Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May 17:26:16.
doi: 10.1186/s12998-018-0185-z. eCollection 2018.

Spinal manipulation in the treatment of patients with MRI-confirmed lumbar disc herniation and sacroiliac joint hypomobility: a quasi-experimental study

Esmaeil Shokri  1 , Fahimeh Kamali  1   2   3 , Ehsan Sinaei  2 , Farahnaz Ghafarinejad  1   2
Affiliations

Spinal manipulation in the treatment of patients with MRI-confirmed lumbar disc herniation and sacroiliac joint hypomobility: a quasi-experimental study

Esmaeil Shokri et al. Chiropr Man Therap. .

Abstract

Background: To investigate the effect of lumbar and sacroiliac joint (SIJ) manipulation on pain and functional disability in patients with lumbar disc herniation (LDH) concomitant with SIJ hypomobility.

Methods: Twenty patients aged between 20 and 50 years with MRI-confirmed LDH who also had SIJ hypomobility participated in the trial in 2010. Patients who had sequestrated disc herniation were excluded. All patients received five sessions of spinal manipulative therapy (SMT) for the SIJ and lumbar spine during a 2-week period. Back and leg pain intensity and functional disability level were measured with a numerical rating scale (NRS) and the Oswestry Disability Index (ODI) at baseline, immediately after the 5th session, and 1 month after baseline.

Results: A significantly greater mean improvement in back and leg pain was observed in the 5th sessions and 1 month after SMT. Mean changes in ODI in the 5th session and 1 month after treatment also showed significant improvement. The MCIC for NRS and ODI scores in the present study were considered 20 and 6 points, respectively. Therefore, the mentioned improvements were not clinically significant in the 5th session or at 1-month follow-up.

Conclusion: Five sessions of lumbar and SIJ manipulation can potentially improve pain and functional disability in patients with MRI-confirmed LDH and concomitant SIJ hypomobility.

Trial registration: Irct.ir (Identifier: IRCT2017011924149N33), registered 19 February 2017 (retrospectively registered).

Keywords: Back pain; Lumbar disc herniation; Sacroiliac joint; Spinal manipulation.

PubMed Disclaimer

Conflict of interest statement

Approval was granted by the Shiraz University of Medical Sciences Ethics Committee (approval code: CT-88-4614).Written informed consent was obtained from the patients for publication of their individual details and accompanying images in this manuscript. The consent form is held by the authors and is available for review by the Editor-in-Chief.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Lumbar rotation manipulation
Fig. 2
Fig. 2
Sacroiliac joint manipulation
Fig. 3
Fig. 3
Trend in back pain intensity during the trial
Fig. 4
Fig. 4
Trend in leg pain intensity during the trial
Fig. 5
Fig. 5
Trend in functional disability level during the trial
See this image and copyright information in PMC

References

    1. Adams MA, Bogduk N, Burton K, Dolan P. The Biomechanics of Back Pain, 2nd Ed. Edinburgh: Churchill Livingstone; 2006.
    1. Lisi AJ, Holmes EJ, Ammendolia C. High-velocity low-amplitude spinal manipulation for symptomatic lumbar disk disease: a systematic review of the literature. J Manip Physiol Ther. 2005;28:429–42. - PubMed
    1. Galm R, Fröhling M, Rittmeister M, Schmitt E. Sacroiliac joint dysfunction in patients with imaging-proven lumbar disc herniation. Eur Spine J. 1998;7:450–453. doi: 10.1007/s005860050107. - DOI - PMC - PubMed
    1. Madani SP, Dadian M, Firouznia K, Alalawi S. Sacroiliac joint dysfunction in patients with herniated lumbar disc: a cross-sectional study. J Back Musculoskel Rehabil. 2013;26:273–278. doi: 10.3233/BMR-130376. - DOI - PubMed
    1. Weksler N, Velan GJ, Semionov M, Gurevitch B, Klein M, Rozentsveig V, Rudich T. The role of sacroiliac joint dysfunction in the genesis of low back pain: the obvious is not always right. Arch Orthop Trauma Surg. 2007;127:885–888. doi: 10.1007/s00402-007-0420-x. - DOI - PubMed