Dysfunction of the Sacroiliac Joint
Dysfunction of the sacroiliac joint (partly - a typical synovial joint, partly - immobile cartilaginous synostosis) underlies up to 30% of nonspecific lumbar pain. A unilateral lumbar pain with no signs of radiculopathy is observed during examination. Pain in the sacroiliac joint may be highly accurately diagnosed by using three or more positive provocation tests, but X-ray controlled diagnostic blockade is a reference standard method to identify painful joints. Treatment is started in accordance with general protocol provided by International guidelines on management of acute and chronic nonspecific back pain. A combination approach including medicines and non-medicated methods should be preferred. Use of local nonsteroidal anti-inflammatory drugs (ibuprofen, Dolgit®) is discussed.