The Effects of Exercise and Manual Manipulation on Sacroiliac Joint Dysfunction: A Critically Appraised Topic.

Abstract

Clinical scenario: Sacroiliac joint dysfunction (SIJD) is pain in the sacroiliac region that can be debilitating and difficult to treat. Many interventions can be used to treat SIJD, including exercise and manual manipulation. The effectiveness of these treatments by themselves, or in conjunction, is not well understood.

Clinical question: In active individuals with SIJD, is an exercise intervention, manual manipulation, or a combination of the 2 effective in reducing pain and improving function?

Summary of key findings: Three studies were included in this critically appraised topic. One study found that both exercise therapy and manipulation therapy decreased pain and improved function, but found no between-group differences. The other 2 studies found that exercise therapy, manipulation therapy, and the combination of the 2 were effective in decreasing pain and improving function in the participants.

Clinical bottom line: The results of the studies suggested that exercise therapy, manual therapy, and a combination of the 2 therapies can be effective in reducing pain and dysfunction in patients with SIJD. While manual therapy techniques alone may be effective in reducing SIJD pain short term, exercise therapy or a combination of the 2 may be more effective in reducing pain long term.

Strength of recommendation: There appears to be level B evidence supporting the use of exercise therapy, manual therapy, or a combination of the 2 for the treatment of SIJD. This recommendation is based on the inconsistent or limited quality patient-oriented evidence presented in the 3 included studies, as defined by the Strength of Recommendation Taxonomy.