Expert: Thomas Sabalaske DO - 6/14/2007

Question
QUESTION: Hi,
I was just told that I have a problems with my SI joint and I was wondering how long (roughly) it could take to make something like this feel even just a little better with chiropractic treatment?

I have the severe pain in my butt and down my leg in the back and also my hip.

Thanks
Char

ANSWER: Hi Char, thanks for the question.  There are a lot of factors to think about in regards to how good you should feel.  The quality of the pain, how far and where it goes down your leg, how long it has been going on, how old/healthy  you are, and are there any lifestyle factors which are making it continue.  Beyond that is the skill of the person working on you.  I am an osteopath which goes to 4 years of med school then 3 years of residency to work on patients, more training than a chiropractor.  I usually see moderate improvement after the first or second treatment.  I also give a few simple home exercises and stretches to allow the patient to continue to improve and stay healthy on their own.  I would ask whoever helps you if there are things you can do to keep yourself healthy between visits (or eventually instead of visits!).  I hope this gives you a little insight!  Tom

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

QUESTION: Hi Doctor,

Thanks a lot for your reply, I appreciate your time!

Now that you mention all of the things that play a role in this SI joint, I guess my question didn't include any of it :)

I am 41 (and too happy, want to be "me" again)

I've had the pain for 1 year.
I had a extremely severe outbreak of Psoriasis 1 year ago and had to be hospitalized for 1 week. The head of Dermatology at Rush (Illinois) put me on Cyclosporin for 3 months, along with 2 topical steroids.
I followed up with a series of 12 shots of Amevieve (12 weeks) and within 8 weeks I was completely clear (miracle)

The Dr at Rush said my pain was so severe in my joints because the Psoriasis was sooo bad. Even though my SED rate was 3 and ANA negative for Rheumatoid arthritis.

I do have other joint pain as well, hip and butt and shoulder blade. All on my left side.
The right side of me feels like I'm still 20.

I don't work outside the home, so I just do regular things around here...I'm not one to exercise though.
I am 5'1 and 125 (don't know if that matters)

I have at least 5 spots on my butt the Chiropractor told me, she said it's in every muscle, also a spot that is higher more up by my waist, then the hip all the way around. It goes down my leg in the back and the front about 1/2 way down the top of my leg.

I went for my 2nd treatment yesterday and she wants to see me again tomorrow.
While she is working on me the pain is horrible (makes me dizzy) but then afterwards it almost goes numb and feels a little better.

She is having me put ice packs on for 20 min 5 times a day, and doing knee to chest stretches laying down and holding it for 10 seconds (4 times a day)

Oh I forgot to mention, the day after my 1st treatment the pain was so severe it felt like my hip and butt was run over by a very large truck. It felt like it was out of the socket. I finally had to go to the ER. They gave me a shot of (spelling?) Toradol (no help), then 3 Prendisone, then
2 vicodin (no help) finally I was still in so much pain they gave me a shot of Morphine and then it felt like I didn't even have a hip or butt.

I guess I'd like to get your opinion on all of this is you have the time...I'd appreciate it!
What you think of the Psoriasis connection, and the Chiropractor treatments, and the at home stuff she's having me do too.

Thanks again
Char

Answer
Ok, here we go.  Psoriasis can also give you joint pains, what they call psoriatic arthritis.  Your rheumatoid factor should be negative in this, but if there is inflammation going on then your sed rate should have been elevated *assuming it was performed correctly*.  If the sed rate was really low, then this was not a psoriatic arthritis.  

As far as chiropractors in general, many are doing some great work.  I don't like to inflict any pain during treatment because the body responds negatively to that, tries to spasm to prevent more pain (especially if it is so intense it makes you dizzy).  The day or two after a treatment it is common to have some soreness for a day or so, hopefully followed by many days of relief.  

Your home stretches seem a little simplistic and I can't be sure they are all you could do to help yourself.  The ice after 1 year of pain is not probably where I would go either.  A good osteopathic physician should be able to not only diagnose and correct the dysfunctions you have present, but also prescribe some better individual home treatments to help this problem.  I see patients exactly like you at least 8 times a day.  I've included a few names of people I know and have worked with that could definitely help you.  Good luck!  Tom

Richard A. Feely, DO, FAAO
Feely, Ltd.
Chicago, IL 60611    (312) 266-8565

Robert E. Kappler, DO, FAAO
Midwestern University
555 31st St.
Downers Grove, IL 60515
630/515-6475