Wieczorek Ashley, Campau Erin, Pionk Elizabeth, Gabriel-Champine Molly E, Ríos-Bedoya Carlos F
McLaren Bay Region.
McLaren Health Care.
Spartan Med Res J. 2021 Apr 13;6(1):21971. doi: 10.51894/001c.21971.
Low back pain is the most common type of global disability and annually costs the United States over two billion dollars. Opioids have been used to reduce low back pain, although current evidence concerning efficacy is lacking. Sacroiliac joint dysfunction (SIJD) is estimated to be a primary pain source of low back pain in between 10 and 25% of affected patients. The primary objective of this study was to evaluate the rate of SIJD identified through osteopathic techniques in a convenience sample of patients seeking low back pain treatment. The secondary objective was to assess prevalence of low back pain and SIJD among different age groups, and genders.
Retrospective chart reviews were completed the adult patients who had received osteopathic manipulative treatment for low back pain at Family Health and Wellness Center in Essexville, MI from January 2018 through June 2019. The prevalence of patients with SIJD was identified during reviews of osteopathic procedural documentation for patients seeking low back pain treatment. Data regarding patients' age, sex, and treatment modalities were also extracted. Descriptive statistics consisting of frequencies and percentages were calculated.
A total of 84 patient records were reviewed. A total of 51 (60.7%) patients seeking low back pain treatment were diagnosed with SIJD identified by osteopathic providers. This included patients with both lumbar and sacral diagnoses simultaneously. SIJD alone accounted for 26 (31%) of patients seeking treatment. Female patients were more likely to have SIJD involvement than males. Forty one (48.8%) treated patients were between 45-64 years old. Muscle Energy Technique was documented to be the most used for 68 (81%) patients. In addition, techniques tended to move from direct to indirect for older patients.
Our study demonstrated that SIJD appeared to contribute to low back pain in 51 (60.7%) of low back pain cases identified using osteopathic techniques. This is much greater than the previously reported percentages of 10 to 25%. One possible confounding influence included varied resident screening and reporting of sacral dysfunction. Since multiple areas of the body can be treated at one time, our current procedure notes did not allow for distinguishing between which types of modalities were used on each region or capture residents' preferred treatments.
Although further studies are needed, our results suggest that knowledge of SIJD's impact on low back pain could lead to improved patient outcomes such as decreased medical costs and opioid use.
下背痛是全球最常见的致残类型，每年给美国造成超过20亿美元的损失。阿片类药物已被用于减轻下背痛，尽管目前缺乏关于其疗效的证据。据估计，在10%至25%的受影响患者中，骶髂关节功能障碍（SIJD）是下背痛的主要疼痛来源。本研究的主要目的是评估在寻求下背痛治疗的便利样本患者中，通过整骨技术识别出的SIJD发生率。次要目的是评估不同年龄组和性别的下背痛和SIJD患病率。
对2018年1月至2019年6月在密歇根州埃塞克斯维尔市家庭健康与 Wellness 中心接受整骨手法治疗下背痛的成年患者进行回顾性病历审查。在审查寻求下背痛治疗患者的整骨程序文档时，确定SIJD患者的患病率。还提取了有关患者年龄、性别和治疗方式的数据。计算了包括频率和百分比在内的描述性统计数据。
共审查了84份患者记录。共有51名（60.7%）寻求下背痛治疗的患者被整骨治疗师诊断为SIJD，这包括同时患有腰椎和骶骨疾病的患者。仅SIJD就占寻求治疗患者的26名（31%）。女性患者比男性患者更易出现SIJD。41名（48.8%）接受治疗的患者年龄在45至64岁之间。记录显示，68名（81%）患者最常使用肌肉能量技术。此外，老年患者的技术使用倾向于从直接技术转向间接技术。
我们的研究表明，在使用整骨技术识别出的51例（60.7%）下背痛病例中，SIJD似乎是导致下背痛的原因。这远高于先前报道的10%至25%的比例。一个可能的混杂影响因素包括住院医师对骶骨功能障碍的筛查和报告存在差异。由于身体的多个部位可以同时接受治疗，我们目前的病程记录无法区分每个区域使用了哪种类型的治疗方法，也无法记录住院医师的首选治疗方法。
尽管需要进一步研究，但我们的结果表明，了解SIJD对下背痛的影响可能会改善患者的治疗效果，如降低医疗成本和减少阿片类药物的使用。
