Chiropractic Procedures for the Sacroiliac Joint

Fig 1: Pressure on the sacroiliac joint
(larger view)

Fig 2: Low force, high amplitude manipulation
(larger view)

Chiropractic care is often considered as the first line of treatment for sacroiliac joint dysfunction. For patients with lower back pain that arises from the sacroiliac joint, a variety of chiropractic procedures can be applied, with these mechanical adjustments representing a relatively conservative form of treatment.

Back Pain Related to the Sacroiliac Joint

Lower back pain arising from the sacroiliac joint is most frequently caused by a trauma (such as a slip or fall) or the process of childbirth.

At times, no clear historical event can be determined, often making a chiropractic or other type of diagnosis difficult by history alone.

Chiropractic Procedures for Sacroiliac Joint Dysfunction

The goal of chiropractic treatment for sacroiliac pain is to utilize a method that is best tolerated by the patient with the goal of yielding the best outcome. Different patients respond better to different approaches, so the chiropractor may adopt various manipulations to treat sacroiliac joint dysfunction.

Chiropractic manipulation of the sacroiliac joint is usually accomplished with the patient lying down on his or her side. More specifically:

1. The knee opposite the side the patient is lying on is flexed and raised toward the patient's chest.
2. The bottom shoulder is positioned forward producing a stretch in the low back and pelvic region.
3. The chiropractor’s contact hand is placed over the sacroiliac joint and pressure is applied while the patient’s upper shoulder is tractioned backward and the knee is tractioned towards the floor (See Figure 1).

4. When the slack is removed from the lumbar spine, and the pre-manipulation position is determined to be comfortable, a low force, high amplitude manipulation is applied by the chiropractor and usually results in an audible release (created by oxygen, nitrogen, and carbon dioxide escaping from the joint).

This chiropractic maneuver creates the typical "crack" often associated with joint manipulation and sounds similar to "cracking the knuckles" (See Figure 2). While this "cracking" description of a chiropractic manipulation by a chiropractor may give an impression of something that is uncomfortable, the sensation is usually quite relieving almost immediately.

In fact, patients who have been treated with this approach in the past often request this procedure again when returning to a chiropractic clinic.

• Article written by:
• Steven G. Yeomans, DC

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