In a prospective cohort study, Leemann et al., investigated the effect of high-velocity, low-amplitude SMT in patients with acute or chronic MRI-confirmed LDH, and reported clinically significant improvement in back and leg NRS and ODI scores in both short-term and long-term assessments . In a follow-up study, Ehrler et al., investigated the association of magnetic resonance imaging features, including axial location and type of herniation, with the outcomes of SMT in patients with LDH . This study reported greater improvements in symptoms among patients with sequestrated SLDD who received SMT to the level of herniation. These studies, however, did not consider the treatment of the SIJ in patients with LDH.