A systematic review of current evidence on clinical outcomes of lumbar roll and modified SIMS manipulation techniques in sacroiliac joint dysfunction.
Farooq Islam, Umair Ahmed, Christopher McCarthy and 3 others
A review of 9 small trials finds that SIJ manipulation (including lumbar roll and modified SIMS) consistently reduces pain and disability in the short term, but no trial directly compared the two techniques, so neither can be recommended over the other.
Key findings
1Eight of nine trials showed significant within-group pain reduction after manipulation-based interventions, and five studies found greater pain reduction compared to electrotherapy or exercise comparators.
2No direct head-to-head trials comparing lumbar roll and modified SIMS techniques were found; the review's comparative findings are based on indirect evidence and should be considered exploratory.
3No serious adverse events were reported across any included trial; the only side effects noted were minor and temporary localized soreness.
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What it does not show
No trial directly compared lumbar roll to modified SIMS; all comparative statements are indirect and exploratory. Included populations were heterogeneous — some had dysmenorrhea, pelvic floor dysfunction, or piriformis syndrome rather than isolated SIJD — so findings may not apply to a patient with a clear SIJ diagnosis. Sample sizes were small (roughly 30 to 90 per trial) and follow-up was short (mostly 4–8 weeks), so long-term benefit is unproven. Technique classification relied on interpreting procedural descriptions rather than standardized protocols, so it is unclear whether the interventions studied were truly lumbar roll or modified SIMS. Risk of bias was moderate in several trials, with unclear allocation concealment and lack of assessor blinding. No formal GRADE assessment was performed; the authors estimate overall certainty as low to moderate.
Declared interests
No funding was received and no conflicts of interest were declared.
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