Top

European Spine Journal

Published in:

01-10-2013 | Original Article

Treatment of the sacroiliac joint in patients with leg pain: a randomized-controlled trial

Authors: L. H. Visser, N. P. Woudenberg, J. de Bont, F. van Eijs, K. Verwer, H. Jenniskens, B. L. Den Oudsten

Published in: European Spine Journal | Issue 10/2013

Abstract

Purpose

The sacroiliac joint (SIJ) may be a cause of sciatica. The aim of this study was to assess which treatment is successful for SIJ-related back and leg pain.

Methods

Using a single-blinded randomised trial, we assessed the short-term therapeutic efficacy of physiotherapy, manual therapy, and intra-articular injection with local corticosteroids in the SIJ in 51 patients with SIJ-related leg pain. The effect of the treatment was evaluated after 6 and 12 weeks.

Results

Of the 51 patients, 25 (56 %) were successfully treated. Physiotherapy was successful in 3 out of 15 patients (20 %), manual therapy in 13 of the 18 (72 %), and intra-articular injection in 9 of 18 (50 %) patients (p = 0.01). Manual therapy had a significantly better success rate than physiotherapy (p = 0.003).

Conclusion

In this small single-blinded prospective study, manual therapy appeared to be the choice of treatment for patients with SIJ-related leg pain. A second choice of treatment to be considered is an intra-articular injection.

Available only for authorised users

Health Council of the Netherlands (1999) Management of the lumbosacral radicular syndrome (sciatica); The Hague: Health Council of the Netherlands, publication no. 1999-18

Buijs E, Visser L, Groen G (2007) Sciatica and the sacroiliac joint: a forgotten concept. Br J Anaesth 99:713–716PubMedCrossRef

Chen WS (1995) Chronic sciatica caused by tuberculous sacroiliitis. A case report. Spine (Phila Pa 1976) 20:1194–1196CrossRef

Humphrey SM, Inman RD (1995) Metastatic adenocarcinoma mimicking unilateral sacroiliitis. J Rheumatol 22:970–972PubMed

Fortin JD, Aprill CN, Ponthieux B, Pier J (1994) Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part II: clinical evaluation. Spine (Phila Pa 1976) 19:1483–1489CrossRef

Fortin JD, Dwyer AP, West S, Pier J (1994) Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part I: asymptomatic volunteers. Spine (Phila Pa 1976) 19:1475–1482CrossRef

Fortin JD, Vilensky JA, Merkel GJ (2003) Can the sacroiliac joint cause sciatica? Pain Phys 6:269–271

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

Visser LH, Nijssen PGN, Tijssen CC, Van Middenkoop J, Schieving J (2013) Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis. Eur Spine J. doi:10.1007/s00586-013-2660-5

10.

Laslett M (2008) Evidence-based diagnosis and treatment of the painful sacroiliac joint. J Man Manip Ther 16:142–152PubMed

11.

Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 305:160–164PubMedCrossRef

12.

Grilo RM, Treves R, Preux PM, Vergne-Salle P, Bertin P (2007) Clinically relevant VAS pain score change in patients with acute rheumatic conditions. Joint Bone Spine 74:358–361PubMedCrossRef

13.

Schwarzer AC, Aprill CN, Bogduk N (1995) The sacroiliac joint in chronic low back pain. Spine (Phila Pa 1976) 20:31–37CrossRef

14.

Merskey H, Bogduk N (1994) Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. IASP Press, Seattle, pp 190–191

15.

Szadek KM, van der Wurff WP, van Tulder MW, Zuurmond WW, Perez RS (2009) Diagnostic validity of criteria for sacroiliac joint pain: a systematic review. J Pain 10:354–368PubMedCrossRef

16.

Berthelot JM, Labat JJ, Le GB, Gouin F, Maugars Y (2006) Provocative sacroiliac joint maneuvers and sacroiliac joint block are unreliable for diagnosing sacroiliac joint pain. Joint Bone Spine 73:17–23PubMedCrossRef

17.

Depalma MJ, Ketchum JM, Trussell BS, Saullo TR, Slipman CW (2011) Does the location of low back pain predict its source? PM R 3:33–39PubMedCrossRef

18.

Liliang PC, Lu K, Weng HC, Liang CL, Tsai YD, Chen HJ (2009) The therapeutic efficacy of sacroiliac joint blocks with triamcinolone acetonide in the treatment of sacroiliac joint dysfunction without spondyloarthropathy. Spine (Phila Pa 1976) 34:896–900CrossRef

19.

Sasso RC, Ahmad RI, Butler JE, Reimers DL (2001) Sacroiliac joint dysfunction: a long-term follow-up study. Orthopedics 24:457–460PubMed

Title: Treatment of the sacroiliac joint in patients with leg pain: a randomized-controlled trial
Authors: L. H. Visser
N. P. Woudenberg
J. de Bont
F. van Eijs
K. Verwer
H. Jenniskens
B. L. Den Oudsten
Publication date: 01-10-2013
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 10/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-013-2833-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Treatment of the sacroiliac joint in patients with leg pain: a randomized-controlled trial

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 10/2013

The percutaneous stabilisation of the sacroiliac joint with hollow modular anchorage screws: a prospective outcome study

AO spine classification system for thoracolumbar fractures

Association of clinical parameters of operatively treated thoracolumbar fractures with quality of life parameters

Biomechanical characteristics of cement/gelatin mixture for prevention of cement leakage in vertebral augmentation