ChiroACCESS Clinical Review



Biomechanical Sacroiliac Joint Pain: Therapy

This information is provided to you for use in conjunction with your clinical judgment and the specific needs of the patient.

Lead Author(s): 

Dwain M. Daniel, D.C.

  

How this evidence was rated:

Strength of Recommendation Taxonomy (SORT)



Published on

June 25, 2007

Text Size:     
Prior to 1934, when Mixter and Barr published their paper suggesting rupture of the intervertebral disc as a major source of low back pain, the sacroiliac joint (SIJ) was considered as the primary source of low back pain (1). The SIJ was rapidly forgotten as a significant pain source in the rush to embrace the disc. In the 1990s interest in the SIJ was revived as technology provided new insights into diagnosis and treatment. Today 10% to 27% of chronic low back pain is attributed to the SIJ (2). Although this represents a rather large population of chronic low back pain sufferers, understanding, diagnosing and treating the SIJ is still awaiting many research answers. The innervation of the joint is argued in the literature (2;3), diagnostic tests are wanting, the evidence for the gold standard for diagnosis is limited and treatment options are poorly investigated. Much needs to be accomplished from a research prospective in order to provide the physician with better tools to treat patients.

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References

1. 

Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med 1934; 211:210-215.



2. 

Hansen HC, McKenzie-Brown AM, Cohen SP, Swicegood JR, Colson JD, Manchikanti L. Sacroiliac joint interventions: a systematic review. Pain Physician 2007; 10(1):165-184.



3. 

Hansen HC, Helm S. Sacroiliac joint pain and dysfunction. Pain Physician 2003; 6(2):179-189.



4. 

Shearar KA, Colloca CJ, White HL. A randomized clinical trial of manual versus mechanical force manipulation in the treatment of sacroiliac joint syndrome. J Manipulative Physiol Ther 2005; 28(7):493-501.



5. 

Osterbauer P, Deboer K, Widmaier R, Petermann E, Fuhr A. Treatment and Biomechanical Assessment of Patients with Chronic Sacroiliac Joint Syndrome. J Manipulative Physiol Ther 1993; 16(2):82-90.



6. 

Beazel J, Hammill-Ruth R, Roberts D. SI joint injections with manipulation: A study in therapeutic efficacy. J Manual and Manipulative Therapy 2004; 12(3):160.



7. 

Damen L, Spoor CW, Snijders CJ, Stam HJ. Does a pelvic belt influence sacroiliac joint laxity? Clin Biomech (Bristol , Avon ) 2002; 17(7):495-498.



8. 

Mens JM, Damen L, Snijders CJ, Stam HJ. The mechanical effect of a pelvic belt in patients with pregnancy-related pelvic pain. Clin Biomech (Bristol , Avon ) 2006; 21(2):122-127.



9. 

Mooney V, Pozos R, Vleeming A, Gulick J, Swenski D. Exercise treatment for sacroiliac pain. Orthopedics 2001; 24(1):29-32.



10. 

Richardson CA, Snijders CJ, Hides JA, Damen L, Pas MS, Storm J. The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine 2002; 27(4):399-405.



11. 

Monticone M, Barbarino A, Testi C, Arzano S, Moschi A, Negrini S. Symptomatic efficacy of stabilizing treatment versus laser therapy for sub-acute low back pain with positive tests for sacroiliac dysfunction: a randomised clinical controlled trial with 1 year follow-up. Eura Medicophys 2004; 40(4):263-268.



12. 

Schuit D, McPoil TG, Mulesa P. Incidence of sacroiliac joint malalignment in leg length discrepancies. J Am Podiatr Med Assoc 1989; 79(8):380-383.



13. 

Forst SL, Wheeler MT, Fortin JD, Vilensky JA. The sacroiliac joint: anatomy, physiology and clinical significance. Pain Physician 2006; 9(1):61-67.



14. 

Cohen SP. Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Anesth Analg 2005; 101(5):1440-1453.



15. 

Chakraverty R, Dias R. Audit of conservative management of chronic low back pain in a secondary care setting--part I: facet joint and sacroiliac joint interventions. Acupunct Med 2004; 22(4):207-213.