Low back pain (LBP) remains a leading cause of disability worldwide, with a substantial proportion (up to 35%) thought to be linked to the sacroiliac joint (SIJ). SIJ pain is traditionally categorized broadly as pregnancy-related, SIJ-specific pathologies and SIJ-related pain of other origin. Clinicians generally attempt to draw a diagnostic distinction between LBP with or without SIJ involvement, with the SIJ, when involved, either acting as the source of the nociception or as a dysfunctional biomechanical junction, which itself either becomes painful or causes pain to be referred to another location.
Differentiating SIJ pain versus SIJ movement dysfunction is an important factor in diagnosis. There are challenges, at least partly due to the ability of provocative tests to identify the SIJ as a source of pain but the corresponding inability of these tests to indicate the reason behind the joint sensitivity. SIJ movement dysfunction is often labelled as the driver of symptoms; however, the ability to reach diagnostic conclusions based on palpation of movement dysfunction has long been questioned. Despite these concerns, these concepts and associated provocative tests continue to be taught to clinicians.
These authors sought to review our current clinical knowledge and offer recommendations for practice based on the existing evidence…LOG IN OR SUBSCRIBE TO ACCESS THIS REVIEW!
THIS WEEK'S RESEARCH REVIEW: “Changing the Narrative in Diagnosis and Management of Pain in the Sacroiliac Joint Area”
This paper was published in Physical Therapy (2019) and this Review is posted in Recent Reviews, Sacroiliac Joint and the 2020 Archive.
SIJ assessment