Sacroiliac Joint Treatment 

Sacroiliac joint

Sacroiliac joint treatment was redefined by Dr Clay Thompson. A violinist at school, he worked in a machine shop to earn a few dollars, gaining valuable mechanical experience. Unable to make a living from his music during the American Depression, he started working in an experimental agricultural equipment company while taking engineering courses.

After a serious injury he was greatly helped by a chiropractor, and entered Palmer College. Starting in practice with an old bench with a worn screw mechanism, he was surprised when relative affluence enabled him to buy a new solid table, but his patients scorned the new machine.

They preferred Mark I that conked as he adjusted them, leading him eventually to design a state of the art sacroiliac joint treatment protocol.

An inventor at heart, this konking by the table started Thompson thinking. In 1954 he finalized production of the first drop headpiece and ultimately collaborated with the Williams Healthcare company to build an adjusting table specialised in sacroiliac joint treatment; it used a pneumatically driven, segmented system, which quickly lowers the section of the patient’s body corresponding with the spinal region being adjusted.

The doctor thrusts at high speed, using minimal force because, while the thrust initiates the movement, the sudden drop helps to effect the adjustment of the fixated sacroiliac joint.

Leg length checks, palpation, Xrays and other appropriate orthopaedic tests are used by the Thompson practitioner in determining what to adjust.

This page was last updated by Dr Barrie Lewis on 1 January, 2019

Chiropractic help

Chiropractic help is the choice sacroiliac joint treatment.

Thompson drop sacroiliac joint treatment

Sacroiliac Joint Treatment

Chiropractic sacroiliac joint treatment enthusiasts often acclaim the Thompson adjusting table as the finest adjusting table in the world.

Then, there's the activator treament for the sacroiliac joint. 

Sacroiliac joint treatment was further refined by Arlan Fuhr and W.C. Lee who developed the Activator technique. Initially, the doctors used thumb thrusts, delivered at rapid rates of speed generated by elbow movement.

They developed the Activator instrument to reduce the injuries to doctors’ hands, and to ensure consistency of the adjustment. The instrument was patented in 1984 for use in the chiropractic help treatment to give consistent low force, high speed treatment to the sacroiliac and other joints.

Sacroiliac joint adjusting using the spring loaded instrument gives a specific line of drive and can be set to deliver force ranging from 9 to 33 pounds per square inch. Before an adjustment is administered, leg length checks and specific tests of joint motion are performed to identify the joints that require an adjustment.

Over 35,000 chiropractors have been trained in activator technique making it the most widely used sacroiliac technique worldwide.

Activator technique

You surgeons of London, who puzzle your pates,

to ride in your coaches and purchase estates,

give over, for shame, for your pride has a fall,

and the doctress* of Epsom has outdone you all.

* A female bonesetter.

Self-confessed batty chiropractor Bernard Preston writes delightful stories described as "Gems, both funny and healthful, from the life and work of a Chiropractor." You will find several stories about the sacro-iliac patient. For more information about Bats in my Belfry ...

Available in the Americas and South Africa as a paperback, and worldwide for a fraction of the price ($2.99) instantly from Amazon as an ebook.

Bats in my Belfry cover

"Keep only those special gems that you know you will return to for wisdom and fun. For the rest, gladly pass your books on for others to enjoy ..."

- Bernard Preston

"Never lend books, for no one ever returns them; the only books I have in my library are books that other folks have lent me."

- Anatole Francois Thibault (Anatole France)


Lumbar roll

This is the classic chiropractic technique, initially developed by D.D. Palmer, the founder of Chiropractic. The focus is on restoration of normal biomechanical function, and the correction of subluxated or fixated joints. Diversified adjusting of the spine uses specific lines of drives for all manual thrusts, allowing for specificity in correcting mechanical distortions of the spine and sacroiliac joint treatment.


Sacroiliac joint treatment and the name Clarence Gonstead go hand in hand. He is the chiropractor often accredited with taking adjusting from crude and rudimentary bone setting to an understandable and logical biomechanical science.

Growing up on a rural farm provided young Gonstead with plenty of opportunities to explore the mechanical world, as Thompson had done before before him, developing an enthusiasm for repairing tractors and early automobiles.

As a young adult he developed acute rheumatoid arthritis. Finally, after about two weeks in bed, unable to stand or walk of even have the bedcovers touch his knee and foot whilst under the care of the University doctors, he was greatly helped by a chiropractor who came to the house to care for Gonstead. After a series of adjustments of his sacroiliac joints, and rest, he could finally walk again. It was a life changing event for Gonstead, and ultimately he became one of the icons of sacroiliac joint adjusting.

SIJ adjusting was neglected in the BJ Palmer era during which chiropractic drifted into an era of adjusting the upper neck only. Although perhaps not his intent, Gonstead redefined the very nature of chiropractic, in particular refining sacroiliac joint treatment.

Knee chest table


Sacroiliac joint conditions respond to all of these techniques. Each have their own particular merit for adjusting the pelvis and most chiropractors will choose one or other sacro-iliac joint treatment that best suits the patient's condition.

Aside: Trolling the net you will find various people promising to train you in how to adjust the spine in a week, or a few weekend courses. I have spent nearly 30 years practising the art of manipulation, and I still find every back unique, and most backs a challenge. The thought of some quack teaching lay-people to do what is extremely complex, one of the real art forms, makes me feel not a little sick. After all, can you learn to bake a decent loaf of bread at a weekend course?

Exercises for sacroiliac joint pain

A simple set of back exercises are vital if you have suffered from chronic lower back pain. Done EVERY morning (they take only 40 seconds) before you get out of bed will make a world of difference. I NEVER miss them... EXERCISES FOR SACROILIAC JOINT PAIN... and also for a weak bladder. 

The sacroiliac joint's greatest enemy is the chair. Well, back pocket wallet would perhaps like to dispute that, and leg length inequality and low back pain is certainly in the running too for the top spot.

And the lower back's best friend? More exercise. These hula hoop exercises are obviously not for the acutely painful back, but the trick with the lower back is to exercise when it's not sore. Like brushing your teeth. 


  • Leg Length Inequality research (short leg)

Chiropractors widely use a variety of orthotics to compensate for a short leg. This is based on research repeatedly done, concluding that low back pain is commonly caused by a difference in leg length.

  • Foot dysfunction or pain?

Commonly we find a patient's sacro-iliac joint condition is related to the foot. It could be pain which makes them limp, or simply dysfunction.

If your SI-joint is not getting better, think FOOT. Read more about Chiropractic treatment of foot pain.


  1. Chiropractic Help
  2. Sacroiliac Joint
  3. Sacroiliac Joint Treatment

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

Do you have a problem that is not getting better?

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Interesting questions from visitors

CLS writes:

Greetings, Dr B.

You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong. Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what a DC does.

The quickest and most interesting way is to read one of my eBooks of anecdotes. Described by a reader as gems, both funny and healthful from the life and work of a chiropractor, you will love them. Priced right at $2.99, though Kindle fiddles the amount without telling me.