Question
I have been to five different chiropractor--a few for several years--to  treat pain from SI joint dysfunction. I've had pain ease a bit but never go away completely. A week ago, I saw a DPT who diagnosed me with an iliac up-slip. She did a quick adjustment that seemed too gentle to do anything to the joint. Guess what? By the next day, thirty years of constant pain is gone. Completely gone.
Now I am wondering if I should ever return to the chiropractor? Why didn't any of these fellows catch the actual problem? Can a chiropractic adjustment cause the up-slip to reoccur?

Answer
Dear Colleen,

Thank you for your question.  Your inquiry is similar to those I have heard from others who are investigating chiropractic.  Unfortunately, though, it is based on some misconceptions.  In order to answer you properly, it will first be necessary for me to give you some background information on the chiropractic profession.

There are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.  It is likely that the chiropractic offices you抳e visited are of this viewpoint.  

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation.  This is not the same as the findings you described, whether termed 揝I joint dysfunction?or 搃liac up-slip.? Those are both terms used in therapeutic practices, such as physiotherapy and mixed chiropractic.  We will talk more about that in a moment.  

Vertebral subluxation is completely different.  The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without brain messages, immediately the cells can no longer function the way they should for optimum performance.  Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such as accidental trauma, sleeping posture, pillow and mattress condition, the birth process, sneezing, falling down, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, etc.), which are, unfortunately, regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.

Tragically, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms.  The reason is that most of what goes on inside you happens without your awareness.  As an example, try to "feel" your liver.  What's it doing right now?  You can't know, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  The branching of the nerve pathways is complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  In order to know if someone has a vertebral subluxation, it is necessary to have that person抯 spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible.

Since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about your pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential.

A key question to ask for your purposes, then, would be, Is someone with hip pain, as you have noted, better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open?  It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise.

As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service.  It is probable, from your description, that the chiropractors you have visited have been of the mixed viewpoint.  I say this because, most significantly, they were addressing such things as your hip pain.

You need to understand very clearly that the practice objectives of therapeutic mixed chiropractic or physiotherapy and non-therapeutic straight chiropractic are quite different, as described above.  What information I give you must not be interpreted from the therapeutic or mixed viewpoint.  Non-therapeutic straight chiropractic is not about the treatment of hip pain ?whether by manipulation or anything else.  Attempts to connect vertebral subluxation to such complaints are not valid.  The theories that are proposed to demonstrate the validity of spinal manipulation as treatment for various ailments certainly is a topic of great debate and is clearly different from what would be proper non-therapeutic straight chiropractic procedures or principles.  I would not have given you therapeutic information such as you had received from the therapeutic mixing chiropractor.  I cannot offer an explanation, then, for the course of your hip pain or what you should have done about it.  The treatments you describe are not the equivalent of adjustments of vertebral subluxations.  What you experienced was something different from non-therapeutic straight chiropractic.

The same can be said for the opinions of the physiotherapist.  His/her objective is also in the therapeutic model, a different area, and so his/her comments are not pertinent to the matter of whether you choose to have the attention of a non-therapeutic straight chiropractor.  Physiotherapists?qualifications are in therapeutic matters and, as a result, they would perhaps have expertise in evaluating hip pain and/or scoliosis and even have disagreement with the therapeutic mixing chiropractor.  Diagnosis and treatment can be inexact and are actually arts rather than sciences, though they can rely on scientific measurement or technology, so it's not uncommon for these artists from differing technical persuasions to disagree.  For me to 搒ide?with either of them, though, would be a disservice to you and beyond my role.  Suffice it to say that I have no professional connection to either of these practitioners or their fields.  

From a non-therapeutic straight chiropractic viewpoint, however, it would certainly be wise to have your spine checked for subluxations by a non-therapeutic straight chiropractor, even if you still elect to have therapeutic attention for other concerns.  It抯 not an either/or choice that you have to make.  Remember, the two objectives are not the same.  One is about your pain, the other is about your life.  

If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area or if you have any other questions, please contact me at this site again or at [email protected].  

Colleen, I wish you the best in understanding what chiropractic has to offer.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.