Elsevier

Disease-a-Month

Volume 50, Issue 12, December 2004, Pages 670-683
Disease-a-Month

Sacroiliac joint pain

https://doi.org/10.1016/j.disamonth.2004.12.004Get rights and content

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Anatomy and biomechanics

A good understanding of the anatomy and biomechanics of the hip, pelvis, and lumbar spine and their relationships to each other is essential in devising a comprehensive treatment program. The pelvis serves as the central base through which forces are transmitted both directly and indirectly. Inherently, the joints of the pelvis are stable joints. Repetitive or high injury loads can lead to ligamentous, bony, and muscle overuse syndromes. Adaptive patterns may occur in the pelvis as a result of

History and presentation

Patients with posterior pelvic pain as a diagnosis may present with a wide variety of complaints. Gluteal pain near or surrounding the posterior superior iliac spine is the most common region as described by Fortin and Colleagues.12, 13 Other symptoms include groin pain, pain radiating into the lower extremity, numbness, and clicking or popping in the posterior pelvis. Pain and/or clicking with transitional activities such as getting up from a chair or in and out of a car may also be noted.

Acute phase (1–3 days)

Acute injury is often associated with a direct trauma such as a fall or marked increase in intensity, frequency, or duration of a specific activity. Often, SIJ pain presents as a progressive problem with fluctuations in symptoms. The patient may only experience symptoms during certain activities including sports or exercise. In the acute setting taking anti-inflammatory medications and icing the areas are helpful. Relative rest after an acute injury assists with pain management. This includes

Conclusion

Sacroiliac joint pain should be considered in the differential diagnosis of patients with low back pain, posterior pelvic pain, and groin pain. Unfortunately the diagnosis and treatment of SIJ pain and dysfunction can be difficult. The healthcare provider needs to have a good understanding of the integrated biomechanics of the spine, pelvis, and hips to guide both the evaluation and the treatment. Care should be taken not to miss concomitant instigating problems outside the SIJ, including

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      The use of the PCB also allows women with pelvic girdle pain to perform active straight leg raising (ASLR) with fewer difficulties (Mens et al., 2006). Therefore, it is often recommended that patients suffering from SIJP wear the PCB while walking and standing (Prather and Hunt, 2004), and many clinicians have incorporated the use of the PCB into their routine therapy (Liebenson, 2004; Mens et al., 2006). The mechanical action of the PCB may alter the activation pattern of the lumbopelvic muscles, depending on where the PCB is worn (Pel et al., 2008).

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