Chiropractic Treatment for Sacroiliac Joint Dysfunction

By Dr. Darren Snodgrass, DC

Dysfunction in the sacroiliac joint is a common cause of low back and/or leg pain. The pain is typically felt on one side of the low back or buttocks, and can radiate down the leg. The pain usually remains above the knee, but at times pain can extend to the ankle or foot. This pain pattern can often mimic the pain caused by a lumbar disc herniation or sciatica.

Low back pain arising from a 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. To this day, sacroiliac joint dysfunction can be difficult to diagnose because of the lack of non-invasive diagnostic tests available to isolate the sacroiliac joint (short of anesthetic blocks specifically applied to the joint).

The sacroiliac joint lies next to the spine and connects the sacrum (the triangular bone at the bottom of the spine) with the pelvis (iliac crest). The sacroiliac joint is:

• Small and very strong
• Transmits all the forces of the upper body to the pelvis (hips) and legs
• Acts as a shock-absorbing structure
• Does not have much motion

For patients with low back pain that arises from the sacroiliac joint, a variety of chiropractic procedures can be applied. These mechanical adjustments are a relativity conservative form of care. Chiropractic care is often considered as the first line of treatment for sacroiliac joint dysfunction. Different patients respond better to different approaches, so chiropractors may adopt various chiropractic techniques to treat sacroiliac joint dysfunction.

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:

• Gravity traction using adjusting blocks
• Respiratory assisted adjusting, long-axis leg traction techniques
• A "drop" approach utilizing a special type of treatment table

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.

Similarly, muscle-strengthening chiropractic techniques are often applied to weak gluteal muscles, low back stabilizing 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.

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.