Prevalence of concomitant sacroiliac joint dysfunction in patients with image proven herniated lumbar discs

  Abstract   Background: Sacroiliac joint (SIJ) dysfunction is a widely known but poorly defined   cause of low back pain. To our knowledge, few published studies have been   conducted to evaluate systematically the prevalence and significance of concomitant   sacroiliac joint dysfunction in patients with herniated lumbar discs. As concomitant   SIJ dysfunction in low back pain patients is likely to respond to particular noninvasive   interventions such as manipulation, improved understanding of the relationship   between these two diagnoses would improve clinical decision making and research.   Methods: This study was designated to estimate the prevalence of concomitant   sacroiliac joint dysfunction in sub acute low back pain patients with image proven   discopathy and evaluate the theory that sacroiliac joint dysfunction can be a source of   pain and functional disability in discopathy. A total of 202 patients with sub acute   radicular back pain and MRI proven herniated lumbar discs underwent standardized   physiatrist history and physical examination, specified for detection of concomitant   sacroiliac joint dysfunction.   Results: Sacroiliac joint dysfunction is a concomitant finding in 72.3% of evaluated   patients. There was significantly higher SIJ dysfunction prevalence in female   patients (p <0.001), patients with recurrent pain (p <0.005) and in patients with positive   straight leg raising provocative test (p <0.0001).   Conclusion: SIJ dysfunction is a significant pathogenic factor with high   possibility of occurrence in low back pain. Thus, in the presence of   radicular and sacroiliac joint symptoms, SIJ dysfunction, regardless of   intervertebral disc pathology, must be considered in clinical decision   making.