Diagnosing SI Pain or Dysfunction
Often times, SI joint pain can resemble the symptoms associated with disc herniation, stenosis, facet joint dysfunctions, or problems arising from the hip. These areas all need to be ruled out in order to truly confirm the source of symptoms coming from the SI joint. The most common association with SI pain is a physical event that led to the symptoms such as a fall, misstep, twisting motion, or childbirth. Due to the nerve root innervations of the sacrum and sacroiliac joint, pain can be presented in a variety of patterns that encapsulate the L2-S3 regions (see body chart section for examples). In order to identify the SI joint as the source of the pain or dysfunction, a variety of provocation tests have been established. These have been included and described in the following sections and include the distraction, thigh thrust, compression, and sacral thrust tests as well as Gaenslen's, active straight leg raise, and flexion tests.
References:
1. Dutton, M. (2008). Orthopaedic Examination Evaluation and Intervention. New York: McGraw-Hill Companies, Inc.
2. Goodman, C., & Snyder, T. (2007). Differential Diagnosis for Physical Therapists Screening for Referral. St. Louis: Saunders Elsevier.
3. Zelle, B.A., Gruen, G.S., Brown, S., George, S. (2005). Sacroiliac Joint Dysfunction: Evaluation and Management. Clinical Journal of Pain, 21(5): 446-455.
Often times, SI joint pain can resemble the symptoms associated with disc herniation, stenosis, facet joint dysfunctions, or problems arising from the hip. These areas all need to be ruled out in order to truly confirm the source of symptoms coming from the SI joint. The most common association with SI pain is a physical event that led to the symptoms such as a fall, misstep, twisting motion, or childbirth. Due to the nerve root innervations of the sacrum and sacroiliac joint, pain can be presented in a variety of patterns that encapsulate the L2-S3 regions (see body chart section for examples). In order to identify the SI joint as the source of the pain or dysfunction, a variety of provocation tests have been established. These have been included and described in the following sections and include the distraction, thigh thrust, compression, and sacral thrust tests as well as Gaenslen's, active straight leg raise, and flexion tests.
References:
1. Dutton, M. (2008). Orthopaedic Examination Evaluation and Intervention. New York: McGraw-Hill Companies, Inc.
2. Goodman, C., & Snyder, T. (2007). Differential Diagnosis for Physical Therapists Screening for Referral. St. Louis: Saunders Elsevier.
3. Zelle, B.A., Gruen, G.S., Brown, S., George, S. (2005). Sacroiliac Joint Dysfunction: Evaluation and Management. Clinical Journal of Pain, 21(5): 446-455.