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

• The Journal of Korean Physical Therapy
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• v.18 no.6
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• pp.51-57
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• 2006

Purpose: This study was to figure out the effect of sacroiliac joints taping therapy on low back pain. Methods: 35 patients who visited to receive the treatments of the physical therapy in H orthopedic clinic in Kyoung-buk had been treated with spiral balance taping for 4weeks from 3 to 29, July 2006. They were divided 3 groups: acute, subacute, chronic. VAS(Visual Analogue Sacle) was analyzed for pain scale, and compared between the pre and post test among groups. Results: The acute patients' degree of the pain post therapy was decreased, the subacute patients' degree of the pain post therapy was decreased and the chronic patients' degree of the pain post therapy was decreased. There were statistically remarkable differences(p<0.05) in 3 groups. Conclusion: This results suggest that sacroiliac joints taping therapy to correct leg length inequality was effective on low back pain.

• Journal of Korean Physical Therapy Science
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• v.6 no.3
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• pp.25-40
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• 1999

The hub of weight bearing in the human body for both static and dynamic activities is the lumbopelvic region. It is a key region of extraordinary stability, since the trunk and ground forces converage in this region. The two sacroiliac joints form an integral part of this lumbopelvic unit. Considerable effort has been expended to study and quantify the normal range of movement of the sacroiliac joints Mitchell suggests that the ilium rotates in a posterior direction at heel strike and progresses in an anterior direction as the individual passes through the stance phase. The overall key appears to lie in determining the weight-bearing pattern of the sacroiliac (lumbopelvic) region from above and below that results in the familiar pain of sacroiliac dysfunction, assessing the status of the injured tissues, and intervening with the proper treatment protocols that maximize the body's healing processes. The purpose of this chapter is to provide a comprehensive overview of the sacroiliac joint's tissues and biomechanics, as well as concepts of evaluation and treatment. This overview is aimed at assisting the clinician in identifying the forces that are potentially destructive to the lumbopelvic tissues.

• Journal of Korean Physical Therapy Science
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• v.5 no.3
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• pp.697-706
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• 1998

Motion at the sacroiliac joints(SIJ) has been reported in the medical literature since the mid-19th century. However, for many years authorities vie~d that no movement occurred at the sacroiliac joints and therefore were not clinically significant. Recent contributions from both the basic and clinical sciences caused a change in perception of the role of the sacroiloiac joint in low back pain(LBP). Movement within the sacroiliac joint is now generally recognized, although it is only a small amount. Controversy continues as to the type of motion available and the axes of motion, and continues as to the ability of a clinician to identify a significant sacroiliac dysfunction. Dysfunction of the pelvic girdle is complex and not easily understood. It is common to find serveral dysfunctions within the same pelvic girdle. Each needs to be individually diagnosed and appropriately treated. The diagnostic and therapeutic system designed by Philip E. Greenmam, D. O. allows the operator to deal with any combination of physical findings that are found within the pelvic girdle Restoration of pelvic girdle function within the walking cycle is a major therapeutic goal, particularly from the biomechanical postural-structural model.

• Physical Therapy Rehabilitation Science
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• v.9 no.4
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• pp.252-260
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• 2020

Objective: Disorder of the autonomic nervous system is considered to be the cause of primary dysmenorrhea. The spine has a close relationship with the autonomic nervous system, and the sacrum is mechanically and neurologically connected to the uterus through ligaments. Therefore, this study was conducted to check the effect on the autonomic nervous system through measurement of heart rate variability by applying manual therapy to the sacroiliac joints of subjects with primary dysmenorrhea and to suggest an effective treatment method for dysmenorrhea. Design: Randomized controlled trial. Methods: Thirty females with dysmenorrhea were assigned to either the manual therapy group and sham treatment group according to the random treatment method. The manual therapy was applied to the sacroiliac joints, and the sham treatment was only treated with the hands placed in the same position of the intervention. Heart rate variability and the Visual Analogue Scale (VAS) were measured on the day when menstruation began ±2. Interventions were performed between the groups, followed by a 5-minute break and then re-measurements were made. Results: There were significant differences in autonomic balance and VAS scores in the manual therapy group before and after the intervention between groups (p<0.05). In the sham treatment group, there were significant differences in low frequency, autonomic balance, and VAS scores (p<0.05). There were significant differences in autonomic balance between groups (p<0.05). Conclusions: In females with primary dysmenorrhea, manual therapy applied to the sacroiliac joint was found to be effective for a short time on autonomic activity.

• The Korean Journal of Nuclear Medicine
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• v.16 no.2
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• pp.63-70
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• 1982

To evaluate the diagnostic usefulness and significance of quantitative sacroiliac joint scintigraphy in the assessment of sacroiliitis, we measured Sacroiliac Joint/Sacrum Uptake Ratio(SIS Ratio) by region of interest(ROI) method using $^{99m}Tc-methylene$ diphosphonate. The observed results were as follows: 1. Using ROI method, the SIS ratios for the control group of 65 persons were $1.05{\pm}0.08$(left) and $1.06{\pm}0.07$(right) which were narrower in range than those of slice method $(mean{\pm}S.D.)$. 2. The effects of age, gender and laterality on SIS ratio were not significant. 3. In left side, one of 6 patients with rheumatoid arthritis had SIS ratio in excess of 2 standard deviation of normal control group, and remainder had SIS ratios within normal limit. In right side, 3 patients had SIS ratios in excess of 2 standard deviation of normal control group, and remainder, within normal limit. 4. In both sacroiliac joint, 2 of 3 patients having sacroiliitis clinically with Reiter's syndrome whose pelvis A-P X-ray findings showed normal had high SIS ratios (left/right; 1.31/1.69, 1.90/1.80), but SIS ratio of one patient who had no evidence of sacroiliitis clinically was within normal limit. 5. In 6 patients with ankylosing spondylitis in both sacroiliac joints, 4 whose pelvis A-P Xray findings showed severe sclerotic change of sacroiliac joints had SIS ratio within normal limit or below that of normal control group, and SIS ratios of 2 patients whose pelvis A-P X-ray findings showed were increased. 6. 4 of 5 patients with low back pain of which cause could not be evaluated clinically and radiologically had SIS ratios in excess of that of normal control group. It would be concluded that quantitative sacroiliac joint scintigraphy is useful and sensitive screening method in the diagnosis as well as in the assessment clinical activity of sacroiliitis.

• Journal of Korean Neurosurgical Society
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• v.38 no.5
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• pp.338-343
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• 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
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• v.33 no.4
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• pp.294-304
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• 2020

The sacroiliac joints connect the base of the sacrum to the ilium. When inflamed, they are suspected to cause low back pain. Inflammation of the sacroiliac joints is called sacroiliitis. The severity of the pain varies and depends on the degree of inflammation. Sacroiliitis is a hallmark of seronegative spondyloarthropathies. The presence or absence of chronic sacroiliitis is an important clue in the diagnosis of low back pain. This article aims to provide a concise overview of the anatomy, physiology, and molecular biology of sacroiliitis to aid clinicians in the assessment and management of sacroiliitis. For this narrative review, we evaluated articles in English published before August 2019 in PubMed. Then, we selected articles related to the painful manifestations of the sacroiliac joint. From the retrieved articles, we found that chronic sacroiliitis may be caused by various forms of spondyloarthritis, such as ankylosing spondyloarthritis. Sacroiliitis can also be associated with inflammatory bowel disease, Crohn's disease, gout, tuberculosis, brucellosis, and osteoarthritis, indicating common underlying etiological factors. The pathophysiology of sacroiliitis is complex and may involve internal, environmental, immunological, and genetic factors. Finally, genetic factors may also play a central role in progression of the disease. Knowing the genetic pre-disposition for sacroiliitis can be useful for diagnosis and for formulating treatment regimens, and may lead to a substantial reduction in disease severity and duration and to improved patient performance.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.26 no.1
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• pp.73-78
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• 2020

Background: The leg length discrepancy (LLD) have been implicated with degenerative diseases since the early 1970s, which also causes musculoskeletal asymmetry problems. The LLD appears due to factors such as balance ability, response time, and muscle strength between the shorter and longer leg. In this study, the effect of manual therapy to LLD has been studied. Methods: Manual therapy has been applied on shorter leg of 30 patients with LLD. The manual therapy was conducted for 2~3 minutes 3 times a week for 4 weeks. Results: The leg length of shorter leg were measured at initial baseline and after 4 weeks. the average leg length of shorter leg increased from 94.10 cm to 94.33 cm. Conclusion: This paper reports that the manual therapy has positive effects on LLD. It was studied by conducting manual therapy on muscles and joints related to shorter leg. In the future, the muscles and joints of the longer leg should be considered and various age group should be studied to develop the understanding of the effect of manual therapy on LLD.

• The Korean Journal of Nuclear Medicine
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• v.25 no.1
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• pp.87-94
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• 1991

To evaluate the diagnostic usefulness of quantitative sacroiliac joint scintigraphy and its clinical significance in the ankylosing spondylitis, we measured SIS ratio (Sacroiliac Joint/Sacrum Uptake ratio) by region of interest method in 52 patients with ankylosing spondylitis. As compared with radiological grade, SIS ratio was significantly elevated in the early stage of ankylosing spondylitis and returned to normal range in the late stage. Scintigraphic finding of focal uptakes of radiotracer at multiple spinal apophyseal joints was characteristic and proximal large joints were more involved than distal joints. The incidence and extent of the arthropathy revealed by scnitigraphy exceeded that which was clinically evident, and scintigraphy was more sensitive to detect symptomatic lesion than radiography. Therefore, it is suggested that bone scan is useful for the early diagnosis and the assessment of clinical activity of involved joints of ankylosing spondylitis.