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22-05-2012 | Physical rehabilitation | Article

‘Quick fix’ for sacroiliac joint pain in children

Abstract

Free abstract

MedWire News: A simple joint-manipulation technique can significantly reduce or eliminate sacroiliac (SI) pain due to joint misalignment in children and adolescents, say researchers.

"Many pediatric patients with SI joint-related low-back pain present for neurosurgical evaluation after spending months undergoing conservative therapy and invasive procedures," write Jeffrey Leonard (Washington University in St Louis, Missouri, USA) and colleagues in the Journal of Neurosurgery: Pediatrics.

"To compound the problem, they have been taken away from physical education classes and have had their activity restricted," they add.

Leonard and team report results from a small study of 37 girls and 11 boys (mean age 15.7 years) who were assessed for lower-back pain and found to have SI joint misalignment. Likely causes of the misalignment were varied, but prior sporting injury was thought to be causal in 37.5% of patients.

The patients were treated using a joint-manipulation technique that involved a physical therapist performing an isometric hip contraction and extension. More specifically, the patient flexes and extends the hip while the therapist holds onto the leg and provides resistance to the move thus forcing the joint back into proper alignment.

As a result of this treatment, 80% of the patients experienced a dramatic improvement in their symptoms and 53% had immediate and complete resolution of pain.

Rated on a visual analog scale from 1 to 10, the mean pain score was 5.7 before treatment and 1.8 after treatment.

Successfully treated patients were shown how to perform exercises to strengthen regional muscles to try and prevent a recurrence of SI joint misalignment. Of the patients who had successful treatment, only two needed re-treatment.

"Back pain is a complex and multifactorial entity, and determining the exact etiology of symptoms can be very challenging in any population," write the authors. "Failure to make an accurate diagnosis can cause prolonged suffering, low self-esteem, drug dependence, and sometimes unnecessary surgery."

They conclude: "It is important to recognize the SI joint as a pain generator. The simple bedside maneuver that we describe here can be used safely in a time-efficient manner with profound improvement of symptoms in the majority of pediatric patients."

By Helen Albert

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