Physiotherapy For Si Joint Pain

Abstract

[Purpose] The aim of this study is to investigate the effectiveness of physical therapy interventions in the treatment of sacroiliac joint dysfunction (SIJD). [Subjects & Methods] MEDLINE. PUBMED. CINAHL. AMED. PEDro. and CIRRIE databases were searched. The inclusion criteria required that only data relevant to the studies were included. To assess the quality and relevance of included studies, CASP tools were used for critical appraisal. [Results] 9 articles were included. Three of them examined exercise’s effect on SIJD. Three others used kinesiotape, while four other studies looked at the effects of manipulation. Different outcomes were considered, including Oswestry’s disability questionnaire (ODQ), the visual analogue (VAS), Oswestry pain rating (NPRS), numerical pain rating (NPRS), as well as pelvic position measurement (PALM), photogrammetry, and pelvimeter. Due to limitations in CASP tools, which were used to validate the studies, the quality ranged between low and average. Results showed that SIJD can be treated with physiotherapy. The most common intervention is manipulation, which was most often used in physical therapy clinics. Conclusion. SIJD can be treated with manipulation, exercise, and kinesio taping.

Abstract

[Purpose] The aim of this study is to investigate the effectiveness of physical therapy interventions in the treatment of sacroiliac joint dysfunction (SIJD). [Subjects & Materials] The MEDLINE databases and the CINAHL, AMED (PEDro), CINAHL, AMED, PEDro and CIRRIE databases have been searched. We only included relevant data from studies which met our inclusion criteria. Critical appraisal was performed using CASP tools to judge the quality of inclusions. [Results] Nine papers met the criteria. Three examined the impact of exercise on SIJD. Three examined the use of kinesiotape. Four studies evaluated the effects of manipulation. There were many outcomes, including Oswestry disability questionnaires (ODQ), visual analogue pain scales (VAS), numerical pain rating system (NPRS), and pelvic positioning measurement (PALM and pelvimeter) The quality of included studies ranged from low to average as the CASP tools revealed several limitations that affect the validity of the studies. Results showed that SIJD can be treated with physiotherapy. The most common intervention is manipulation, which was most often used in physical therapy clinics. [Conclusion] SIJD treatment includes manipulation, exercise and kinesiotap.

Keywords: Physiotherapy; Sacroiliac joint dysfunction; Systematic review.

Physiotherapy Therapy

SI dysfunction that has been present for less time than 3 months is when physiotherapy treatment can be most beneficial. Beyond that time, physiotherapy is expensive and requires a high compliance rate.

SIJ dysfunction is often diagnosed first by physiotherapists, who are frequently mistaken for it. There are many options available for treating SIJ dysfunction.

The release of the proximal gluteal muscles. Most often, this is done badly by physiotherapists. This results in painful and sometimes even fatal treatments. These treatments are essential for recovery. They should be painless.

Joint mobilisations of the lumbar and sacroiliac muscles

Appropriate sacroiliac brace fitting

These exercises, which include core strengthening and pelvic floors exercises, have limited support. However it is difficult to believe that they will be funded by third-party insurers.

It is important to note that there is not any evidence supporting the use of ultrasonography for ANY type of pathology.

Be wary of the therapist who advocates expensive rehabilitation programmes. There is little evidence that a program is effective, and even less patient acceptance.

Surgical Treatments

SI joint fusion can be very successful. But it’s not often done. This is complex, high-risk surgery.

Take home message

Over-diagnosed in physiotherapy and under-diagnosed in doctors.

It is possible to use physiotherapy to manage lumbar discomfort

Local anaesthetic (+/- Steroid) is the best choice for diagnosing problems. It will not provide long-term relief.

It is crucial to keep a detailed pain diary after SI/LA injections.

Poor diagnostic indicators include imaging.

Extremely rare in males and nulliparous women.

Coordinate rhizotomy with a pain doctor to arrange follow up injections as well as physiotherapy. To achieve complete recovery, it is important to provide quality after-care.

If you have persistent lumbar and benign imaging pain, consider this diagnosis.

How Can We Treat Sij Pain And Dysfunction?

Exercise! As stated above, SIJ dysfunction and pain can be attributed to muscle weakness. Once you have taken care of the pain with medication and heat/ice if necessary, it is time to focus your attention on exercises that activate and strengthen muscles. These will assist in stabilizing the joint.

Exercises will be specifically targeted to the muscles that are identified to be weak, as well as general advice given on lifestyle modifications and prevention of recurrence.

In addition to strengthening your muscles, deep tissue massage or stretching may help relieve muscular tensions. These can have an immediate effect on pain relief and dysfunction.

Examples of some SIJ exercises include:

TA activation exercise

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Birddog

Resisted Hip Extension

Hip adduction in the side (isometric).

If you are or know someone who is suffering from SIJ pain, please contact us ono 1800 992 999 or email admin@msphysiotherapyaustralia.com to book an appointment for diagnosis and initial assessment today! Or, you can contact us with any questions.

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