Approximately 80% of adults will have low back pain at some time in their lives. Furthermore, it appears that adolescents with low back pain are more likely to have problems as adults. Above all, chiropractic treatment is a valuable treatment associated with clinical improvement for acute and chronic low back pain for all ages (infants to seniors). 

Read on to learn about 3 Causes of Low Back Pain a Chiropractor Can Help With.


  1.  Sacroiliac Sprain

The sacroiliac joint is located in the pelvis. You have 2 sacroiliac joints (left and right). It links the iliac bones (pelvis) to the sacrum (lowest part of the spine above the tailbone).

A sprain is an injury (micro tears) to the ligaments around a joint. Ligaments are strong, flexible fibers that hold bones together. With a sacroiliac sprain, you may have pain over the joint(s). The pain is often sharp and stabbing and may radiate down the back of the leg. You may have relief somewhat by sitting or lying.

Importantly, adjusting (chiropractic manipulative therapy) of the sacroiliac joints should be performed gently, to avoid increased stretch to the sacroiliac ligaments.



Certainly, the sacroiliac ligamentous support of the sacroiliac joint is strong.  Nevertheless, injury can occur from prolonged or sudden lifting of an object or bending.

An evaluation for seronegative arthritides (i.e., ankylosing spondylitis or psoriatic) may be done in case of an underlying complication in unremitting or recurring cases. For instance, elbow or scalp skin lesions (e.g. dry itchy rash) suggests psoriatic arthritis. X-rays may help with the diagnosis.


  1. Sacroiliac Subluxation


So in the chiropractic office, we see many sacroiliac joint subluxations (chiropractic joint misaligments/intersegmental dysfunctions) in addition to sprains. Subsequently, sacroiliac dysfunction probably accounts for almost half the cases of low back pain. With a sacroiliac subluxation, the pain is often sharp and stabbing.


Firstly, as a sacroiliac sprain, prolonged or sudden lifting or bending may also cause a sacroiliac subluxation.  It may also be due to incorrect ergonomics/posture.

Secondly, sacroiliac joint innervation (supply with nerves) is from a broad area including both sacral levels S1-S2 (between low back and tailbone) and lumbar levels L1-L3 (low back) plexuses (network of nerves). This may explain the varied pain patterns with sacroiliac joint involvement. The varied pain patterns can be low back, buttock, lower extremity (leg) and groin pain.

Thirdly, the chiropractic subluxation presents with reduced joint motion and alignment which is corrected by the chiropractic adjustment. Spinal or extremity (arms and legs) joint dysfunction/ subluxation (chiropractic subluxation complex), can adversely affect nerve function, and the body’s ability to regulate and maintain health. Chiropractic adjustments address disturbed joint biomechanics and the associated effects on nervous system function.

Lastly, both sacroiliac sprains and sacroiliac joint dysfunction/pain affect the majority of adult patient population. However, there are some peaks of increased occurrence in younger adults following sporting injury, pregnancy and older adults from degeneration. 


  1. Piriformis Syndrome


The piriformis is a flat, pear-shaped muscle located in the gluteal (buttock) region of the hip/proximal thigh. You will have buttock and posterior (back of ) leg pain without any trauma.


The sciatic nerve runs under the piriformis muscle where it may be compressed (pinched) by the piriformis muscle. As the biggest nerve in your body, it originates from several nerves in your lower back. These nerves branch outward from the spine and then come together at each buttock to form the sciatic nerve, which then travels down each leg.

Predisposition to piriformis syndrome may be due to an anatomically short leg (one leg is structurally shorter than the other due to bone length differences).  Other reasons could be due to excessive pronation (inward rotation of foot) of your foot or a pelvic rotation/misalignment.

Postisometric relaxation techniques or myofascial release soft tissue techniques to the piriformis muscle is important along with the chiropractic manipulative therapy for treatment of piriformis syndrome.

Dr. Meiri adjusts the spine


At Meiri Chiropractic, we spend the time necessary to examine, diagnose and treat every neuromusculoskeletal condition and various ailments you have. Chiropractic is a holistic and natural way to not only treat low back pain, but to keep your body in its best working condition. We have been offering effective chiropractic care in Palm Beach County since 2006. Many of our patients reviews note our excellence. We are your best bet and are here for you. Call us today at 561-253-8984 to make an appointment or to find out more about 3 Causes of Low Back Pain a Chiropractor Can Help With.



Thomas Souza,  (2018) Differential Diagnosis and Management for the Chiropractor




This post is about Spondylolisthesis and Low Back Pain: a Chiropractor Can Help.  Approximately 80% of adults will have low back pain at some time in their lives. Furthermore, it appears that adolescents with low back pain are more likely to have problems as adults. And Spondylolithesis can be the cause of your back pain. Chiropractic treatment is a valuable conservative treatment associated with clinical improvement in patients with acute and chronic Low back pain due to spondylolithesis in various studies. 


What is Spondylolisthesis?


Spondylolisthesis is a condition in which a vertebra (bone) in the spine moves forward out of the proper position onto the bone below it.There are several types of spondylolisthesis. However, the most common are isthmic, occurring in the young, and degenerative, occurring in the older person.


If you are young, low back pain may be worse with extension (arching back). In older persons, the degenerative (due to “wear and tear”) spondylolisthesis may cause signs of stenosis (narrowing of the spaces within your spine, which can put pressure on the nerves).


What is the Cause of Spondylolisthesis?


Although congenital (present from birth) types and destructive (e.g., tuberculosis,cancer) types are possible, they are rare. The isthmic type is due to a problem with the Pars interarticularis (pars).  The pars is  a small segment of bone that joins the facet joints (joint connects two or more bones) in the back of the spine. A defect in this portion of the spine leads to a condition called spondylolysis. This is due either from a stress fracture of the pars interarticularis (spondylolysis) or an elongated (lengthened) pars. The elongated pars is a result from micro (small) fractures that heal with an elongated pars. And stress fractures are more an issue of overuse.  Similarly, a microfracture could be caused by trauma, like getting hit by something or a fall. 

90% of spondylolytic spondylolisthesis occurs at Lumbar spinal vertebral level 5. The spondylolysis type is more likely to become symptomatic in children more than 5 years old. Spondylolisthesis is more common in girls. Sports such as gymnastics, which require repetitive hyperextension (extensive arching of the back), are more likely to cause problems.

There are 4 levels of grading spondylolisthesis. Most grade 1 spondylolisthesis are asymptomatic and stable. Progressive slippage is rare, occurring in only 2% to 3% of patients. Grade 2 spondylolisthesis may be symptomatic, but are considered stable.

There is a good response to chiropractic manipulative treatment with grades 1 or 2. With grade 3 or 4 spondylolisthesis, there is a need for orthopedic/surgical consultation. Additionally, Single-photon emission tomography (SPECT) is often used to distinguish athletic patients who require a brace and rest for several weeks. Spondylolisthesis is primarily a radiographic (x-ray) diagnosis.


Dr. Meiri adjusts the spine


Treatment of Spondylolysis and/or Spondylolisthesis at Meiri Chiropractic


An important point is that Chiropractors do not reduce the slippage of spondylolisthesis. Instead, they address the spinal joints above and below the slipped vertebra to improve motion in the region.  Therefore, your low back pain is relieved by addressing the mechanical and neurological causes of pain around the spondylolisthesis. The pain goes away because function improves and/or normalizes.

Dr. Natalie Meiri will examine you and come up with a treatment plan to get you better. Through regular visits, you can get pain relief and improve your back health with chiropractic manipulative treatments without surgery.  She has treated and helped patients with spondylolysis and/or sponylolisthesis for over 16 years.

“Softer” approaches involving “no rotation” chiropractic manipulative treatments such as flexion-distraction, blocking, and prone (patient face down) drop-table adjusting are available.  Our other therapies, such as soft tissue techniques, therapeutic exercise, electric muscle stimulation, ice/ heat therapies and homeopathic consultations, may also provide relief for your pain. 

Call our office which serves North Palm Beach, Jupiter, Palm Beach Gardens and West Palm Beach.  Ask about Spondylolisthesis and Low Back Pain: a Chiropractor Can Help at 561-253-8984.



Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 5th edition, 2018



Arthritis has a “geriatric” connotation, yet it may affect any age group. The term simply means that the joint is affected (joint disease/disorder). Arthritis can be due to many causes such as degeneration or destruction that is age-related or trauma related, infectious, inflammatory, and/or autoimmune.  This post is about Chiropractic Care for Degenerative Arthritis of the Spine and Extremities (arms and legs).

Degenerative arthritis or degenerative joint disease is also referred to as osteoarthritis. This serious, painful condition can affect any joint of the body (e.g. hands, knees, hips, shoulders, back and neck). It is by far the most common form of arthritis, affecting more than 32.5 million adults in the United States, according to the Centers for Disease Control and Prevention.

Firstly, osteoarthritis is a disease of the entire joint, including bone, cartilage, ligaments, menisci (e.g. knee meniscus) and the tissues lining the joint (the synovium). There can also be changes in periarticular (around the joint) muscles, nerves, bursa, and local fat pads that may contribute to the symptoms of osteoarthritis. Secondly, it is referred to as a “wear and tear” arthritis because it degrades cartilage, changes bone shape and this causes inflammation.  Thirdly, the result is pain, stiffness and loss of mobility. Lastly, pain and other symptoms of osteoarthritis may lead you to feel tired, have problems sleeping, and feel depressed.


Different Types of Osteoarthritis

  1. Primary Osteoarthritis

Primary Osteoarthritis occurs usually in middle-aged to elderly people (>45 years old). It is more prevalent in women (female to male 10:1). Primary means this osteoarthritis develops due to aging and the wear and tear that comes along with it.

An example would be primary femoroacetabular (hip) osteoarthritis. Typically, your symptoms consists of hip and possibly buttock, groin, or knee pain that was insidious (came on gradually) in onset. Additionally, you note a slow stiffening, specifically internal (inward) rotation. This often results in walking with the hip held in external (outward) rotation. You may complain of low back pain due to excessive extension with weight bearing. The low back pain is really due to compensating for limited hip movement due to hip osteoarthritis.

Common joints involved in primary osteoarthritis are the hips, knees, sacroiliac joint, acromioclavicular (shoulder and collar bone), first metacarpophalangeal (part of thumb joint), first metacarpotrapezium (part of thumb joint closer to wrist), and the distal interphalangeal joints (joints at tips of fingers).

Often initially asymptomatic, you will have a gradual increase in joint stiffness and pain. Moreover, deformity may be apparent such as  herberden’s nodes in the hands (bony bumps).  If not treated, primary osteoarthritis may eventually lead to joint subluxation (dislocation) and instability.


Primary osteoarthritis is due to progressive degeneration of the joint or joints involved by an accumulation of microtrauma.  A microtrauma is an injury resulting from repetitive stress to tissues. 

Dr. Meiri adjusts the patient's hip


  1. Secondary Osteoarthritis

Starting as young as the twenties, secondary osteoarthritis can occur at a younger age than primary osteoarthritis (>25 years old). It occurs equally in both men and women. Common joints involved are the glenohumeral (shoulder), acromioclavicular (shoulderblade and collarbone), sacroiliac ( sacrum and iliac  links spine and pelvis), hip, elbow, knee, foot, and hand. Secondary osteoarthritis is similar to primary osteoarthritis in signs and symptoms.  However, there may be a history of trauma to the joint(s) such as an accident or fall, or you may have other joint diseases. For example for the hip, you could have crystal deposition disease (i.e., gout).


Secondary osteoarthritis is due to other disorders or diseases/ injuries. These primary causes could be trauma, septic or inflammatory arthritis, slipped epiphyses (near growth plates of long bones in kids), dysplasias (rare genetic disorders in kids), fracture/dislocation, avascular necrosis (death of bone tissue due to a lack of blood supply), and acromegaly (disorder in adults in which the pituitary gland produces too much growth hormone).


  1. Erosive Osteoarthritis

Erosive osteoarthritis affects predominantly women (40-50 year olds).  The only joints involved are the interphalangeal joints of the hand.  Each finger on your hand, with the exception of the thumb, has three phalanges (bones that make up the fingers) separated by two joints known as interphalangeal joints.  Basically, erosive osteoarthritis is interphalangeal joint arthritis or arthritis of the fingers.

Erosive osteoarthritis is an Inflammatory variant of degenerative arthritis. It is characterized by cartilage degeneration and synovial proliferation (joint lining gets inflamed).  While pain is common in osteoarthritis, obvious inflammation (redness and swelling) is not. Osteoarthritis has traditionally been classified as a noninflammatory arthritis because obvious inflammation (redness and swelling) is considered a symptom of other types of arthritis. However, erosive osteoarthritis does have redness and swelling which makes it a variant.

Acute episodes that appear similar to inflammatory/synovial arthritis (e.g. rheumatoid arthritis) happens. Chronically, erosive osteoarthritis may evolve to subluxation (joint dislocation) and development of herberden’s nodes.  On x-ray, the findings are similar to the noninflammatory (primary or secondary) osteoarthritis with additional findings of central erosions (bone erosions seen on ray).


       4. Degenerative Spine Disease

Degenerative Spine Disease (Osteoarthritis of the spine) presents equally among both men and women (>30 year olds). Common spinal joint levels involved are cervical (neck) levels C5-C7, thoracic (midback) levels T2-T5, T10-T12, lumbosacral (lowback) levels L4-S1. Your pain and stiffness may range from mild to severely symptomatic. Osteoarthritis of the spine may contribute to intervertebral foramen (opening where nerve roots exit the spine between every two vertebrae) narrowing resulting in spinal stenosis. This puts pressure on the nerves that travel through the spine.



Dr. Natalie Meiri adjusts the knee


Chiropractic Care of Degenerative Arthritis of the Spine and Extremities at Meiri Chiropractic:

General program includes Chiropractic Manipulative Therapy to the spine and extremity (arms and legs) joints for 2-3 months. Then “maintenance of normal joint motion and function of the spine and extremities may be facilitated by adjusting/manipulation” (1).  

Additionally, manipulation of muscle contractures with soft tissue techniques may be accomplished with gentle PNF/PIR (e.g. post isometric relaxation) and/or myofascial release techniques. Next, therapeutic exercises for strengthening of the joint will help for active care at home.   Finally,  recommendations on anti-inflammatory diet will be of benefit for patients.

Research on How Chiropractic Adjustments Can Help With Arthritis

A 2017 review in the Journal of the American Medical Association, found that spinal manipulation reduces lower back pain. And a 2013 study published in Osteoarthritis and Cartilage found that patient education combined with 12 chiropractic treatments (twice a week for six weeks) were more effective for hip Osteoarthritis than a daily stretching program or patient education alone.


Getting regular chiropractic treatment at a West Palm Beach chiropractic center can help naturally relieve the pain and dysfunction of degenerative arthritis of the spine and extremities. Chiropractic is a holistic and natural way to not only treat existing conditions, but to keep your body in its best working condition.

Contact Meiri Chiropractic today at 561-253-8984  on Chiropractic Care of Degenerative Arthritis of the Spine and Extremities or/and other ailments.



(1) Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 3rd edition, 2011


Meiri Chiropractic