Pelvic Belt Effects on Sacroiliac Joint Ligaments: A Computational Approach to Understand Therapeutic Effects of Pelvic Belts

Abstract

Background: The sacroiliac joint is a widely described source of low back pain. Therapeutic approaches to relieve pain include the application of pelvic belts. However, the effects of pelvic belts on sacroiliac joint ligaments as potential pain generators are mostly unknown. Objectives: The aim of our study was to analyze the influence of pelvic belts on ligament load by means of a computer model. Study Design: Experimental computer study using a finite element method. Methods: A computer model of the human pelvis was created, comprising bones, ligaments, and cartilage. Detailed geometries, material properties of ligaments, and in-vivo pressure distribution patterns of a pelvic belt were implemented. The effects of pelvic belts on ligament strain were computed in the double-leg stance. Results: Pelvic belts increase sacroiliac joint motion around the sagittal axis but decrease motion around the transverse axis. With pelvic belt application, most of the strained sacroiliac joint ligaments were relieved, especially the sacrospinous, sacrotuberous, and the interosseous sacroiliac ligaments. Sacroiliac joint motion and ligament strains were minute. These results agree with validation data from other studies. Limitations: Assigning homogenous and linear material properties and excluding muscle forces are clear simplifications of the complex reality. Conclusions: Pelvic belts alter sacroiliac joint motion and provide partial relief of ligament strain that is subjectively marked, although minimal in absolute terms. These findings confirm theories that besides being mechanical stabilizers, the sacroiliac joint ligaments are likely involved in neuromuscular feedback mechanisms. The results from our computer model help with unraveling the therapeutic mechanisms of pelvic belts. Key words: Finite element computer study, low back pain, neuromuscular feedback, pelvic biomechanics, pelvic belt intervention, sacroiliac joint ligaments, sacroiliac joint motion