M.D. Avillar     J. G. Keating       V. Sims

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lNTRODUCTION 

Incidences of lower back pain continue to escalate, both in number and in total cost to health-care systems (Kelsey & White 1980). This trend of increased injury and cost continues in spite of large increases in research and funding that is directed at all areas of spine care. Low back pain is a 50 billion dollar a year growth industry in our society (Graves et al 1990a).

Waddell (1980) nates that there has been an epidemic of low back pain in the Western world since 1956. The reason behind this phenomenon is unclear; however, it is believed that the increase can be attributed to increasingly sedentary lifestyles and the sedentary work roles that are developed in a society based on information. Read More

VICKI SIMS, PT CHT
DAVID MESNICK, PT
ALAN LIPPITT, MD
MICHAEL AMARAL, MD, FACS

550 Peachtree Street, Suite 1760
Atlanta, Georgia USA 30308
(404) 817-0734
dmesnick@afptc.com

INTRODUCTION

Disruption of the sacroiliac joint is recognized as a potential source of spine and pelvic pain. Unfortunately, there is no standard objective study to demonstrate this.

The physiopathology is a tearing or stretching of the posterior sacroiliac ligament complex with subsequent Read More

POSTER FOR THE SPINE & PERIPHERAL NERVES SECTION OF THE AMERICAN ASSOCIATION OF NEUROLOGICAL SURGEONS.

Michael A. Amaral, MD, FACS; Alan B. Lippitt, MD; Vicki Sims, PT.

Background:

Sacroiliac dysfunction accounts for about 15% of low back pain patients. The pain is typically posterior, in the area of the sacroiliac joint. It may irradiate in the groin and toward the knee. A subset of patients also presents with sciatica-like pain which, to date, has remained unexplained. The diagnosis is usually made by a fluoroscopically guided sacroiliac intra-articular block. An improvement of 75% or better is considered diagnostic while an improvement of 50% to 74% is considered equivocal. Responses below 50% generally rule out this diagnosis. Read More

Vicki Sims, P.T.

Alan Lippitt, M. D.

David Mesnick, P.T.

Introduction

Lower back pain (LBP) is a 50 billion-dollar per year growth industry in our society (Graves et al, 1990).  The frequency of back pain is such that in the United States alone there are seven million people off work because of it at any one time.  In fact, the most common cause of occupational disability is, indeed, lower back pain (McKenzie, 1981).

While there has been considerable research directed toward identifying the etiology of LBP, only syndromes that are associated with neurologic compression of the nerve roots are well understood by clinicians.  It has been estimated that a precise diagnosis is unknown in 80-90% of patients with LBP (Richardson and Inglarsh, 1994). Read More

Brolinson, PG.

Kozar, AJ.

Cibor, G.

The sacroiliac (SI) joint is a common source of low back pain in the general population. Because it is the link between the lower extremities and the spine, it sustains even higher loads during athletic activity, predisposing athletes to a greater probability of joint dysfunction and pain. The diagnosis and treatment of SI joint dysfunction remains controversial, due to complex anatomy and biomechanics, and a lack of universally accepted nomenclature and terminology, consistently reliable clinical tests and imaging studies, and consistently effective treatments. This article clarifies these issues by presenting a model of SI joint anatomy and function, a systematic approach to the diagnosis of dysfunction, and a comprehensive treatment plan.

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