Sacroiliac Pain: A Clinical Approach for the Neurosurgeon

Moscote-Salazar, Luís Rafael; Alvis-Miranda, Hernando Raphael; Joaquim, Andrei Fernandes; Amaya-Quintero, Jessica; Padilla-Zambrano, Huber; Agrawal, Amit

doi:10.4103/jnrp.jnrp_171_17

Cited by 5 publications

(7 citation statements)

References 22 publications

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“…Prosedur blok diagnostik berupa injeksi lidokain 2% 1cc secara intraartikular pada bagian medial inferior sendi sakroiliaka dengan bantuan C-arm. Skala nyeri dievaluasi 15-30 menit pasca-injeksi, [3][4][5] jika nyeri menurun 75%, maka pasien dimasukkan ke dalam sampel penelitian.…”

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“…Perubahan yang didapatkan pada pemeriksaan radiologis juga sering kali bersifat asimtomatik, sehingga diagnosis nyeri sendi sakroiliaka tetap dapat ditegakkan meski tanpa kelainan radiologis. [4][5] Faktor lainnya yang dapat membantu menunjang diagnosis nyeri sakroiliaka adalah posisi tubuh yang mencetuskan dan memperberat nyeri serta pola area nyeri alih yang menyertai nyeri. Terdapat beberapa posisi tubuh yang mencetuskan nyeri tetapi belum ada penelitian yang mendalami posisi tubuh tersebut.…”

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Pola Distribusi Nyeri Alih Dan Posisi Tubuh Pencetus Nyeri Sendi Sakroiliaka

Siahaan

Puspitasari

Hartoyo

2018

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REFERRAL PAIN DISTRIBUTION PATTERN AND TRIGGERING POSITION OF SACROILIAC JOINT PAINABSTRACTIntroduction: sacroiliac joint (sIJ) contribution to cause low back pain is still widely debated. sIJ is hardly distinguished from facet joint pain or other musculoskeletal disorder causing low back pain and leads to diagnostic difficulties. There are several factors that contribute to SIJ pain diagnosis, which are referral pain area and triggering position.Aim: To investigate the distribution pattern of referral pain and position that could trigger the sacroiliac joint pain.Method: Patients with complaints of pain in buttock area and diagnosed as sIJ pain by intra articular block diagnostic test at Neurology Clinic of of siloam Hospitals Lippo Village between August to december 2017 were interviewed to record the area of referral pain and position which triggered the pain.Results: 114 subjects with complaint of buttock pain, ratio between men and women was 1:2.35 (n=34 and 80), were included in this study. Posterior compartment of the thigh (19.3%, n=22) is the most common referral pain area followed by lateral part of the thigh (11.4%, n=13). Getting up from sitting position and long period of sitting were the two most dominant factors that could trigger pain (61.4%, n=70 and 49.1%, n=56).Discussion: The referral pain distribution pattern of sacroiliac joint pain was dominated by the posterior part and lateral part of thigh, while getting up from sitting and long period of sitting is found in majority of the subjects as the most dominant triggering position.Keywords: Pain pattern, sacroiliac joint pain, triggering positionABSTRAKPendahuluan: Kontribusi nyeri sendi sakroiliaka sebagai penyebab nyeri pinggang masih menjadi perdebatan. Secara klinis, nyeri sendi sakroiliaka sulit dibedakan dengan nyeri sendi faset lumbal maupun gangguan muskuloskeletal lainnya sehingga menyulitkan dalam diagnosis. Terdapat faktor yang memengaruhi terjadinya nyeri sendi sakroiliaka antara lain posisi tubuh yang mencetuskan nyeri dan area nyeri alih yang menyertainya.Tujuan: Untuk mengetahui pola distribusi nyeri alih dan faktor posisi tubuh yang mencetuskan atau memperberat nyeri sendi sakroiliaka.Metode: Pasien yang datang dengan keluhan nyeri bokong yang terdiagnosis mengalami nyeri sendi sakroiliaka berdasarkan tes diagnostik injeksi blok intraartikular di poliklinik saraf RS Siloam Lippo Village dalam rentang waktu Agustus–Desember 2017 dilakukan wawancara untuk mengetahui area nyeri alih dan posisi pencetus nyeri.Hasil: Sebanyak 114 pasien dengan keluhan pada area bokong, rasio antara laki-laki dan perempuan dengan perbandingan 1:2,35 (n=34 dan 80) diikutsertakan dalam studi ini. Paha bagian posterior merupakan area nyeri alih terbanyak (19,3%, n=22) diikuti area paha lateralis (11,4%, n=13). Sedangkan posisi tubuh yang paling dominan memicu timbulnya nyeri sendi sakroiliaka adalah posisi bangun dari duduk (61,4%, n=70) dan duduk lama (49,1%, n=56).Diskusi: Pola distribusi nyeri alih pada pasien nyeri sendi sakroiliaka yang paling banyak ditemukan adalah nyeri pada daerah paha sisi posterior dan paha sisi lateral sedangkan faktor yang paling dominan mencetuskan atau memperberat nyeri sendi sakroiliaka adalah posisi bangun dari duduk dan posisi duduk yang lama.Kata kunci: Nyeri sendi sakroiliaka, pola nyeri, posisi tubuh pencetus

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Pola Distribusi Nyeri Alih Dan Posisi Tubuh Pencetus Nyeri Sendi Sakroiliaka

Siahaan

Puspitasari

Hartoyo

2018

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“…Despite the large number of patients who experience SIJ dysfunction, there is disagreement about optimal methods for diagnosis and treatment [3]. Pain originating from sacroiliac joint may also cause pain in the lumbar and gluteal region in 15 percent of population [12]. The clinical manifestation represents a public health problem due to the great implications on the quality of life and health related costs [13].…”

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confidence: 99%

“…By describing several diagnostic techniques, many authors have studied the prevalence of this pathology, finding more positive data than expected; coming to the conclusion that even though there is no diagnostic gold standard yet, an important amount of cases might be detected by properly applying several special tests at physical examination. Thus, it is necessary to have knowledge of the physiopathology and clinical presentation so that diagnosis can be made to those patients that manifest this problem [12]. Physical Therapy Self-mobilization exercises:Posterior innominate self-mobilization was done in a supine position.…”

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confidence: 99%

Musculoskeletal Physical Therapy for Sacroiliac Joint Pain: Case Report

Alhakami¹,

Qasheesh²,

Bose³

2020

IJPR

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This case report describes a clinical case of a 53 years aged male with Low Back Pain(LBP) at Sacro Iliac Joint(SIJ). Patient referred to physical therapy department with LBP over the past 3 weeks. Pain extended to posterior aspect of left thigh and worsening with prolonged standing, sitting and with stair climbing. Moreover, he found difficulty to ride his car or going from sit to stand. He had a history of road traffic accident 30 years ago that led to severe pain in his lower back area, he was a farmer as well and was working hardly more than 8 hours daily by lifting heavy objects. Patient came to the department by walking with assistive cane. By palpation, there was a local tenderness at the posterior aspect of the SIJ. Range of motion was limited by pain in lumbar flexion, extension, rotation and bilateral side bending movements. Pain scored 7 out of 10 on Numerical Pain Rating Visual Analogue Scale. Functional disability scored 19 out of 24 on Roland-Morris Disability questionnaire. Patient underwent special test of FABER, SLR and sacroiliac stress tests and Physical therapy modalities of TENS, dry cupping, myofascial release technique and manipulation, medical taping, hot packs applied before and after exercise. Stretching exercises included single knee to chest, trunk rotation, child's pose and stabilization exercises of bird dog pose, superman's, bridge, ball squeeze. Outcomes of treatment were assessed with same pretest measures. At the end of 3 weeks, patient improved in all symptoms of reduced pain to 2 out of 10 on Numerical Pain Rating, 3 out of 24 on Roland-Morris disability questionnaire. Post rehabilitative findings on all provocative tests were negative. Evidence on physical therapy management of patients with SIJ pain appears underreported. Patients presenting with SIJ pain should be routinely screened for sacroiliac component in LBP. Physical therapists are encouraged to report their findings so as to strengthen the evidence available for physical therapy for SIJ pain.

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“…Moscote-Salazar et al . [ 7 ] in the paper, “A clinical approach for the neurosurgeon” explored the SIJ pain and presented a nice overview of a common pain syndrome, though often ignored or missed in consideration of neurosurgical evaluation and differential diagnosis of low back pain. When medicine is evolving from therapeutic to preventive and holistic medicine, low back pain, and chronic pain should be assessed and treated appropriately.…”

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confidence: 99%

Commentary

Ranjan¹

2017

Journal of Neurosciences in Rural Practice

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Sacroiliac Pain: A Clinical Approach for the Neurosurgeon

Cited by 5 publications

References 22 publications

Pola Distribusi Nyeri Alih Dan Posisi Tubuh Pencetus Nyeri Sendi Sakroiliaka

Pola Distribusi Nyeri Alih Dan Posisi Tubuh Pencetus Nyeri Sendi Sakroiliaka

Musculoskeletal Physical Therapy for Sacroiliac Joint Pain: Case Report

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