This month I'd like to tackle a subject that, to be honest, many chiropractics don't understand very well. I will try my best to explain it to you as I do my patients. The sacroiliac (or SI) joints join the two hip bones to the sacrum at the base of the spine. These joints do many important jobs in your body. They allow for proper motion and balance as you move through daily activities. They keep you from falling down by supporting your hip bones to which your legs are attached.

There are many nerve endings in the SI joints that can sense any major change in your body's position. These nerves send messages to the brain which in turn (in a split second) tell the muscles in your body how to adjust to these changing positions. Proper motion of the SI joints is important in another way. It aids in the flow of cerebrospinal fluid (or CSF) through the brain and spinal cord. The CSF feeds these tissues while providing a protective barrier against germs and harmful chemicals. Recent research suggests that CSF may also aid in transferring messages from the brain to the spinal cord and surrounding tissues.

The SI joints can become either stuck (reducing motion) or sprained (allowing too much motion). These conditions can reduce the flow of CSF and cause an unstable or unlevel base for the upper body.

As a semi-retired carpenter and builder I see it like this. A weak and damaged foundation in a house causes cracked walls and the doors and windows don't work well. It's the same in the human body but, instead of remaining still like a building, the SI joints must resist the forces of gravity on the body through a complex range of motions. The range of motion in the SI joints also allows the sacrum at the base of the spine to serve as a pump to return CSF back up the spinal cord to the brain where it can be reabsorbed and renewed. A bad SI joint can lead many other health problems.

Many chiropractors are only trained to treat the SI joints as if they get stuck in 1 or 2 of 4 possible directions, and are slow to recognize a sprained joint that moves too much. In my experience, few chiropractors are properly trained in the importance of SI joint motion for proper CSF flow and the importance of that flow to health.

The work of Dr. Nelson DeCamp and others at Sacro-Occipital Research Society International (SORSI) has shown us that the SI joint can get stuck in many directions, each requiring a different direction of correction. SORSI doctors lead the world in researching better ways to improve CSF flow by improving SI joint function. They also have a unique way to treat a sprained joint which needs a different treatment than a stuck joint.

In my practice, I see a lot of patients with logging, pipeline or farming jobs that can put heavy force into the SI joints. These cases can fail to respond or even get worse with improper treatment. Here is my rule of thumb: if a patient isn't improving noticeably in 4 to 5 visits, either I've missed something, I'm doing the wrong treatment, or the patient is not following their care plan. Patients have a right to expect results. Proper SI joint evaluation and treatment should be the foundation of a good care plan.