Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, localized low back and buttock pain, exacerbated by prolonged sitting, standing, or transitional movements such as rising from a chair. Pain is described as dull, aching, and occasionally sharp, radiating into the posterior thigh, but not extending below the knee. No associated neurological deficits, bowel/bladder dysfunction, or constitutional symptoms reported.
Clinical Examination Findings
Physical examination reveals tenderness to palpation over the SI joint and the posterior superior iliac spine (PSIS). Provocative testing is positive for SI joint dysfunction, including positive FABER (Patrick’s) test, Gaenslen’s test, and Thigh Thrust maneuver, reproducing the patient’s concordant pain. Gait is antalgic. Neurological examination, including motor strength, sensory testing, and deep tendon reflexes, is within normal limits.
Treatment Protocol
Initial management includes a structured physical therapy program focusing on pelvic stabilization and core strengthening. Pharmacological intervention includes non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants as needed. If conservative measures fail, consider fluoroscopically-guided intra-articular corticosteroid injection for diagnostic and therapeutic purposes. Activity modification and ergonomic adjustments are advised.