Treatment and biomechanical assessment of patients with chronic sacroiliac joint syndrome.

OBJECTIVE

To evaluate diagnostic and biomechanical correlates and treatment outcomes of manipulative/adjustive care in patients highly selected for sacroiliac joint syndrome (SIJS).

DESIGN

Descriptive case series, 1 wk baseline, 1 yr follow-up.

SETTING

Private chiropractic practice.

PATIENTS

Ten out of 153 consecutive new patients (4 male and 6 female) with "primary," chronic, uncomplicated SIJS were selected over an 11-mo period on the basis of painful SIJ and provocation tests.

MAIN OUTCOME MEASURES

Back pain (visual analogue scale), Oswestry disability index, lumbar provocation tests and biomechanical measures of gait and postural sway.

INTERVENTION

Six-wk regimen of mechanical force, manually assisted, short lever adjustments (MFMA) with an Activator instrument.

RESULTS

Pain decreased significantly from a mean baseline value of 25 to 12 (t = 2.28; p < .05). Likewise, the average disability scores diminished from 28 to 13% (t = 2.3; p < .05), and a reduction in the number of positive provocation tests was noted (Fisher Exact Probability range Z = 0.025-0.045). Gait and sway parameters were indistinguishable from normals, before or after treatment. Response to the 1-yr follow-up questionnaire (6/10) revealed stability of symptoms at a low level.

CONCLUSIONS

While the majority of subjects recorded some degree of positive outcome, we conclude that: a) discrete SIJS remains difficult to diagnose, but may be possible by judicious choice of screening tests; b) MFMA may benefit some patients with chronic SIJ pain; and c) gait and sway measurement yielded no correlation with clinical conditions.