Less forceful chiropractic manipulation techniques

At times, a less forceful chiropractic treatment approach for sacroiliac joint problems may be favored. There are several treatment approaches of this variety that can be utilized. These techniques include, but are not limited to:

• Stretching
• Gravity traction using adjusting blocks (Figure 1)
• Respiratory assisted adjusting, long-axis leg traction techniques (Figure 2)
• A "drop" approach utilizing a special type of treatment table (Figure 3),
• A specialized adjusting tool or device called an Activator, as well as a technique called "flexion distraction" (Figure 4).

The choice as to which chiropractic technique the chiropractor applies for sacroiliac joint pain and/or low back pain is case specific and often results from prior approaches that did not yield the desired result.

Muscle relaxation and strengthening in chiropractic care
Muscle release techniques are often applied during chiropractic treatments in order to minimize excessive strain on the sacroiliac joint arising from an overly tight muscle. Muscles that may require stretching as part of chiropractic care include (but are not limited to) the:

• Hamstrings
• Piriformis
• Adductors
• TFL
• Overly tight low back paraspinal muscles

Similarly, muscle-strengthening chiropractic techniques are often applied to weak gluteal muscles, low back stabilizing muscles, and/or the abdominal muscles.

Specific home-based exercises designed to strengthen the phasic (weak) muscles and/or stretch the tonic (overly tight) postural muscles are often prescribed by chiropractors.

Additional chiropractic treatments
At times, when low back pain arising from the sacroiliac joint is not responding to treatments, an orthotic such as a sacroiliac belt or support can be helpful.

Examination and treatment of other associated chiropractic problems may be necessary to achieve long term results. For example, an anatomical short leg may be treated by the use of a shoe insert (heel lift, arch support/foot orthotics, or a combination of both) may be deemed necessary by the chiropractor.

Similarly, proper management of other spinal conditions that may co-exist may also be required to obtain a satisfying outcome for the chiropractic treatment.

Potential risks and complications of chiropractic treatment
When chiropractic treatment approaches are carefully applied by an experienced chiropractor there are very few serious side effects. For this reason, chiropractic manipulation for treatment of pain from the sacroiliac joint is often preferred prior to more invasive medical treatments.

By: Steven G. Yeomans, DC, FACO
May 7, 2000 (Updated December 27, 2000)