Sacroiliac Joint and Pelvic Dysfunction Due to Symphysiolysis in Postpartum Women

Sekhon, Manraj; Doan, Thao; Bowers, Brianne; Covarrubias, Claudia; Barthelmass, Michaela; Stefano, Frank De; Kondilis, Athanasios

doi:10.7759/cureus.18619

Cited by 16 publications

(16 citation statements)

References 37 publications

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“…In this line the present study showed that females had significantly higher odds for pain in the hip. This has been observed previously [38] and has been linked to specific changes causing laxity in spine and pelvic structures [64]. Sex discrepancies have been observed for shoulder pain [39] and the present study observed a similar directional pattern although not statistically significant.…”

Section: Individual Risk Factorssupporting

confidence: 84%

Ergonomic and individual risk factors for musculoskeletal pain in the ageing workforce

et al. 2022

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Background The present study aimed to investigate the possible association between specific ergonomic and individual risk factors and musculoskeletal pain (MSP) in the back, shoulder, hip and knee region in workers aged 50-65y. Methods The study was a population based cross-sectional survey. The study population comprised citizens born between 1952–1966, living in Esbjerg municipality, Denmark, ultimo 2016 (n = 23,463). A questionnaire was sent electronically or by mail. The analysis included the working population only. A multivariate logistic regression was used for each of the following dependent variables; musculoskeletal pain for the past 3 months in the back, shoulder, hip and knee, where independent variables included ergonomic exposure, age, sex, body mass index (BMI) and leisure time physical activity (LTPA). Results The overall response rate was 58% and the data of individuals at work (n = 9,263) demonstrated several ergonomic exposures with increased odds for pain in specific regions. Exposure to back twisted or bend, squatting or lying on knees and to carrying or lifting were associated with musculoskeletal pain in the back, whereas exposure to back twisted or bend, arms above shoulder and repeated arm movement were associated with pain in the shoulder. Exposure to back twisted or bend, repeated arm movement, squatting or lying on knees and to carrying or lifting were associated with musculoskeletal pain in the hip. Important individual risk factors were also identified. Increasing age was significantly associated with increased pain in the hip but associated with less risk for pain in the back and shoulder. Males had higher odds for pain in the back and knee compared to females but lower odds for pain in the hip. BMI was particularly important for knee pain. The level of LTPA did not have an important association with MSP in any region. Conclusion There is a significant positive association between ergonomic exposures and musculoskeletal pain, which were specific for the back, shoulder, hip and knee. In addition, the data demonstrated a differential association with age, sex and BMI. This needs to be considered for the treatment and classification of musculoskeletal pain and for future preventive initiatives.

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Section: Individual Risk Factorssupporting

confidence: 84%

Ergonomic and individual risk factors for musculoskeletal pain in the ageing workforce

et al. 2022

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“…It is shown that leg length discrepancies greater than 2 cm can contribute to long-term pathology and lower back pain [8], however, in this case, the leg length discrepancy showed to be more of a marker of her sacropelvic dysfunction. Sacroiliac joint disorders affect the entire sacropelvic girdle, which can subsequently lead to short let syndrome [9]. Because lower back pain is so common, there are a variety of treatment options, such as physical therapy, stabilization belts, acupuncture, massage, nerve stimulation, muscle relaxants, pain relievers, relaxation, and yoga [7].…”

Section: Discussionmentioning

confidence: 99%

The Importance of Pelvic and Leg Length Assessment in the Setting of Postpartum Lower Back Pain

Tafler¹,

Wilson²,

Tafler³

2022

Cureus

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One of the most common complaints during pregnancy is lower back pain. Women believe that this will disappear after they give birth, however, there are a significant number of women who suffer from persistent, unresolving pain that affects their daily lives. Very often, women will wrongfully blame the epidural anesthesia as the cause, however, there are physiologic and anatomic changes that occur. Patients often experience persistent pain when there is an absence of proper postpartum management. The lack of proper management can lead to unresolved pelvic rotation and dislocation, resulting in short leg syndrome. The common treatment for postpartum lower back pain includes various analgesics, physical therapy, and steroid injections. However, with a proper pelvic assessment, treatment with osteopathic manipulation alone, or reinforced with anesthesia, can be successful. Here, we present a case in which a patient presented with persistent lower back two years postpartum. She had been treated with common modalities prior to coming to our clinic and was subsequently found to have a short leg. We discuss the importance of a proper pelvic and leg length assessment in women who present with postpartum lower back pain, as well as how to both prevent and treat short leg syndrome in postpartum patients.

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“…Although SIJ pain and dysfunction are characteristically linked to osteoarthritic degeneration, postpartum pelvic girdle pain has recently been appreciated as an antecedent to chronic SIJ problems. 27 It has been estimated that almost 10% of women continue to have chronically severe pelvic pain of SIJ origin two years postpartum. 27 A number of studies suggest that minimally invasive SIJ fusion is effective in attenuating the impact of pelvic pain on function and quality of life in these patients.…”

Section: Biomechanical and Clinical Correlatesmentioning

confidence: 99%

“… 27 It has been estimated that almost 10% of women continue to have chronically severe pelvic pain of SIJ origin two years postpartum. 27 A number of studies suggest that minimally invasive SIJ fusion is effective in attenuating the impact of pelvic pain on function and quality of life in these patients. 27 , 28 Ongoing research in this key area is being undertaken to optimize clinical outcomes using a patient-tailored approach in selecting the appropriate surgical option for this important sub-population.…”

Section: Biomechanical and Clinical Correlatesmentioning

confidence: 99%

Minimally Invasive Inferior Intra-Articular Sacroiliac Joint Fusion: Successful Application of Osseous Stabilization Using Allograft Bone

Lynch¹,

Tubic²,

Foster³

et al. 2022

ORR

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Minimally invasive sacroiliac joint (SIJ) fusion is the preferred surgical method for managing patients with recalcitrant, chronically severe SIJ pain and dysfunction refractory to conservative medical measures. The primary surgical objective of all minimally invasive SIJ fusion procedures is to provide immediate stabilization within the joint space to support osseous consolidation and the development of a mechanically solid arthrodesis. The intra-articular surgical approach to the SIJ with allograft bone placement utilizes a trajectory and easily identifiable landmarks that allow the surgeon to control the risk of violating important neuro-vascular structures. The intra-articular approach can employ a superior or inferior operative trajectory, with the former restricted to allograft placement in the ligamentous portion of the SIJ. The inferior approach utilizes decortication to surgically create a channel originating in the purely articular portion of the joint space allowing for truly intra-articular implant placement within the osseous confines of the ilium and sacrum. Positioning the implant along the natural joint line and securing it within the underlying sub-chondral bone, mortise and tenon fashion provides stabilization and large surface area contact at the bone implant interface. The inferior, intra-articular approach also places the implant perpendicular to the S1 endplate, near the sacral axis of rotation, which addresses the most significant biomechanical forces across the joint. Short-term, post-surgical observational data from a 57 patient multi-center registry using the inferior, intra-articular approach show uniform and statistically significant improvement in all clinical outcomes (p < 0.001 for all comparisons), including an average 3-point improvement in back pain severity from 6.8 preoperatively to 3.8 at 6 months. Further clinical evaluation with longer-term follow-up of the inferior, intra-articular SIJ fusion procedure is encouraged.

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Sacroiliac Joint and Pelvic Dysfunction Due to Symphysiolysis in Postpartum Women

Cited by 16 publications

References 37 publications

Ergonomic and individual risk factors for musculoskeletal pain in the ageing workforce

Ergonomic and individual risk factors for musculoskeletal pain in the ageing workforce

The Importance of Pelvic and Leg Length Assessment in the Setting of Postpartum Lower Back Pain

Minimally Invasive Inferior Intra-Articular Sacroiliac Joint Fusion: Successful Application of Osseous Stabilization Using Allograft Bone

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