Biomechanical Sacroiliac Joint Pain: Therapy [Clinical Review Discussion]

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.