J Manipulative Physiol Ther. 1993 Feb; 16(2): 82-90.
Treatment and biomechanical assessment of patients with chronic sacroiliac joint syndrome.
National Institute of Chiropractic Research, Phoenix, AZ 85018.
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.