradiated.  It can modulate inflammatory reactions.  It can alter pain sensation.  Some people seem to be good responders to laser, and others not.  A scientific review on laser for treating back pain showed little benefit.  A recent study on laser for neck pain showed some benefit.  There are mixed reports of benefit for laser use on tendons.   I use one in my office, and it think it has its place in the therapeutic armamentarium, but I wouldn't bet the bank that it will cure your problem.    You really need to look at some of the other items I suggested previously.   If your chiropractor does not have the training to "functionally examine" you (google: Gary Gray and Functional Examination) and does not have the training to examine and treat soft tissue (Active Release Technique or Graston Technique), then you are missing out on the best care.   

'Best,

Dr. G