Blum CL, LETTER TO THE EDITOR: Sacroiliac Dysfunction and SOT - Response to the Nov. JACA Online Focus article on sacroiliac joint dysfunction. Journal of the American Chiropractic Association. Dec 2006: 20-1.

I found this [November JACA Online] article quite fascinating for two reasons. First, it left out sacro occipital technique and its view and treatment of the sacroiliac joint dysfunction. Second, various tests of limited validity and reliability are discussed along with the reasons behind their use, yet a chiropractic technique that has as its focus the treatment of the sacroiliac joint was ignored.

It is well understood that SOT needs more research on the topic but at the very least, the past 25 years of SOT-related published peer-reviewed clinical studies [1-20] warrants some acknowlegment.

In fact, according to Hestœk and Leboeuf-Yde, other than palpation for pain, the only other chiropractic test considered to have, "some evidence in favor of validity" was sacro occipital technique's arm fossa test [21], which has as its primary focus the evaluation of SI joint hypermobility dysfunction.

As an advocate of SOT, I would appreciate the opportunity to share some valuable insights into the treatment of SI joint dysfunction, particularly with regard to the work done by SOT practitioners who have this as their primary focus of care. A recent Dynamic Chiropractic article offers a sample of how sacro occipital technique views the multifactorial nature of the SI joint, discussing both SI joint dysfunction as having either a joint fixation or hypermobility etiology [22].

We need more clinical research on chiropractic’s care of SI joint dysfunction. A review of the literature, focusing on how allied health care practitioners treat SIJ dysfunction is elucidating and helpful, but researchers should also look to the work being done by our own profession to help build a chiropractic evidence base in this area..

Thank you for your kind consideration and thought-provoking article.

Charles Blum, DC
Santa Monica, CA

References (All the following references have abstracts which can be found at the SOTO-USA Literature section on the SOTO-USA website)

1. Tellefsen T. Chiropractic management of anterior pelvic girdle pain and instability in pregnancy: A case study, including the management of birth preparation in the chiropractic setting. European Chiropractic Union Annual Conference, Stockholm, Sweden, May 25-28, 2006.

2. Hochman JI. The effect of sacro occipital technique category II blocking on spinal ranges of motion: a case series. Journ Manipul & Physiol Ther, Nov 2005;28(9):719-23.

3. Hossu M, Rupert R, Harrison N. Changes in biophoton emission associated with chiropractic treatments: A descriptive pilot study. Journ Chiro Educ Spr 2005;19(1):60.

4. Knutson G. The sacroiliac sprain; neuromuscular reactions, diagnosis and treatment with pelvic blocking. Journ Amer Chiro Assoc, Aug 2004;41(8):32-9.

5. Cooperstein R, Crum E, Morschhauser E, Lisi A. Sitting PSIS positions and prone blocking preferences. Journ Chiro Edu Spr 2004;18(1):44-5.

6. Thompson D. Influence of sacroiliac joint belt on pain threshold along the inguinal ligaments. Journ Chiro Educ Spr 2004;18(1):88-9.

7. Lisi AJ, Cooperstein R, Morschhauser E. An exploratory study of provocation testing with padded wedges: can prone blocking demonstrate a directional preference? Journ Manipul & Physiol Ther. Feb 2004; 27(2):103-8.

8. Cooperstein R, Lisi AJ. Blocking procedures: an expanded approach. Journ Amer Chiro Assoc. 2004 Jan; 41(1):44-6.

9. Klingensmith RD, Blum CL. The relationship between pelvic block placement and radiographic pelvic analysis. Journ Chiro Med Summer 2003; 2(3):102-6.

10. Thompson DM, Vrugtman RP, Johnson KM, Dicks SK, Unger-Boyd M. Correlation of lateral pelvic sway to variances of pain along the inguinal ligaments: a pilot study. Journ Chiro Educ Spr 2003; 17(1):76.

11. Cooperstein R. Padded wedges for lumbopelvic mechanical analysis. Journ Amer Chiro Assoc, Oct 2000:24-6.

12. Getzoff H. Sacro occipital technique categories: a system method of chiropractic. Chiro Technique, May 1999;11(2):62-5.

13. Unger JF, Jr. The effects of a pelvic blocking procedure upon muscle strength: a pilot study. Chiro Technique, Nov 1998;10(4):50-5.

14. Tabar, J. Treatment of sacroiliac joint: a review of procedures. Chiro Technique, Nov 1997;9(4):185-92.

15. Bilgrai-Cohen K. Chiropractic treatment of the musculoskeletal system during pregnancy. Journ Amer Chiro Assoc. May 1997:33-34,90.

16. Cooperstein R. Sacro occipital technique. Chiro Technique, Aug 1996;8(3):125-31.

17. Denton DG. Biomechanics of the pelvis. Basal Facts, 1986,8:4,211-21.

18. Otter R. Literature on the sacroiliac joint. Euro Journ Chiro, Dec 1985;33(4):221-42.

19. Howatt, J. Chiropractic: the cranial sacral complex. Journ Orthop Med, 1988;(1):13-20.

20. Maltezopoulos V, Armitage N. A comparison of four chiropractic systems in the diagnosis of sacroiliac malfunction. Euro Journ Chiro, 1984;32:4-42.

21. Hestœk L, Leboeuf-Yde C. Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review. Journ Manipul &Physiol Ther. May 2000;23:258–75.

22. Blum CL. Sacro-occipital technique's "category two": a remedy for fixated thinking. Dynamic Chiropractic. Sep 1, 2006;24(18).