Chiropractic, although very effective in aligning the joint and removing stress, a quick short thrust, is not effective enough to remove all the fluid from the SI joint space. However, it will usually give considerable relief because it can take a lot of stress off the injured ligaments.
Muscle strengthening programs, as done by physical therapists and rehab specialists, are also highly regarded as a treatment for SIJ instability. When done properly, muscle strengthening and stretching can realign the body structure to remove stress on the joint. However, the muscles cannot provide enough power to compress the SIJ sufficiently to push out the excess fluid, so the lesion remains.
Injection therapy, such as prolotherapy, is use of an irritant injected into the joint space, or surrounding ligaments. This is done in an attempt to create additional scar tissue which will help the ligaments hold the SI joint together. But, without removing the excess fluid, the best it can do is hold the SIJ in a separated position.
The only method available to provide the correct amount of pressure, direction, and time to effectively compress the weight bearing portion of the SIJ to eventually result in permanent removal of excess fluid, re-establishment of ligamentous integrity by re-integration of the ligament into the joint surface, restoration of muscular balance, and normalization of joint function is Category 2 blocking. When done properly, muscle strength will be increased immediately after the procedure
