A reader asked recently, over in our new Sacroiliac Joint Discussion Group, what my opinion is of chiropractic care.
Those of you who’ve been reading my blog for a long time know that I have a lot to say about this.
A chiropractor was the first person who diagnosed me with SI joint dysfunction, back when my joints first locked up in 2011. I can only imagine how awful it would have been if he hadn’t been there, and instead I’d been stuck with the first few doctors and PT’s I saw– who didn’t know anything.
I mean, my joint was stuck on one side, and I could barely move my leg. None of the other medical professionals I saw could even come up with an explanation for it, let alone realign the joint and free my leg.
So I will never be one of those people who says chiropractors are complete quacks, or that their adjustments don’t do anything. I think they can do a lot.
Looking back, I don’t think a chiropractor was the best person to oversee my rehab.
He had me in the mindset that if I just kept coming back for adjustments, I would get better. And that isn’t really how it works– you need to strengthen the muscles around the joint, and learn movement patterns that are less likely to stress the ligaments.
But at the time, no one else seemed to understand my problem. I tried going to various doctors, such as orthopedists and physiatrists (who are, in general, actually a good place to start if you have SI joint dysfunction. I think we’ve come a long way since 2011). But I back then, I just couldn’t seem to find help from anyone. No one actually said they knew how to treat SI joint dysfunction.
So I stuck with this one chiropractor for years. He did tell me that, in the long run, the problem wouldn’t go away unless I built up enough muscle strength to hold the joint in alignment. But he also didn’t tell me how to do this.
Our appointments were very short– adjustments only. Looking back, I really needed someone to work with me, one on one, and help me understand what was going on.
I later found that, when I finally discovered a physical therapist who could actually treat me. She helped me to understand the anatomy of the joint itself, and pointed out that all of the aqua jogging I was doing was only building cardiovascular endurance… it wasn’t really building strength (these are very different concepts).
So… for five years, all of the chiropractic adjustments I received were really just quick fixes… they’d last for a day or two, then my joints would move out of place again.
This physical therapist also taught me how to adjust the SI joint myself, using a form of gentle muscular contractions known as the Muscle Energy Technique.
In 2016, I went on vacation and discovered– by accident– that my joints stayed more stable if I just adjusted them myself, rather than receiving chiropractic adjustments.
This was sort of my breakthrough moment. I had everything else I needed in place in order to heal– the right strengthening program, the right stretches, knowing how to use MET on myself.
It turned out that the chiropractic adjustments had actually been too rough on my ligaments. Although they’d technically put my hip bones into the correct position, relative to my sacrum, they’d actually destabilized the ligaments at the same time. That’s why my adjustments only lasted 1-2 days.
Now, I really don’t care to recall how much time and money I spent on these adjustments that were secretly backfiring the whole time. I really don’t. But, it was a lot.
So you can see how I have mixed feelings.
On the one hand, a chiropractor was the first– and for a while, only– person to understand me.
But I also regret listening to him for so long. I was trapped in a mindset based on needing adjustments, and constantly putting the joint into the right place. Without this vacation, I don’t know if I would have ever known that the adjustments were backfiring.
For a while, my philosophy was that sometimes chiropractic adjustments can be a necessary evil.
I still continued to receive them, from time to time, to the rest of my back (never my SI joints again).
I never really noticed the same effect in my actual spine, where things felt “less stable” after an adjustment. Unlike my SI joints, I’d never really had an actual injury to the rest of my back, involving ligaments that were sprained, so I thought maybe it was okay.
Then, as many of you know, in May 2018 I went to the emergency room following a chiropractic adjustment to my lower back that gave me temporary symptoms of a nerve injury.
I’m still not entirely positive what went wrong– all I know is that the emergency room doctor and nurse told me to thank my lucky stars that it wasn’t permanent, because they see people come in all the time with injuries that are.
It’s not my goal to freak anyone out, but I do want to be realistic and tell you the truth.
So they told me they see strokes (which can happen when one of the arterties that supply blood to the brain gets poked during a neck adjustment).
They see bone fractures.
They see nerve injuries… they see blood vessel injuries (arteries and veins).
They both looked me in the eye and told me they would never receive adjustments themselves.
So, I feel as though I’m in a difficult position with my blog.
I remember what it was like to have no one– no one– understand why I couldn’t move my leg except for a chiropractor.
I do remember the extreme pain relief I’d gotten at times.
I hesitate to tell people not to go to a chiropractor, because I know this may be the only person they can find at the present moment who can actually tell what’s happening with their SI joints.
But I also hesitate them to go, because the truth is that I personally don’t want to ever receive another chiropractic adjustment in my life.
And of course I would never recommend something to you that I didn’t think was safe, myself.
I’ve also since learned that the “diagnosis” my chiropractor gave me for my lower back– rotation of the lumbar vertebrae– was actually sort of a misconception. Although my vertebrae probably are rotating… it’s more because they are hypermobile and need more muscle strength to stabilize them. (Hypermobile means “moving too much”). So a better diagnose is Lumbar Spine Hypermobility.
I’ve since had two professionals — a PT specializing in Orthopedic Manual Therapy and a Primary Spine Provider– tell me I shouldn’t be receiving adjustments at all. It only makes things worse, when you’re hypermobile.
Which is, of course, basically the same principle that was at work with my SI joints. (Although one of the joints would get “stuck,” ultimately it was moving out of position because it was hypermobile).
Which leads me to where I am now.
I’ve been on sort of a quest recently, to figure out exactly what I think of chiropractic adjustments, versus the gentler joint mobilizations physical therapists usually perform.
And I’ve been really curious to see collaborations between chiropractic and mainstream medicine. I think that’s really where the future will be.
I do think chiropractic has a lot to offer, because they really can diagnose subtleties in alignment that cause pain, that traditional medicine misses.
But right now, I don’t think chiropractic education is well-regulated enough (which is why you get such a wide range in skill level).
If you’re going to see a chiropractor, please see one of the more science-based ones… not one of the ones who thinks they can cure toothaches and ear infections, as well.
One of my friends actually dated a chiropractor once. She explained to me that there are two main schools of thought in chiropractic education:
Straight chiropractic is more in line with the profession’s historical roots (and in my opinion, a little bit crazy… that’s where you get people claiming they can cure EVERYTHING that’s wrong with your body)…
Mixed is where the chiropractic profession has actually adapted to and collaborated with mainstream medicine.
I explain more about our conversation in this post… PLEASE, if you’re going to go to a chiropractor, go to one of the science-based ones! It should ONLY be to help musculoskeletal pain!
And please also be aware of the risks– you can check out these articles:
- Playboy Model Katie May Died After Chiropractor Ruptured an Artery in Her Neck, Coroner Says
- How safe are the vigorous neck manipulations done by chiropractors?
- Adverse effects of spinal manipulation: a systematic review (basically saying we need more research, because chiropractic adjustments do have negative effects!).
After my experience, I have sworn off chiropractic adjustments for safety concerns.
However, my recent conversations with new types of treatment providers have given me reason not to write off the whole field just yet.
I’ve written about my appointment with an Orthopedic Manual PT, who can actually perform chiropractic adjustments himself, and studied under a chiropractor as part of his training.
I also have a post coming up about my visit with a Primary Spine Provider.
Both of these individuals have given me reason to think there may still be room for the knowledge of the chiropractic field to benefit mainstream medicine.
I just really, really think the two things need to go hand in hand. I’m excited about the future; I just don’t think we are quite there yet.
If you’re looking for help with the SI joint:
I really think your best bet is to see a PT who is certified in Manual Therapy– especially the Muscle Energy Technique.
MET is way gentler than chiropractic adjustments because you’re actually using your own muscle contractions to realign the joint. Your nervous system has built-in reflexes that will prevent you from contracting your muscles hard enough to cause an injury. In contrast, a chiropractic adjustment is being done by someone else who doesn’t really know how much force is too much for your ligaments.
This is why I really recommend you look for a PT like David, or Natasha, or Paula (some of the previous PT’s I’ve found who could help me).
I have a bunch of tips in my Physical Therapy posts on how to find a good person to help you (look under the “Physical Therapy” section of my Site Guide).
But if you are going to see a chiropractor:
Please, know the risks.
The Activator tool is more gentle than other kinds of adjustments.
And I would never, ever let a chiropractor perform a hands-on adjustment to your neck (that’s where the risk of stroke really comes in).
Okay, this was a long one but at least now, we are all up to date on where things stand!
If you’ve been seeing a chiropractor who’s helping you, and you want to keep going, I won’t judge you. We all have our own path.
But this has been my experience, and I hope it’s been helpful for you.
For more of my chiropractic-related posts:
From the spring of 2016, when I finally had my epiphany after going on vacation:
Chiropractic and the SI Joints:
The goal of strengthening is to maximize your body’s own support system (and why getting too many adjustments is a bad idea)
What I think chiropractic has to offer (“Straight” vs. “Mixed”)
Spring of 2018, after going to the emergency room:
Lumbar Spine Epiphany, Part 1: realizing that a more accurate term for the pain I was experiencing was segmental spinal instability. And that, contrary to what I had thought, I didn’t have to depend on chiropractors to treat it– PT’s can treat it as well.
Lumbar Spine Epiphany, Part 2: Explains a little more about segmental spinal instability and how to treat it.
My search for providers who understand both chiropractic and mainstream medicine. Although my injury didn’t turn out to be serious, I never got an exact explanation from anyone about my symptoms. Part of the problem was that none of the people treating me were familiar with chiropractic adjustments. That’s when I decided to seek out people who’d had training in both areas.
Integrative Spinal Research: collaboration between chiropractors and traditional medicine at University of Balgrist, Switzerland.
And the rest of my posts related to my temporary injury and hospitalization can be found here on my Lumbar Spine Hypermobility Page.
And… if you are looking to find a physical therapist to help with the SI Joint:
How to find a good physical therapist:
- Thinking creatively
- Find someone with experience in treating the SIJ
- Search tips
- The PT’s I observed as a student
I hope this helps!
If you have any questions, or want to connect with others, please don’t forget to check out our new Sacroiliac Joint Discussion Forum! We’ve had some great conversations so far!