Prevalence of Sacroiliac Joint Dysfunction Among Patients with Low Back Pain: A Descriptive Cross-Sectional Study
TL;DR
The findings highlight the importance of routine use of validated SIJ provocation test clusters together with pain and hip/lumbar ROM assessment to facilitate timely diagnosis and targeted management in patients with LBP.
Abstract
Background: Low back pain (LBP) is a leading cause of disability worldwide, affecting more than 540 million people. Sacroiliac joint dysfunction (SIJD) is a well-recognized yet frequently underdiagnosed source of LBP, with a reported prevalence of 13–48% among patients with LBP. However, evidence regarding the prevalence and associated factors of SIJD in the Pakistani population remains limited. Objective: To determine the prevalence of sacroiliac joint dysfunction (SIJD) among patients with low back pain (LBP) and evaluate its association with demographic and clinical characteristics, including age, sex, occupation, pain intensity, and hip and lumbar range of motion (ROM). Methodology: A descriptive cross-sectional study was conducted over four months (March–June 2025) at two rehabilitation centres and community settings in Islamabad and Rawalpindi, Pakistan. Using purposive sampling, 377 patients with LBP aged 18–45 years were recruited. SIJD was diagnosed when at least three of five validated sacroiliac joint provocation tests (FABER, distraction, compression, Gaenslen’s, and thigh thrust) were positive. Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), disability using the Oswestry Disability Index (ODI), and hip and lumbar ROM were measured using a goniometer and an inclinometer. Associations were analyzed using the chi-square test. Results: The prevalence of SIJD was 23.6% (89/377). The prevalence was significantly higher among males than females (28.1% vs. 16.3%; χ² = 7.30, p = 0.007). No significant associations were observed with age (p = 0.940) or occupation (p = 0.791). Significant associations were identified between SIJD and pain severity (χ² = 66.14, p < 0.001), hip extension (χ² = 202.26, p < 0.001), hip internal rotation (χ² = 121.96, p < 0.001), hip external rotation (χ² = 51.94, p < 0.001), and lumbar forward flexion (χ² = 97.62, p < 0.001). Conclusion: Approximately one-quarter of patients with LBP had SIJD. It was more common among males and was associated with greater pain severity and reduced hip and lumbar ROM. These findings highlight the importance of routine use of validated SIJ provocation test clusters together with pain and hip/lumbar ROM assessment to facilitate timely diagnosis and targeted management in patients with LBP.