Most sacroiliac pain trials omitted screening of the middle and lower back
In trials treating adults diagnosed with sacroiliac joint pain, most omitted screening of the middle and lower back before diagnosis. The review assessed diagnostic procedures, not treatment benefits.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
In trials involving adults treated for sacroiliac joint pain, screening of the middle and lower back was usually absent before diagnosis. This raises questions about how consistently the trials identified the source of pain. It does not establish that participants were misdiagnosed, or show whether any particular treatment or screening approach improves patient outcomes.
Every included trial had at least some risk of bias. This abstract-based account cannot examine the criteria used to judge screening as reasonable or determine how omitted screening affected diagnosis or treatment results.
What researchers found
Screening before sacroiliac joint diagnosis
Before diagnosis, 32 of 43 trials (74.4%) performed no thoracolumbar screening, compared with reasonable or partial screening in other trials. This proportion describes trial procedures, not patient outcomes.
Why another region was considered
The review was motivated by concern that pain around the sacroiliac joint may originate in the middle or lower back. It examined whether trials checked that possibility before assigning a diagnosis, rather than testing a screening method.
What the review cannot resolve
Some trials completed screening only partly, while others used a process judged reasonable. Because the review assessed diagnostic procedures, its results cannot quantify how many participants were misdiagnosed or identify which treatment worked best.
The original publication
Screening of the thoracolumbar spine is almost completely absent in trials evaluating conservative management for sacroiliac joint pain: a systematic review of 43 randomized controlled trials.
Schumacher MR, Kovash DT, Forkin KT et al.
J Man Manip Ther · 2026
- PubMed ID
- 40720882
- Record checked
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