Skip to main content
Erschienen in: European Spine Journal 10/2013

01.10.2013 | Original Article

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

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

Erschienen in: European Spine Journal | Ausgabe 10/2013

Einloggen, um Zugang zu erhalten

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.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Health Council of the Netherlands (1999) Management of the lumbosacral radicular syndrome (sciatica); The Hague: Health Council of the Netherlands, publication no. 1999-18 Health Council of the Netherlands (1999) Management of the lumbosacral radicular syndrome (sciatica); The Hague: Health Council of the Netherlands, publication no. 1999-18
2.
Zurück zum Zitat Buijs E, Visser L, Groen G (2007) Sciatica and the sacroiliac joint: a forgotten concept. Br J Anaesth 99:713–716PubMedCrossRef Buijs E, Visser L, Groen G (2007) Sciatica and the sacroiliac joint: a forgotten concept. Br J Anaesth 99:713–716PubMedCrossRef
3.
Zurück zum Zitat Chen WS (1995) Chronic sciatica caused by tuberculous sacroiliitis. A case report. Spine (Phila Pa 1976) 20:1194–1196CrossRef Chen WS (1995) Chronic sciatica caused by tuberculous sacroiliitis. A case report. Spine (Phila Pa 1976) 20:1194–1196CrossRef
4.
Zurück zum Zitat Humphrey SM, Inman RD (1995) Metastatic adenocarcinoma mimicking unilateral sacroiliitis. J Rheumatol 22:970–972PubMed Humphrey SM, Inman RD (1995) Metastatic adenocarcinoma mimicking unilateral sacroiliitis. J Rheumatol 22:970–972PubMed
5.
Zurück zum Zitat 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, 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
6.
Zurück zum Zitat 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, 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
7.
Zurück zum Zitat Fortin JD, Vilensky JA, Merkel GJ (2003) Can the sacroiliac joint cause sciatica? Pain Phys 6:269–271 Fortin JD, Vilensky JA, Merkel GJ (2003) Can the sacroiliac joint cause sciatica? Pain Phys 6:269–271
8.
Zurück zum Zitat Cohen SP (2005) Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Anesth Analg 101:1440–1453PubMedCrossRef Cohen SP (2005) Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Anesth Analg 101:1440–1453PubMedCrossRef
9.
Zurück zum Zitat 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 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.
Zurück zum Zitat Laslett M (2008) Evidence-based diagnosis and treatment of the painful sacroiliac joint. J Man Manip Ther 16:142–152PubMed Laslett M (2008) Evidence-based diagnosis and treatment of the painful sacroiliac joint. J Man Manip Ther 16:142–152PubMed
11.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Schwarzer AC, Aprill CN, Bogduk N (1995) The sacroiliac joint in chronic low back pain. Spine (Phila Pa 1976) 20:31–37CrossRef Schwarzer AC, Aprill CN, Bogduk N (1995) The sacroiliac joint in chronic low back pain. Spine (Phila Pa 1976) 20:31–37CrossRef
14.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Sasso RC, Ahmad RI, Butler JE, Reimers DL (2001) Sacroiliac joint dysfunction: a long-term follow-up study. Orthopedics 24:457–460PubMed Sasso RC, Ahmad RI, Butler JE, Reimers DL (2001) Sacroiliac joint dysfunction: a long-term follow-up study. Orthopedics 24:457–460PubMed
Metadaten
Titel
Treatment of the sacroiliac joint in patients with leg pain: a randomized-controlled trial
verfasst von
L. H. Visser
N. P. Woudenberg
J. de Bont
F. van Eijs
K. Verwer
H. Jenniskens
B. L. Den Oudsten
Publikationsdatum
01.10.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 10/2013
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-013-2833-2

Weitere Artikel der Ausgabe 10/2013

European Spine Journal 10/2013 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.