Prevalence and Risk Factors of Sacroiliac Joint Pain in Athletes: A Systematic Review and Proportional Meta-Analysis.

Abstract

Objective: Low back pain (LBP) is a prevalent musculoskeletal condition, often mechanical in nature, affecting millions globally. Mechanical LBP originating from sacroiliac joint (SIJ) discomfort is common but underappreciated. Determining sacroiliac joint pain or dysfunction (SIJP/D) prevalence poses challenges because of varied diagnostic criteria and characteristics. This systematic review aims to explore SIJP/D risk factors, biomechanics, and prevalence, in athletic populations, to inform preventive strategies.

Data sources: We conducted a systematic review following PRISMA guidelines. Searches were performed in Web of Science, Embase, MEDLINE, and Scopus databases up to February 2024. Eligible studies reported sacroiliac joint pain or dysfunction in athletes in English. Data extraction included prevalence and risk factors. NIH quality assessment tool was used for bias assessment. Proportional meta-analysis was used, and forest plots were generated using STATA 18 and SPSS-25.

Main results: A systematic review identified 1515 studies, of which 913 were excluded after screening titles and abstracts. Full-text evaluation led to the inclusion of 13 studies. These studies involved 2842 athletes from various sports, predominantly males. The prevalence of SIJP/D varied widely across studies, with mean prevalence of 10.72% among all athletes, 5.61% among injured athletes, 32.39% among athletes with low back pain, and 35.99% among those with pelvic or pubis pain. Risk factors for SIJP/D included stress injuries, biomechanical movements, and years of experience, with exercise showing potential for prevention. Methodological quality ranged from low to moderate, with bias mainly due to lack of exposure confirmation and sample size justification.

Conclusions: Based on the current literature assessed in this review, we cannot report an accurate prevalence of SIJ pain or dysfunction in athletes. Owing to heterogeneity of the available data, further evaluation is necessary.