Sacroiliac dysfunction in construction workers

In the literature of manual medicine the sacroiliac joint is widely accepted as a potential source of low back pain. On the other hand, some investigations have detected sacroiliac joint dysfunction without concomitant low back pain. The prevalence of sacroiliac dysfunction in the population has been noted in the medical literature to be between 19.3% and 47.9%. However, the prevalence of sacroiliac dysfunction in the general population and for construction workers is unknown.

This article presents results from the Hamburg Construction Workers Study in respect to sacroiliac diagnostics. The prevalence of and connection between sacroiliac dysfunction and low back pain are particularly interesting.

The sacroiliac joint diagnostics were studied in a cross-section investigation of a cohort of 480 male construction workers. Manual examination is the standard in the diagnostics of sacroiliac joint conditions at present. The assessment of sacroiliac joint function by standing flexion test, the spine test, the iliac compression test, and the iliac springing test was operationalized as two categories: sacroiliac dysfunction I and II.

A prevalence of 29.0% was found for dysfunction I and 6.3% for dysfunction II, whereas a prevalence of 7.9% was found for the coprevalence of low back pain and sacroiliac dysfunction on the day of examination. This study demonstrated no statistical associations between low back pain and sacroiliac joint dysfunction.

The reason why symptomatic and asymptomatic sacroiliac dysfunctions exist has not yet been sufficiently explained. The identification of pain-provoking factors should be the aim of subsequent investigations. A further study with a prospective design will be necessary to answer the questions that remain.