Prevalence of concomitant sacroiliac joint dysfunction in patients with image proven herniated lumbar discs

Sacroiliac joint (SIJ) dysfunction is a widely known but poorly defined cause of low back pain. To our knowledge, few published studies have been conducted to evaluate systematically the prevalence and significance of concomitant sacroiliac joint dysfunction in patients with herniated lumbar discs. As concomitant SIJ dysfunction in low back pain patients is likely to respond to particular noninvasive interventions such as manipulation, improved understanding of the relationship between these two diagnoses would improve clinical decision making and research. This study was designated to estimate the prevalence of concomitant sacroiliac joint dysfunction in sub acute low back pain patients with image proven discopathy and evaluate the theory that sacroiliac joint dysfunction can be a source of pain and functional disability in discopathy. A total of 202 patients with sub acute radicular back pain and MRI proven herniated lumbar discs underwent standardized physiatrist history and physical examination, specified for detection of concomitant sacroiliac joint dysfunction. Sacroiliac joint dysfunction is a concomitant finding in 72.3% of evaluated patients. There was significantly higher SIJ dysfunction prevalence in female patients (p <0.001), patients with recurrent pain (p <0.005) and in patients with positive straight leg raising provocative test (p <0.0001). SIJ dysfunction is a significant pathogenic factor with high possibility of occurrence in low back pain. Thus, in the presence of radicular and sacroiliac joint symptoms, SIJ dysfunction, regardless of intervertebral disc pathology, must be considered in clinical decision making.