Abstract
Introduction: Low back pain is a leading cause of disability, activity limitation and loss of productivity on a global scale. Major causes of gluteus medius myofascial dysfunction are prolonged periods of sitting and unbalanced movement, a consequence of modern living. Gluteus medius referral pain is often overlooked as a cause of low back pain. Active gluteus medius trigger points commonly lead to primary pain around the low back into the buttocks and across the sacroiliac joint. The primary aim of this study was to compare the effects of sacroiliac manipulation and pelvic blocking in the treatment of active gluteus medius trigger points, with the secondary aim of understanding the correlation between joint hypomobility and myofascial pain dysfunction. Method: This was a comparative study utilising convenient sampling and random group allocation. A selection of 30 male and female participants between the ages of 18 and 45 years were recruited for this study. On meeting the inclusion criteria, participants were allocated into one of two groups by random draw, with 15 participants per group. Group A received chiropractic manipulation to the sacroiliac joints. Group B received biomechanical pelvic blocking. Each participant received two treatments per week over a three-week trial period with a total of six treatments. In the seventh and final consultation, only measurements were taken. Subjective and objective data were collected during the first, fourth and seventh consultations. Subjective measurements were captured using the Numerical Pain Rating Scale and the Oswestry Disability Index. Objective measurements were performed using a pressure pain algometer. The data was captured and analysed by the researcher with the assistance of STATKON. Results: The Numerical Pain Rating Scale readings revealed that Group A (78.8%) had a greater improvement in decreasing perceived pain scores in comparison to Group B (66.9%). The Oswestry Disability Index scores revealed that Group B (70.6%) had a greater improvement in perceived pain related to their level of function in activities of daily living in comparison to Group A (58.0%). The inter- and intra-group analysis of the Numerical Pain Rating Scale and Oswestry Disability Index readings revealed that both vii groups showed an equally statistically significant improvement in perceived pain. The pressure algometer readings revealed that Group A (38.7%) had a greater improvement in pressure pain threshold in comparison to Group B (29.9%). The inter- and intra-group analysis of pressure algometer readings revealed that groups A and B showed an increase in the pressure pain threshold of the gluteus medius trigger points. The results indicated that neither of the two groups showed statistically significant superiority over the other in terms of treating active gluteus medius trigger points. Conclusion: Both treatment protocols had positive clinical effects on the participants. Subjectively, the participants – on average – experienced a decrease in perceived pain. Objectively, the pressure algometer readings decreased throughout the trial period, which was noted in both groups. This suggests that, although both treatment protocols had positive clinical effects on participants over the trial, neither treatment protocol was statistically superior when compared to the other.
M.Tech. (Chiropractic)