title: Chronic sacroiliac joint and pelvic girdle dysfunction in a 35-year-old nulliparous woman successfully managed with multimodal and multidisciplinary approach.
abstract: OBJECTIVE
  Sacroiliac joint pain and dysfunction affect 15-25% of patients reporting low back pain, including reports of spontaneous, idiopathic, traumatic, and non-traumatic onsets. The poor reliability and validity associated with diagnostic clinical and imaging techniques leads to challenges in diagnosing and managing sacroiliac joint dysfunction.
  
  
  METHODS
  A 35-year-old nulliparous female with a 14-year history of right sacroiliac joint dysfunction was managed using a multimodal and multidisciplinary approach when symptoms failed to resolve after 2 months of physical therapy. The plan of care included four prolotherapy injections, sacroiliac joint manipulation into nutation, pelvic girdle belting, and specific stabilization exercises.
  
  
  RESULTS
  The patient completed 20 physical therapy sessions over a 12-month period. At 6 months, the patient's Oswestry Disability Questionnaire score was reduced from 34% to 14%. At 1-year follow-up, her score was 0%. The patient's rating of pain on a numeric rating scale decreased to an average of 4/10 at 6 months and 0/10 at 1-year follow-up.
  
  
  CONCLUSIONS
  A multidisciplinary and multimodal approach for the management of chronic sacroiliac joint dysfunction appeared successful in a single-case design at 1-year follow-up.
authors: The George Washington University School of Medicine & Health Sciences Department of Physical Therapy, Washington, DC, USA.
authors: Holly
authors: H
authors: Jonely
authors: Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
authors: Jean-Michel
authors: JM
authors: Brismée
authors: International Spine, Pain & Performance Center, Washington, DC, USA.
authors: Mehul J
authors: MJ
authors: Desai
authors: The George Washington University School of Medicine & Health Sciences Department of Physical Therapy, Washington, DC, USA.
authors: Rachel
authors: R
authors: Reoli
keywords: Manual therapy; Pelvic ring instability; Prolotherapy; Rehabilitation; Sacroiliac joint dysfunction