The effectiveness of manipulation of the symptomatic sacroiliac joint compared to manipulation of both the asymptomatic and symptomatic sacroiliac joints in the treatment of unilateral sacroiliac syndrome

Abstract

Low back pain (LBP) is a significant public health problem that has had a marked impact on quality of life and on health care costs (Weiner, et al. 2000:450). Toussaint, et al. (1999:134) established that the prevalence of sacroiliac joint dysfunction in the population has been noted in the medical literature to be between 19.3% and 47.9%. There is a lack of consensus among medical practitioners, chiropractors, osteopaths, physiotherapists and others as to the most appropriate therapy or management for sacroiliac syndrome. This study was designed to determine the effectiveness of manipulation of the symptomatic sacroiliac joint compared to manipulation of both the symptomatic and the asymptomatic sacroiliac joints in the treatment of unilateral sacroiliac syndrome. Anecdotal evidence would seem to indicate that the direction of the chiropractic manipulation is immaterial to clinical improvement (Till, 1994). Bilateral manipulation of the symptomatic and asymptomatic joints has been used in clinical practice in an attempt to increase the efficacy of chiropractic management for unilateral sacroiliac joint syndrome (Till, 1994, Lewis, 2001 and Nook, 2000). Walker (1992:914) was of the opinion that 'Unless reliability and validity of assessments and effectiveness of treatment procedures can be demonstrated, clinicians should temper their claims of measurement of, and direct effects on, the sacroiliac joint.' This randomized, comparative clinical trial consisted of sixty voluntary subjects each suffering from sacroiliac joint syndrome. There were two groups of thirty subjects, each of whom received five treatments within a three week period. Group one received manipulation of the symptomatic sacroiliac joint