Gentle Chiropractic Techniques for the Sacroiliac Joint

gravity traction
Fig 1: Gravity traction
(larger view)

respiratory assisted adjusting
Fig 2: Respiratory assisted adjusting
(larger view)

Drop approach
Fig 3: "Drop" approach
(larger view)

Flexion distraction
Fig 4: "Flexion distraction"
(larger view)

Some patients with low back or buttock pain resulting from sacroiliac joint dysfunction may favor a more gentle chiropractic treatment over the traditional spinal manipulation techniques.

Less forceful spinal manipulation involves slower (low-velocity) techniques that allow the joint to remain within its passive range of motion. Gentle chiropractic techniques include:

  • Gravity traction using adjusting blocks: Padded "blocks" that vary in shape and size are strategically placed underneath the body. With the patient lying face down, the practitioner can gently reposition the sacroiliac joint and other areas, employing gravity from the block instead of relying solely on force. (See Figure 1)
  • Respiratory-assisted adjusting, long-axis leg traction techniques: While the chiropractor gently pulls a leg at a specific angle, the patients takes deep breaths to facilitate the adjustment. (See Figure 2)
  • A "drop" approach using a special chiropractic table: This table has sections that can be raised up to be dropped at the same time as the thrust, allowing gravity to assist the adjustment. (See Figure 3)
  • A specialized adjusting tool or device called an Activator: The Activator is a spring-loaded instrument that is used during an adjustment to provide a low-force impulse directed at specific locations along the spine.
  • The "flexion distraction" technique: Flexion distraction involves the use of a specialized table that gently distracts, or stretches, the spine. The chiropractor is able to isolate the area of pain while slightly flexing the spine in a pumping rhythm. (See Figure 4).
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Gentle Chiropractic Mobilization vs. Adjustment

Gentle chiropractic techniques typically do not involve twisting of the body. There are several reasons a chiropractor may recommend gentle chiropractic techniques over a traditional high-velocity, low-amplitude chiropractic adjustment, such as:

  • Patient preference: Some patients simply do not feel comfortable with the traditional high-velocity thrust manipulation and prefer an approach that does not involve twisting or joint "popping."
  • Contraindications: Some patients may not be able to tolerate traditional chiropractic manual manipulation, such as patients with certain types of spinal instability or advanced osteoporosis.

In addition to one or a combination of spinal manipulation techniques, the chiropractor may recommend various combinations of adjunctive therapy for sacroiliac joint pain.