What are your options?

I was lucky enough to be able to heal my SI joints using a conservative approach, but unfortunately this doesn’t end up being the case for everyone.

Everyone’s body is different, and so can be the nature of their injuries.  Some people may find conservative treatment methods aren’t enough, and end up progressing to some of the more aggressive options.  It’s all about balancing the potential risks versus the benefits.

So here is a list of some of the different options available, ranging from the least to the most aggressive.  (This page is still slightly under construction!).

Conservative approach

Physical therapy (took me four before I found the right one)

allowing ligaments to heal; strengthening muscles

How I healed my SI joints without surgery

I would say this probably the ideal approach, because it’s the least invasive

Probably the approach you should aim for: the more conservative, the fewer risks (something like surgery has a lot of risks)

Strengthening

Aquatic Therapy

Muscle Energy Technique

Evidence-Based Examination and Treatment of the Pelvis (fascinating continuing education course for physical therapists, taught by Dr. Alexis Wright for Medbridge)

Chiropractic adjustments–

I think of chiropractic adjustments for the SI joint as sort of a necessary evil, only to be used very sparingly.

I find that (proficient) chiropractors can be very skilled at identifying subtleties; perhaps even more so than a physical therapist.

(Although I’m not sure that fixing ALL of the little subtleties is necessary or even helpful, since in my experience each adjustment can also destabilize the joint).

Link to The Sports Physio post

Have been meaning to write some kind of overview post on my opinion of chiropractors

Injections– Orthopedist/physiatrist/spine surgeon?

Lidocaine

Cortisone

of course even if you do this, will need to continue strengthening

Coordinated Health Part 4 has good info on all of these

Prolotherapy

What is prolotherapy? (and why I didn’t end up having it)

Radiofrequency ablation– minimally invasive procedure in which a doctor uses a device to destroy the ability of some of the nerves around the SI joint to send pain signals.  This procedure is only for pain relief; it does not affect the function of the joint or make it more or less stable.

Surgery