Effectiveness of Manual Therapy in the Management of Sacroiliac Joint Pain and Disability: A Narrative Review
DOI:
https://doi.org/10.62464/ah27hy14Keywords:
manual therapy, Sacroiliac joint pain, sacroiliac jointAbstract
Background: Sacroiliac joint pain and disability is a significant and expensive condition that drives up healthcare expenses. Ten to twenty-five percent of people who suffer low back pain (LBP) have SIJ listed as a contributing factor. Objective: The purpose of this review is to investigate the use of manual therapy for the management of SIJ syndrome, identify any gaps in the literature on the topic, and offer suggestions for future research in the area. Methods: This study was conducted as a narrative review. A search for relevant studies in English has been conducted across several databases, including PubMed NCBI, Trip Medical Database as well as PEDro – Physiotherapy Evidence Database, for randomized controlled trials (RCTs) published from 1992 to July 2024. The search included the use of manual therapy in SIJ dysfunction and pain management. Results: Nine RCTs were included. Manual therapy was shown to be the preferable course of treatment for pain and function disability when compared to alternative forms of therapy Conclusion: All of the studies in this review demonstrated the effectiveness of manual therapy in treating SIJ patients' pain and improving their functioning.
References
Bharti, N., Arora, M., & Anand, P. (2016). Effectiveness of therapeutic interventions in sacroiliac joint dysfunction: A systematic review. International Journal of Physiotherapy and Research, 4(3), 484-488.
Cormier, G., Patenaude, J., Massé-Alarie, H., Chouinard, A., & Schneider, C. (2021). Lumbopelvic motor control and sacroiliac joint pain: A scoping review. Journal of Sport Rehabilitation, 30(3), 400-412.
Dhinkaran, M., Sareen, A., & Arora, T. (2011). Comparative analysis of muscle energy technique and conventional physiotherapy in treatment of sacroiliac joint dysfunction. Indian Journal of Physiotherapy and Occupational Therapy, 5, 127-130.
Dogan, N., Sahbaz, T., & Diracoglu, D. (2021). Effects of mobilization treatment on sacroiliac joint dysfunction syndrome. Revista da Associação Médica Brasileira, 67, 1003-1009.
Dunning, J. R., Butts, R., Perreault, T., Mettille, J., & Nuñez, F. (2016). Upper cervical and upper thoracic spine manipulation versus mobilization and exercise in patients with mechanical neck pain: A multi-center randomized clinical trial. BMC Musculoskeletal Disorders, 17(1), 64.
Evjenth, O., & Hamberg, J. (1984). Muscle stretching in manual therapy: The spinal column and the temporo-mandibular joint. Alfta Rehab.
Fersum, K. V., Dankaerts, W., O'Sullivan, P. B., Maes, J., Skouen, J. S., Bjordal, J. M., & Kvale, A. (2010). Integration of subclassification strategies in randomised controlled clinical trials evaluating manual therapy treatment and exercise therapy for non-specific chronic low back pain: A systematic review. British Journal of Sports Medicine, 44(14), 1054-1062.
Hidalgo, B., Detrembleur, C., Hall, T., Mahaudens, P., & Nielens, H. (2014). The efficacy of manual therapy and exercise for different stages of non-specific low back pain: An update of systematic reviews. Journal of Manual & Manipulative Therapy, 22(2), 59-74.
Hussein, Y. I., Hassan, K. A., & EL-Nahass, B. G. E. (2022). Strain-counterstrain versus muscle energy technique in sacroiliac joint dysfunction: A randomized controlled trial. International Journal of Health Sciences, 6, 8738-8754.
Kamali, F., & Shokri, E. (2012). The effect of two manipulative therapy techniques and their outcome in patients with sacroiliac joint syndrome. Journal of Bodywork and Movement Therapies, 16(1), 29-35.
Kuczynski, J. J., Schwieterman, B., Columber, K., Knupp, D., Shaub, L., & Cook, C. E. (2012). Effectiveness of physical therapist administered spinal manipulation for the treatment of low back pain: A systematic review of the literature. International Journal of Sports Physical Therapy, 7(6), 647-662.
Miller, P. J., & Jones-Harris, A. R. (2005). The evidence-based hierarchy: Is it time for change? A suggested alternative. Journal of Manipulative & Physiological Therapeutics, 28(6), 453-457.
Mizuno, K., & Tsuji, H. (1993). Sacroiliac joint dysfunction: Evaluation and treatment. Orthopedic Surgery and Traumatology, 36, 1-6.
Nejati, P., Safarcherati, A., & Karimi, F. (2019). Effectiveness of exercise therapy and manipulation on sacroiliac joint dysfunction: A randomized controlled trial. Pain Physician, 22(1), 53-61.
Rana, K., & Bansal, N. (2009). Comparative analysis on the efficacy of GD Maitland's concept of mobilization & muscle energy technique in treating sacroiliac joint dysfunction. Indian Journal of Physiotherapy and Occupational Therapy, 3(2), 18-21.
Rubinstein, S. M., van Middelkoop, M., Assendelft, W. J., de Boer, M. R., & van Tulder, M. W. (2011). Spinal manipulative therapy for chronic low-back pain. Cochrane Database of Systematic Reviews, 2011(2), CD008112.
Shearar, K. A., Colloca, C. J., & White, H. L. (2005). A randomized clinical trial of manual versus mechanical force manipulation in the treatment of sacroiliac joint syndrome. Journal of Manipulative and Physiological Therapeutics, 28(7), 493-501.
Subahi, D., Sluijter, M. E., Colclough, K., Sluijter, J., & Eldabe, S. (2022). Sacroiliac joint pain: Anatomy, diagnosis and treatment. Nature Reviews Rheumatology, 18(12), 719-732.
Szadek, K. M., van der Wurff, P., van Tulder, M. W., Zuurmond, W. W., & Perez, R. S. (2009). Diagnostic validity of criteria for sacroiliac joint pain: A systematic review. The Journal of Pain, 10(4), 354-368.
Van der Wurff, P., Buijs, E. J., & Groen, G. J. (2006a). A multitest regimen of pain provocation tests as an aid to reduce unnecessary minimally invasive sacroiliac joint procedures. Archives of Physical Medicine and Rehabilitation, 87(1), 10-14.
Van der Wurff, P., Buijs, E. J., & Groen, G. J. (2006b). Intensity mapping of pain referral areas in sacroiliac joint pain patients. Journal of Manipulative and Physiological Therapeutics, 29(3), 190-195.
Van der Wurff, P., Meyne, W., & Hagmeijer, R. (2000). Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability. Manual Therapy, 5(1), 30-36.
Van Middelkoop, M., Rubinstein, S. M., Kuijpers, T., Verhagen, A. P., Ostelo, R., Koes, B. W., & van Tulder, M. W. (2011). A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. European Spine Journal, 20(1), 19-39.
Visser, L. H., Woudenberg, N. P., de Bont, J., van Eijs, F., Verwer, K., Jenniskens, H., & van Kleef, M. (2013). Treatment of the sacroiliac joint in patients with leg pain: A randomized-controlled trial. European Spine Journal, 22(10), 2310-2317.
Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., ... & Abraham, J. (2012). Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2163-2196.
Wreje, U., Nordgren, B., & Åberg, H. (1992). Treatment of pelvic joint dysfunction in primary care—A controlled study. Scandinavian Journal of Primary Health Care, 10(4), 310-315.
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