• Journal of Korean Physical Therapy Science
• /
• v.4 no.1
• /
• pp.351-359
• /
• 1997

The joint dysfunction is the major cause of pain in trunk and extremities according to J. McM. Mennell who mentioned that there were no pathological changes that was found in the painful joint. The referred pain due to joint dysfunction has to be differentiated from other painful conditions, particularly of the neuromusculoskeletal system. Most of the pain in the lower extremities is due to the sacroiliac joint dysfunction according to Setsuo Hakata who had developed arthrokinematic approach(AKA) for sacroiliac joint in 1989. AKA for sacroiliac dysfunction is made up of distraction & gliding technics that are no violent to recover the disturbed intra-articular movement and result in immediate relief of pain.

• The Korean Journal of Pain
• /
• v.8 no.2
• /
• pp.293-297
• /
• 1995

Despite applying recent advances in research and technology and taking into acount proper histories and performing thorough physical examinations, a high percentage of patients with low back pain have no identifiable pathology. Problems especially of the sacroiliac joint are commonly missed. The purpose of this article is to describe the effects of sacroiliac injection of local anesthetics and corticosteroids on patients with acute sacroiliac sprain. The sacroiliac joints are essentially nonweight-bearing joints that allows a small amount of anteroposterior rotatory movement around transverse axis usually about 5 to 10 cm below the promontory of the sacrum vertically. The ligamentous portion of sacroiliac joint is vulnerable to rotatory movement particularly when the individual is in an awkward position. Injections of 3 ml of 2% lidocaine and 10 mg of methylprednisolone were given twice at two day intervals to 26 patients with acute sacroiliac sprain. Most of those patients obtained excellent results without any adverse effects.

• Journal of Korean Neurosurgical Society
• /
• v.38 no.5
• /
• pp.338-343
• /
• 2005

Objective : The sacroiliac joint complex is often related with functionally incapacitating pain in old aged people. The purpose of this study is to delineate the investigation strategies and to determine the long-term effect of radiofrequency [RF] neurotomies for pain arising from sacroiliac Joint dysfunction[SIJD]. Methods : Sixteen patients were diagnosed as having chronic pain from SIJD by comparative controlled blocks on L5 dorsal rami, sacroiliac Joints and deep interosseous ligaments. After confirming the positive response [more than 50% of pain relief], sensory stimulation was applied to detect the 'pathological' branches. Subsequently, RF neurotomies were performed on the selected nerve branches. Surgical outcome was graded as successful, moderate improvement, and failure after a 6month follow-up period. Results : Stimulation intensity was 0.45V to elicit pain response in the L5 dorsal rami and lateral sacral branches. The number of RF-lesioned nerve branches was 6per patient. The average number of lesions for each branch was 1.3. Most commonly selected branches were L5 dorsal ramus [88%] and S2-upper division [88%]. Ten patients [63%] reported a successful outcome according to the outcome criteria after 6months of follow-up, and five patients [31%] reported complete relief [100%]. Five patients [31%] showed moderate improvements. One patient reported failure. Conclusion : RF neurotomy of lateral sacral branches is an excellent treatment modality for the pain due to SIJD, provided that comparative controlled block shows a positive response.

• The Korean Journal of Pain
• /
• v.29 no.1
• /
• pp.53-56
• /
• 2016

Sacroiliac (SI) joint pain can result from degeneration, infection, malignancy, and trauma. Patients with metastatic bone pain who do not respond to conventional treatment may need more aggressive neuroinvasive approaches. Recently, pulsed radiofrequency (PRF) neuromodulation has emerged as a promising treatment alternative for refractory cases of SI joint pain. Nevertheless, there is no report on the treatment of pain arising from SI joint metastases with PRF. We are reporting about a 63-year-old woman suffering from buttock pain due to breast cancer metastases in the SI joint. We treated this patient with PRF neuromodulation of the L4-S3 primary dorsal rami and lateral branches using a rotating curved needle technique. The patient tolerated the procedures well, without any complications. She experienced about 70% reduction in pain, and pain relief was sustained for 10 months. This result suggests that PRF neuromodulation is a safe, effective treatment for pain from SI joint metastases.

• The Korean Journal of Pain
• /
• v.22 no.3
• /
• pp.229-233
• /
• 2009

Background: Sacroiliac (SI) joint pain is a challenging condition that causes lower back or buttock pain; however, there is no universally accepted long-term treatment. There have been several reports of ligament prolotherapy for SI joint pain, but these have had inconsistent results, probably due to the lack of a specific diagnosis for patient selection and variability in the volume, number and sites of injection. Therefore, this study was conducted to assess the efficacy of intraarticular prolotherapy for relieving SI joint pain diagnosed by local anesthetic intraarticular injection. Methods: Twenty-two patients with SI joint pain confirmed by 50% or more improvement in response to local anesthetic block underwent intraarticular prolotherapy with 25% dextrose water every other week three times. The numeric rating scale (NRS) for pain and Oswestry disability index (ODI) were assessed at the initial visit and after completion of a series of prolotherapy and the NRS was checked during monthly follow-up sessions to evaluate the long-term effectiveness of this technique. Results: Twenty patients completed prolotherapy and followed up as scheduled. The NRS and ODI were significantly improved from 6 (4-8) and $34.1{\pm}15.5$ to 1 (0-3) and $12.6{\pm}9.8$ (P < 0.01), respectively, at 1 month after prolotherapy. The mean duration of pain relief of 50% or more was 12.2 months (95% CI, 10.0-14.3) as determined by Kaplan-Meier survival analysis. Conclusions: Intraarticular prolotherapy provided long-term relief of sacroiliac joint pain and may have more benefits than ligament prolotherapy or neurolysis.

• PNF and Movement
• /
• v.8 no.1
• /
• pp.41-50
• /
• 2010

Pain originating from the sacroiliac joint(SIJ) has been associated with poor performance, yet specific diagnosis of sacroiliac dysfunction(SID) has been difficult to achieve. Clinical presentation of SID appears that pain and poor performance is responsive to local analgesia of periarticular structures with poorly defined pathology, and poor performance with bony pathological changes present as a result of chronic instability. Previous research indicates that physical examination cannot diagnose SIJ pathology. Earlier studies have not reported sensitivities and specificities of composites of provocation tests known to have acceptable inter-examiner reliability. Tests based on mechanics as manual provocation for SIJ pain have formed the basis of tests used to diagnose SIJ dysfunction. In this review summary, the purpose of this study was to describe the sacroiliac tests with a model of examination, diagnosis, and management of SID. Further research is warranted to determine whether SIJ tests is reliable means of evaluating innominate impairments.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.29 no.3
• /
• pp.85-99
• /
• 2023

Background: This study aimed to investigate the effects of a complex manual therapy program on hip and knee pain occurring together with menstrual pain and iliotibial band tightness in a woman with sacroiliac joint dysfunction. Methods: This study was carried out over a period of 3 months by dividing the treatment process into three sequential stages. Intensities of menstrual pain, hip pain, and knee pain, and hip range of motion (ROM) in the participant were assessed at baseline and at the end of each stage, and a modified intervention was applied according to results of assessments after each stage. Results: There was a decrease in the intensity of menstrual pain after the first and third stages of treatment, and there were reductions in the intensities of hip and knee pain after the third stage. Hip ROM was rather decreased after the second stage, but it was increased after the third stage. Conclusion: The findings of this study indicate that treatment of the instability and positional fault of sacroiliac joint can relieve hip and knee pain, improve hip ROM, and alleviate primary dysmenorrhea in patients with sacroiliac joint dysfunction.

• Journal of Digital Convergence
• /
• v.12 no.12
• /
• pp.651-658
• /
• 2014

The purpose of this study is to see how the sling lumbar stabilization exercise affects muscle body type and subjective pain degree of 17 middle-age men who are diagnosed with sacroiliac joint syndrome and investigate the effectiveness. The subjects of this study are patients who have been diagnosed with sacroiliac joint syndrome through tests like X-ray in S Orthopedics in C City and have had chronic lumbar pain for more than 6 months and the before and after results about subjective pain degree through three dimension Moire Muscle Body Type Tester and subjective pain degree through VAS Pain Awareness after sling lumbar stabilization exercise 3 times a week, 30 minutes a time, total 24 times for 8 weeks have revealed the following: The change of muscle body type has been comprehensively improved in the statistics before and after the exercise and the subjective pain degree has also comprehensively decreased in the statistics. Therefore, sling lumbar stabilization exercise is proved to give positive affect to muscle body type and pain improvement of the patients with sacroiliac joint syndrome.

• Journal of Korea Entertainment Industry Association
• /
• v.14 no.3
• /
• pp.383-392
• /
• 2020

This study was to compare the effects of joint mobilization, treadmill with insole, and joint mobilization and treadmill with insole on pain, pelvic angle, and foot pressure in patients with sacroiliac joint pain. 24 patients randomly assigned to joint mobilization group(n=8), treadmill with insole group(n=8), or joint mobilization and treadmill with insole group(n=8). Each groups were conducted 30 minutes a day, two days a week for four weeks. Pain was evaluated using visual analogue scale and pelvic angle was measured using palpation meter and foot pressure(fore/rear ratio) was measured using Gateview AFA-50 before intervention and after 4 weeks. All groups were significant differences pain in intragroup(p<.01). In pelvic angle, the joint mobilization group was statistically significant in the anterior tilt only, the joint mobilization and treadmill with insole group showed statistically significant improvement in both anterior and posterior tilt(p<.01), and the treadmill with insole group did not show any statistically significant change(p>.05). Also the joint mobilization and treadmill with insole group were significant differences in foot pressure(p<.01). All the interventions reduce sacroiliac joint pain and joint mobilization and treadmill with insole training are most effective changes in pelvic angle and foot pressure. This study can be used as a basic data for prevention of injury, posture correction and gait training in patients with sacroiliac joint pain, as well as chronic low back pain and plantar pressure problem.

• The Korean Journal of Pain
• /
• v.33 no.2
• /
• pp.183-191
• /
• 2020

Background: Opioids can present intolerable adverse side-effects to patients who use these analgesics to mitigate chronic pain. In this retrospective analysis, cooled radiofrequency (CRF) denervation was evaluated to provide pain and disability relief and reduce opioid use in patients with sacroiliac joint (SIJ) derived low back pain (LBP). Methods: Twenty-seven patients with pain from SIJ refractory to conservative treatments, and taking opioids chronically (> 3 mo), were included. Numeric rating scale (NRS) and Oswestry disability index (ODI) scores were collected at 1, 6, and 12 months post-procedure. Opioid use between baseline and each follow-up visit was compared for the entire group and for those who experienced successful (pain reduction ≥ 50% of baseline value) or unsuccessful CRF denervation. Results: Severe initial mean pain (NRS score: 7.7 ± 1.0) and disability (ODI score: 50.1 ± 9.0), and median opioid use (morphine equivalent daily dose: 40 ± 37 mg) were significantly reduced up to 12 months post-intervention. CRF denervation was successful in 44.4% of the patients at 12 months. Regardless of procedure success, patients demonstrated similar opioid reductions and changes in opioid use at 12 months. Two patients (7.4%) experienced neuritis following CRF denervation. Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain.