Association of Hip Radiograph Findings With Pain and Function in Patients Presenting With Low Back Pain.
Heidi Prather, Abby Cheng, Karen Steger-May and 2 others
PMID 28629805WHAT IT FOUND
Among adults with low back pain and a positive hip test, eighty-four percent had hip radiograph findings of deformity or arthritis.
Those with moderate to severe hip arthritis had worse low back function, but pain scores did not differ.
Key findings
01In 63 patients with usable hip radiographs, 53 had at least one positive radiographic measurement of hip deformity or arthritis.
02Patients with moderate to severe radiographic hip OA did not report significant differences in numeric pain ratings, but they had worse function on the mODI (p=.0001) and RMQ (p=.03).
03Patients with radiographic FAI had worse low back-related function, and their worst and least pain ratings differed.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study only looked at people with low back pain who already had at least one positive hip test, so it does not describe hip radiograph findings in all patients with low back pain. Only 63/80 patients had radiographs appropriate for accurate assessment; inadequate positioning prevented measurement in others. Radiographic measurement cutoffs and reliability are controversial, and no single measurement reliably identifies a specific hip deformity. Mixed hip deformity was not separated because it has not been specifically defined. The study did not test treatment, so it cannot show that addressing the hip improves low back pain.
Declared interests
The supplied text does not include a conflict-of-interest declaration. The publication types list research support from N.I.H., Extramural, and non-U.S. government sources.
The easy way to misread this
Do not conclude that hip radiograph findings explain all low back pain or that treating the hip will improve it. This study only compared people who already had a positive hip test, and it did not test any treatment.