ABSTRACT
This case report describes a clinical case of a 53 years aged male with Low Back Pain (LBP) at Sacro Iliac Joint (SIJ). Patient referred to physical therapy department with LBP over the past 3 weeks. Pain extended to posterior aspect of left thigh and worsening with prolonged standing, sitting and with stair climbing. Moreover, he found difficulty to ride his car or going from sit to stand. He had a history of road traffic accident 30 years ago that led to severe pain in his lower back area, he was a farmer as well and was working hardly more than 8 hours daily by lifting heavy objects. Patient came to the department by walking with assistive cane. By palpation, there was a local tenderness at the posterior aspect of the SIJ. Range of motion was limited by pain in lumbar flexion, extension, rotation and bilateral side bending movements. Pain scored 7 out of 10 on Numerical Pain Rating Visual Analogue Scale. Functional disability scored 19 out of 24 on Roland-Morris Disability questionnaire. Patient underwent special test of FABER, SLR and sacroiliac stress tests and Physical therapy modalities of TENS, dry cupping, myofascial release technique and manipulation, medical taping, hot packs applied before and after exercise. Stretching exercises included single knee to chest, trunk rotation, child’s pose and stabilization exercises of bird dog pose, superman’s, bridge, ball squeeze. Outcomes of treatment were assessed with same pretest measures. At the end of 3 weeks, patient improved in all symptoms of reduced pain to 2 out of 10 on Numerical Pain Rating, 3 out of 24 on Roland-Morris disability questionnaire. Post rehabilitative findings on all provocative tests were negative. Evidence on physical therapy management of patients with SIJ pain appears underreported. Patients presenting with SIJ pain should be routinely screened for sacroiliac component in LBP. Physical therapists are encouraged to report their findings so as to strengthen the evidence available for physical therapy for SIJ pain.