Spielt es eine Rolle, ob das ISG als Schmerzquelle diagnostiziert wird?

Wie kann das Iliosakralgelenk zuverlässig als Schmerzquelle identifiziert werden^? Und ist dies für eine adäquate Therapie überhaupt notwendig^? Sean GT Gibbons nimmt zu beiden Fragen Stellung und begründet, warum eine möglichst zuverlässige Diagnosestellung notwendig ist.

Publikationsverlauf

Artikel online veröffentlicht:
19. Juli 2023

• Literatur

• 1 Buchbinder R, van Tulder M, Oberg B. et al. Low back pain: a call for action. Lancet 2018; 391: 2384-2388
• 2 Balagué F, Mannion AF, Pellisé F. et al. Non-specific low back pain. Lancet 2012; 379: 482-491
• 3 O'Sullivan PB, Beales DJ.. Diagnosis and classification of pelvic girdle pain disorders. Part 1: a mechanism based approach within a biopsychosocial framework. Man Ther 2007; 12: 86-97
• 4 Vleeming A, Albert HB, Ostgaard HC. et al. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J 2008; 17: 794-819
• 5 Vleeming A, Schuenke MD, Masi AT. et al. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat 2012; 221: 537-567
• 6 O’Shea FD, Boyle E, Salonen DC. et al. Inflammatory and degenerative sacroiliac joint disease in a primary back pain cohort. Arthritis Care Res (Hoboken) 2010; 62: 447-454
• 7 Cohen SP, Chen Y, Neufeld NJ.. Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Expert Rev Neurother 2013; 13: 99-116
• 8 Carlson SW, Magee S, Carlson WO.. An algorithm for the evaluation and treatment of sacroiliac joint dysfunction. S D Med 2014; 67: 445-449 451
• 9 Kanakaris NK, Roberts CS, Giannoudis PV.. Pregnancy-related pelvic girdle pain: an update. BMC Med 2011; 9: 15
• 10 Keller A, Hayden J, Bombardier C. et al. Effect sizes of non-surgical treatments of non-specific low-back pain. Eur Spine J 2007; 16: 1776-1788
• 11 O’Connell NE, Cook CE, Wand BM, Ward SP.. Clinical guidelines for low back pain: A critical review of consensus and inconsistencies across three major guidelines. Best Pract Res Clin Rheumatol 2016; 30: 968-980
• 12 Almousa A, Lamprianidou H, Kitsoulis G.. The effectiveness of stabilising exercises in pelvic girdle pain during pregnancy and after delivery: A systematic review. Physiother Res Int 2018; 23
• 13 Liddle SD, Pennick V.. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev 2015; 2015: CD001139
• 14 Al-Subahi Mhttps://pubmed.ncbi.nlm.nih.gov/28932014/ – affiliation-1, Alayat M, Alshehri MA. et al. The effectiveness of physiotherapy interventions for sacroiliac joint dysfunction: a systematic review. J Phys Ther Sci. 2017. 29. 1689-1694
• 15 Mapinduzi J, Ndacayisaba G, Mahaudens P. et al. 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. J Back Musculoskelet Rehabil 2022; 35: 713-728
• 16 Nejati P, Safarcherati A, Karimi F.. Effectiveness of Exercise Therapy and Maniplation on Sacroiliac Joint Dysfunction: A Randomized Controlled Trial. Pain Physiscian 2019; 22: 53-61
• 17 Treede R-D, Rief W, Barke A. et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain 2019; 160: 19-27
• 18 Funkhouser WK.. Pathology: The Clinical Description of Human Disease. In: Coleman WB, Tsongalis GJ, eds. Essential Concepts in Molecular Pathology. Elsevier Science & Techn; 2010: 137-142
• 19 White F.. Application of Disease Etiology and Natural History to Prevention in Primary Health Care: A Discourse. Med Princ Pract 2020; 29: 501-513
• 20 Horwitz RI, Singer BH, Hayes-Conroy A. et al. Biosocial pathogenesis. Psychother Psychosom 2022; 91: 73-77
• 21 McGill SM.. The biomechanics of low back injury: implications on current practice in industry and the clinic. J Biomech 1997; 30: 465-475
• 22 Hsu C, Castillo E, Lieberman D.. The relationship between trunk muscle strength and flexibility, intervertebral disc wedging, and human lumbar lordosis. The Harvard Undergraduate Research Journal Spring 2015; 8: 1
• 23 Müller A, Rockenfeller R, Damm N. et al. Load Distribution in the Lumbar Spine During Modeled Compression Depends on Lordosis. Front Bioeng Biotechnol 2021; 10: 661258
• 24 Dolan P, Adams MA.. Influence of lumbar and hip mobility on the bending stresses acting on the lumbar spine. Clin Biomech (Bristol, Avon) 1993; 8: 185-192
• 25 Gibbons SGT.. “Something is causing it”: Tissue loading mechanisms in the pathogenesis and chronicity of chronic primary musculoskeletal pain. 2023 Submitted
• 26 Gallagher S, Marras WS.. Tolerance of the lumbar spine to shear: a review and recommended exposure limits. Clin Biomech 2012; 27: 973-978
• 27 Chatprem T, Puntumetakul R, Kanpittaya J.. A diagnostic tool for people with lumbar instability: a criterion-related validity study. BMC Musculoskelet Disord 2021; 22: 976
• 28 Finnerup NB, Haroutounian S, Kamerman P. et al. Neuropathic pain: an updated grading system for research and clinical practice. Pain 2016; 157: 1599-1606
• 29 Cook C, Hegedus E.. Orthopedic Physical Examination Tests: An Evidence-Based Approach. 2^nd ed. Upper Saddle River, New Jersey: Prentice Hall; 2011
• 30 Saueressig T, Owen PJ, Diemer F. et al. Diagnostic accuracy of clusters of pain provocation tests for detecting sacroiliac joint pain: systematic review with meta-analysis. J Orthop Sports Phys Ther 2021; 51: 422-431
• 31 Liem EB, Joiner TV, Tsueda K. et al. Increased sensitivity to thermal pain and reduced subcutaneous lidocaine efficacy in redheads. Anesthesiology 2005; 102: 509-514
• 32 Northover C, Thapar A, Langley K. et al. Pain Sensitivity in adolescent males with attention-deficit/hyperactivity disorder: Testing for associations with conduct disorder and callous and unemotional traits. PLoS One 2015; 10: e0134417
• 33 Bear T, Philipp M, Hill S. et al. A preliminary study on how hypohydration affects pain perception. Psychophysiology 2016; 53: n 605-610
• 34 Hidalgo B, Hall T, Nielens H. et al. Intertester agreement and validity of identifying lumbar pain provocative movement patterns using active and passive accessory movement tests. J Manipulative Physiol Ther 2014; 37: 105-115
• 35 Lee D.. The Pelvic Girdle: An approach to the examination and treatment of the lumbo-pelvic region. 3^rd ed. Edinburgh: Churchill Livingstone; 2004
• 36 Goode A, Hegedus EJ, Sizer P. et al. Three-Dimensional Movements of the Sacroiliac Joint: A Systematic Review of the Literature and Assessment of Clinical Utility. J Manual Manip Ther 2008; 16: 25-38
• 37 Jull J.. The Hands-on/Hands-off Debate. (Zusatzmaterial). MSK – Muskuloskelettale Physiotherapie 2021; 25: 117-124
• 38 van Dieën JP, Reeves P, Kawchuk G. et al. Analysis of motor control in patients with low back pain: A key to personalized care?. J Orthop Sports Phys Ther 2019; 49: 380-388
• 39 Gibbons SGT.. Can manual therapists diagnose instability of the sacro-iliac joint?. manuelletherapie 2015; 19: 211-216
• 40 Mens JM, Vleeming A, Snijders CJ. et al. The active straight leg raising test and mobility of the pelvic joints. Eur Spine 1999; 8: 468-473
• 41 Hungerford BA, Gilleard W, Moran M. et al. Evaluation of the ability of physical therapists to palpate intrapelvic motion with the Stork Test on the support side. Phys Ther 2007; 87: 879-887
• 42 Gibbons SGT.. Inter-rater reliability of a battery of tests to challenge force closure of the sacro-iliac joint. Unpublished data. 2008. St. John's, Memorial University of Newfoundland;
• 43 Gibbons SGT.. A randomized controlled trial of specific motor control stability exercise versus specific directional exercises in acute low back pain. New directions towards prognostic indicators. Proceedings of: The 6^th Interdisciplinary World Congress on Low Back Pain. 2007: 7-11 Barcelona, Spain:
• 44 Gibbons SGT, Strassl H.. Can altered movement patterns and muscle imbalance be related to FAI and other hip disorders?. manuelleherapie 2012; 16: 119-131
• 45 Kamper SJ, Haanstra TM, Simmons K. et al. What do patients with chronic spinal pain expect from their physiotherapist?. Physiother Can 2018; 70: 36-41
• 46 Sherriff B, Clark C, Killingback C. et al. Impact of contextual factors on patient outcomes following conservative low back pain treatment: systematic review. Chiropr Man Therap 2022; 30: 20
• 47 Sherriff B, Clark C, Killingback C. et al. Musculoskeletal practitioners' perceptions of contextual factors that may influence chronic low back pain outcomes: a modified Delphi study. Chiropr Man Therap 2023; 31: 12
• 48 Straker L.. Evidence to support using squat,semi-squat and stoop techniques to lift low-lying objects. International Journal of Industrial Ergonomics 2003; 31: 149-160
• 49 Saraceni N, Kent P, Ng L. et al. To flex or not to flex? Is there a relationship between lumbar spine flexion during lifting and low back pain? A Systematic review with meta-analysis. J Orthop Sports Phys Ther 2020; 50: 121-130
• 50 Schmid S.. The Stoop-Squat-Index: a simple but powerful measure for quantifying whole-body lifting behavior. Arch Physiother 2022; 12: 8
• 51 Stewart M, Loftus S.. Sticks and Stones: The impact of language in musculoskeletal rehabilitation. J Orthop Sports Phys Ther 2018; 48: 519-522
• 52 Logan GS, Dawe RE, Aubrey-Bassler K. et al. Are general practitioners referring patients with low back pain for CTs appropriately according to the guidelines: a retrospective review of 3609 medical records in Newfoundland using routinely collected data. BMC Fam Pract 2020; 21: 236
• 53 Laslett M.. Personal communication with Gibbons SGT. 2023
• 54 Horton SJ, Franz A.. Mechanical Diagnosis and Therapy approach to assessment and treatment of derangement of the sacro-iliac joint. Man Ther 2007; 12: 126-132
• 55 Gibbons SGT.. What are the functional mechanisms of altered movement patterns during trunk flexion tasks? The need for further sub-classification: A systematic review. Musculoskelet Sci Pract 2017; 28: e16-17
• 56 Gibbons SGT.. Sub-classification of core stability exercise for the purpose of a systematic review. Proceedings of: The 6^th Interdisciplinary World Congress on Low Back Pain. 2007: 7-11 Barcelona, Spain:
• 57 Gibbons SGT, Comerford MJ, Emerson P.. Rehabilitation of the stability function of psoas major. Orthopaedic Division Review 2002; 7-16
• 58 Gibbons SGT.. The role of psoas major and deep sacral gluteus maximus in lumbo-pelvic stability. In: Vleeming A, Stoeckhart R, Mooney V, eds. Movement, Stability and Lumbopelvic Pain. 2^nd ed. Edinburgh: Churchill Livingstone; 2007
• 59 Gibbons SGT.. Assessment and rehabilitation of the stability function of psoas major. manuelletherapie 2007; 11: 177-187
• 60 Richardson CA, Snijders CJ, Hides jA. et al. The relationship between the transversus abdominis muscle, sacroiliac joint mechanics and low back pain. Spine (Phila Pa 1976) 2002; 27: 399-405
• 61 Pel JJM, Spoor CW, Pool-Goudzwaard A. et al. Biomechanical analysis of Rreducing sacroiliac joint shear load by optimization of pelvic muscle and ligament forces. Ann Biomed Eng 2008; 36: 415-424
• 62 Pool-Goudzwaard A, van Dijke GH, van Gurp M. et al. Contribution of pelvic floor muscles to stiffness of the pelvic ring. Clin Biomech (Bristol, Avon) 2004; 19: 564-571
• 63 Talasz H, Kofler M, Kalchschmid E. et al. Breathing with the pelvic floor? Correlation of pelvic floor muscle function and expiratory flows in healthy young nulliparous women. Int Urogynecol J 2010; 21: 475-480
• 64 Lehtola V, Luomajoki H, Leinonen V. et al. Efficacy of movement control exercises versus general exercises on recurrent sub-acute nonspecific low back pain in a sub-group of patients with movement control dysfunction. Protocol of a randomized controlled trial. BMC Musculoskelet Disord 2012; 13: 55
• 65 Lehtola V, Luomajoki H, Leinonen V. et al. Sub-classification based specific movement control exercises are superior to general exercise in sub-acute low back pain when both are combined with manual therapy: A randomized controlled trial. BMC Musculoskelet Disord 2016; 17: 135
• 66 Foster NE, Hill JC, O’Sullivan P et al. Stratified models of care. Best Pract Res Clin Rheumatol 2013; 27: 649–661. DOI: 10.1016/j.berh.2013.10.005
• 67 Tagliaferri SD, Mitchell UH, Saueressig T et al. Classification approaches for treating low back pain have small effects that are not clinically meaningful: A systematic review with meta-analysis. J Orthop Sports Phys Ther 2022; 52: 67–84. DOI: 10.2519/jospt.2022.10761
• 68 Mueller MJ, Maluf KS. Tissue adaption to physical stress: a proposed "Physical Stress Theory" to guide physical therapist practice, education, and research. Phys Ther 2002; 82: 383–403