Pain in the lumbar region, buttocks, and legs is often caused by dysfunction in the sacroiliac joints. Also known as the SI joint, its primary purpose is to absorb shock between the lower extremities and upper body. The joint itself moves minimally and is supported by ligaments that aid in shock absorption. Muscles in the thigh region and buttocks also provide the support needed for optimal functioning of the sacroiliac joints.

When an individual experiences SI joint pain, it can often be confused for sciatica (if the pain is radiating down the legs) or other common underlying problems that cause lower back pain. Therefore, if you are experiencing symptoms of sacroiliac joint dysfunction, it is recommended that you visit your physician sooner rather than later.  

After an accurate diagnosis has been made, your doctor will suggest the best line of treatment for sacroiliac joint pain. Generally, the preferred and most effective treatment for this is chiropractic care. Depending on the patient’s medical history and tolerance to spinal adjustments, the chiropractor will choose one or more effective techniques (as per the individual’s comfort level) to treat their sacroiliac joint dysfunction.

How Sacroiliac Joint Dysfunction is Treated With Chiropractic 

The type of chiropractic treatment used to treat sacroiliac joint pain will depend on how the patient responds to each approach and, as mentioned earlier, their medical history and/or current underlying health issues. 

Let’s take a look at the two types of chiropractic approaches used to treat dysfunction of the SI joint.

Spinal Mobilisation Techniques

This is a gentle, low-velocity adjustment that is typically recommended for individuals with advanced osteoporosis, severe spinal conditions, or those who are uncomfortable with the force, twisting of the body, and ‘cracking’ and ‘popping’ sounds of high-intensity, low-amplitude (HVLA) thrusts. With spinal mobilisation, the treatment ensures that the joint is not moved past its natural range of motion.

The most common spinal mobilisation techniques to treat sacroiliac joint dysfunction are mentioned below.

Gravity Traction with Padded Aids

On a chiropractic table, the patient is made to lie face down over padded aids that are differently shaped (square, round, etc), and placed in various positions under the body to allow gravity to play a role in the adjustment. This helps replace an HVLA thrust with gentle pressure to reposition the SI joint. 

Activator Technique

For this technique, the chiropractor uses a handheld tool that applies a small amount of force to a targeted point of the spine. Known as the ‘Activator’, this device is equipped with a spring that helps perform the quick, low-force push. 

Breathing + Leg Traction Technique

Deep breathing is important when receiving spinal mobilisation as it assists the adjustment. During this technique, the practitioner will position the legs at specific angles and, one at a time, he or she will gently pull a leg and ask that the patient breathe deeply (simultaneously).

Drop-Table Technique

The patient is made to lie down on a specialised table that is divided into two or more sections. To treat sacroiliac joint dysfunction, the chiropractor will raise different sections of the table (typically not more than two inches); then, while applying a gentle thrust to a targeted region around the joint, the section(s) of the table in that specific area will simultaneously drop down, thus allowing gravity to facilitate the adjustment.

Spinal Manipulation for Sacroiliac Joint Dysfunction

High-velocity, low-amplitude adjustments are extremely effective in successfully treating sacroiliac joint pain. Between spinal mobilisation and spinal manipulation, the latter is often the first-choice approach among chiropractors, provided that the patient is eligible for the treatment, and that they are willing to go forward with it.

When treating dysfunction of the SI joint, chiropractic adjustments are carried out in the following manner:

1. On a general chiropractic table, the patient will lie down on their side. 
2. The top hip and knee should be fully flexed with the knee bent and positioned forward (towards the chest) while the foot rests on the bottom leg between the inner thigh and knee. The bottom leg should be slightly bent at the knee.
3. The head is slightly raised with an elevated headrest to keep the neck and spine aligned.
4. The shoulder that the patient is lying on is moved forward to produce and hold a gentle stretch around the pelvic area and lower back.
5. To begin the adjustment, the chiropractor pushes the top shoulder back slightly and holds it in position; using the other hand, they will apply pressure to the sacroiliac joint, pushing down to the point of its maximum range of motion. 
6. After ensuring that the patient is comfortable and ready for the adjustment, the chiropractor will apply an HVLA thrust that safely pushes the SI joint outside its range of motion, thereby releasing carbon dioxide, nitrogen, and oxygen.

Depending on how the patient’s body responds to the treatment, the chiropractor will determine how many sessions it will take to successfully treat sacroiliac joint dysfunction and/or if they require other treatment such as adjunctive therapy. 

At MSK Therapy, you can avail a wide range of chiropractic treatments which include advanced techniques to get rid of sacroiliac joint pain safely. Rest assured that we are a team of fully trained, licensed, and experienced practitioners who treat patients with the utmost care and respect. To consult with a chiropractor for sacroiliac joint pain or lower back pain, book an appointment at MSK Therapy today!