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Sacroiliac surgery should
be considered only after
patients have tried some
combination of physical
therapy, chiropractic
manipulation, medication
management or rhizotomy
injections that denervate
the nerves in the sacroili-
ac joint. Surgery is indicat-
ed if these treatments fail to restore the sacroiliac joint to its nor-
mal stable, immobile function.
The following provocative tests help identify patients who have
sacroiliitis and are candidates for surgery:
• Distraction. The examiner applies force to the patient's hips
as they lie in the supine position with their forearm under their
lower back.
Thigh thrust. The patient lies in the same position, but with the
leg on the side of the injured hip bent 90 degrees. The examiner
applies pressure on the bent knee and the opposite hip.
• Faber. The patient now moves the leg on their injured side to
the right as the examiner applies pressure to the inside of the
knee and the opposite hip.
• Compression. The patient lies on their side with their good hip
on the table, and the examiner applies downward pressure on the
affected hip.
• Gaenslen's test. The patient, lying in the supine position, fully
Identifying Candidates for Surgery
CLEAR PICTURE Providers are better able to diagnose sacroiliac dis-
order and determine if surgery would be the best treatment option.
LAST RESORT
