THE SACROILIAC JOINT-VICTIM OR CULPRIT

BACKGROUND & OBJECTIVE:

10-30% of all low back pain cases and 20-80% of all pelvic pain cases may be attributed to the sacroiliac joint (SIJ) (1, 2). Pregnant women, athletes playing football, basketball, golf; and people using elliptical, stair stepper machines and step aerobics are predisposed to developing SIJ pathology (2, 3). There is a lack of clarity on the aetiology and the most rational treatment approach to treat these pathologies. This review aimed to identify the source of pain in SIJ pathologies and therefore determine whether the treatment must be directed locally at the SIJ or at the factors/structures potentially generating pain at the SIJ.

A combination of pain provocation tests and the ASLR test is the most appropriate clinical examination method to establish SIJ pain presently

METHODS

This comprehensive literature review included publications on topics such as SIJ anatomy and function, causes of SIJ dysfunction, clinical assessment of SIJ, and management of the painful SIJ. The clinical recommendations in this review are based on the 98 included publications dated from 1988 to 2018.

RESULTS

Causes: Trauma is the only established cause for SIJ pain. Two causative theories for SIJ pain are impairment in force closure, and maladaptation from lumbar and lumbosacral fusion. Impairment in force closure can be caused by trauma, ligamentous laxity at

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