Conceptual model of patho- and sanogenesis of the sacroiliac joint osteoarthritis

Objective. To develop a conceptual model of patho- and sanogenesis of the sacroiliac joint (SIJ) osteoarthritis on base of the known data about the SIJ, the results of our own biomechanical studies of this joint, its ligaments and stabilizing muscles by finite element modelling, data of clinical verification of these results. Methods. The object of the model is the SIJ as a link, which connects the spine and pelvis. The proposed conceptual model is based on the M. Panjabi hypothesis of chronic lumbar pain in the case of partial damage to ligaments, which leads to muscle dysfunction. Results. A new conceptual model of SIJ osteoarthritis was developed. In this model we tried to take into account the limitations of the existing SIJ stability hypotheses and models of the appearance of the pelvic girdle pain, SIJ dysfunction and SIJ arthrosis. The model is based on the results of our own research. It was proved, that patients with SIJ osteoarthritis have an asymmetry of the width of the joint slits, the inclination of the sacrum and pelvis, sacral rotation, hyperlordosis in the LV–SI segment. These factors lead to a shift of the horizontal axis of sacral rotational mobility relative to the pelvic bones. This horizontal axis shift leads to the instability of the SIJ on one side of the joint, and to the functional block on another side. The results of these functional changes were damage of the SIJ ligaments-stabilizers, dysfunction of the SIJ muscles-stabilizers, degenerative changes of SIJ elements and pain. The developed model allows to explain the distortion of muscular response pattern in patients with improper SIJ biomechanics in conditions of SIJ osteoarthritis. The increase of the SIJ biomechanics changes enlarges the the muscle response pattern distortion. Conclusions. The developed conceptual model explains many clinical manifestations of the SIJ osteoarthritis and will help to understand better the mechanics of the pelvic girdle pain in such conditions, will improve the results of diagnosis and treatment.

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Pregnancy-related lumbopelvic pain: classification and diagnostics according to European guidelines and a review of literature

Rehabilitacja Medyczna ◽

10.5604/01.3001.0010.5005 ◽

2017 ◽

Vol 21 (3) ◽

pp. 58-63

Author(s):

Małgorzata Starzec ◽

Aleksandra Truszczyńska-Baszak

Keyword(s):

Lumbar Spine ◽

Clinical Symptoms ◽

Negative Impact ◽

Mechanical Load ◽

Pelvic Girdle ◽

Pelvic Girdle Pain ◽

Lumbar Pain ◽

Foreign Literature ◽

European Guidelines ◽

Pain Syndromes

Lumbopelvic pain associated with pregnancy may originate from the lumbar spine, the pelvic girdle or may be mixed. According to European guidelines, individual subtypes of pain require different procedures, for which a detailed differential diagnosis is necessary. These ailments arouse a lot of controversy. The aim of the work was to present the current state of knowledge on the aforementioned ailments, including European guidelines and the latest trends in foreign literature. The diagnosis of lumbopelvic pain, with particular emphasis on the pathophysiology and methods of differentiation of both pain syndromes, was discussed. Lumbar spine pain is mainly related to the mechanical load caused by a pregnant uterus. In the case of pelvic girdle pain, the main cause is the disorder of optimal stability, which depends on the correct mechanisms of force and form closure. Pelvic girdle pain is characterized by other clinical symptoms and risk factors, it also often remains after pregnancy, having negative impact on the daily functioning of a woman even years after giving birth. Depending on the location (one or both sacroiliac joints, pubic symphysis), several types of this pain syndrome are distinguished. The worst prognosis is pelvic pain associated with the involvement of all three joints at the same time. Until now, this term has not been more widely used in the Polish-language literature. The complexity of chronic pain syndromes, in which the discomforts of the pregnancy period may develop, entails the necessity of early identifi cation and deliberate action. Knowledge of the etiopathogenesis of these ailments is a prerequisite for therapeutic success. Introduction of terminology popular in foreign literature will improve treatment of these diseases, adapting it to current standards and will also enable better exchange of experience between professionals. pelvic girdle pain, lumbar pain, pregnancy

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Radiosteriometric analysis of movement in the sacroiliac joint during a single-leg stance in patients with long-lasting pelvic girdle pain

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2014.02.002 ◽

2014 ◽

Vol 29 (4) ◽

pp. 406-411 ◽

Cited By ~ 18

Author(s):

Thomas J. Kibsgård ◽

Olav Røise ◽

Bengt Sturesson ◽

Stephan M. Röhrl ◽

Britt Stuge

Keyword(s):

Sacroiliac Joint ◽

Pelvic Girdle ◽

Pelvic Girdle Pain ◽

Single Leg Stance

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Pelvic Girdle Pain and Lumbar Pain in Relation to Postpartum Depressive Symptoms

Spine ◽

10.1097/brs.0b013e318060a673 ◽

2007 ◽

Vol 32 (13) ◽

pp. 1430-1436 ◽

Cited By ~ 46

Author(s):

Annelie Gutke ◽

Ann Josefsson ◽

Birgitta Öberg

Keyword(s):

Depressive Symptoms ◽

Pelvic Girdle ◽

Pelvic Girdle Pain ◽

Lumbar Pain ◽

Postpartum Depressive Symptoms

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A Case Study of Chronic Iliopsoas Tendinopathy and Sacroiliac Joint Dysfunction Masquerading As Pelvic Girdle Pain

Cureus ◽

10.7759/cureus.15719 ◽

2021 ◽

Author(s):

Victoria M Mank ◽

Javier Barranco-Trabi ◽

Jeffrey K Mank ◽

Jefferson Roberts ◽

David P Newman

Keyword(s):

Sacroiliac Joint ◽

Pelvic Girdle ◽

Pelvic Girdle Pain ◽

Sacroiliac Joint Dysfunction

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Pelvic Girdle Pain and Lumbar Pain in Pregnancy: A Cohort Study of the Consequences in Terms of Health and Functioning

Spine ◽

10.1097/01.brs.0000201259.63363.e1 ◽

2006 ◽

Vol 31 (5) ◽

pp. E149-E155 ◽

Cited By ~ 117

Author(s):

Annelie Gutke ◽

Hans Christian Östgaard ◽

Birgitta Öberg

Keyword(s):

Cohort Study ◽

Pelvic Girdle ◽

Pelvic Girdle Pain ◽

Lumbar Pain ◽

In Pregnancy

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Effectiveness of motor control exercises versus other musculoskeletal therapies in patients with pelvic girdle pain of sacroiliac joint origin: A systematic review with meta-analysis of randomized controlled trials

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-210108 ◽

2021 ◽

pp. 1-16

Author(s):

Jean Mapinduzi ◽

Gérard Ndacayisaba ◽

Philippe Mahaudens ◽

Benjamin Hidalgo

Keyword(s):

Motor Control ◽

Randomized Controlled Trials ◽

Sacroiliac Joint ◽

Meta Analysis ◽

Pain Reduction ◽

Pelvic Girdle ◽

Pelvic Girdle Pain ◽

Controlled Trials ◽

Short Term ◽

Randomized Controlled

BACKGROUND: Pelvic girdle pain represents a group of musculoskeletal pain disorders associated with the sacroiliac joint and/or the surrounding musculoskeletal and ligamentous structures. Its physical management is still a serious challenge as it has been considered the primary cause of low back pain. OBJECTIVE: This review sought to determine the effectiveness of motor control exercises for two clinicallyrelevant measures; i.e., pain and disability, on patients with pelvic girdle pain of sacroiliac joint origin. METHODS: This review covered only randomized controlled studies. Online databases, such as PubMed, Embase, Scopus, and Cochrane Library, were searched from January 1, 1990, to December 31, 2019. PEDro scale was used to assess the methodological quality of included studies, while Review Manager was employed to synthesize data in view of meta-analysis. The PRISMA guidelines were applied for this review. RESULTS: Twelve randomized controlled trials of moderate-to-high quality were included in this review. The studies involved 1407 patients with a mean age ranging from 25.5 to 42.1 years as well as intervention and follow-up durations from 1 week to 2 years. Motor control exercises alone for pelvic girdle pain of sacroiliac joint origin were not effective in terms of pain reduction (SMD = 0.29 [-0.64,1.22]) compared to control interventions whereas they were slightly effective in terms of disability reduction (SMD =-0.07 [-0.67, 0.53]) at short-term. The combination of motor control exercises with other musculoskeletal therapies, however, revealed to be more effective than control interventions in terms of pain reduction (SMD =-1.78 [-2.49, -1.07]; 95%CI) and lessened disability (SMD =-1.80 [-3.03, -0.56]; 95%CI) at short-term. CONCLUSION: Motor control exercises alone were not found to be effective in reducing pain at short-term. However, their combination with other musculoskeletal therapies revealed a significant and clinically-relevant decrease in pain and disability at short-term, especially in peripartum period.

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