Hip and Lumbar Spine Physical Examination Findings in People Presenting With Low Back Pain, With or Without Lower Extremity Pain.
Heidi Prather, Abby Cheng, Karen Steger-May and 2 others
PMID 28158964WHAT IT FOUND
Most patients with low back pain had reduced hip movement or pain during hip tests.
Those with these hip findings reported worse pain and disability. Examining the hip is common in this group and may help identify contributing factors, though this study does not prove hip treatment improves back pain.
Key findings
0180% of patients had at least one positive provocative hip test that produced pain in the groin, lateral hip, or buttocks.
02Patients with reduced hip flexion reported higher disability scores, and those with reduced hip internal rotation reported worse back pain function scores.
03Patients with at least one positive provocative hip test reported greater pain and reduced hip and spine function compared to those without positive tests.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only 101 patients seen by a single physician at one tertiary center, so results may not apply to other populations or clinicians. Most patients had chronic low back pain (median duration classified as chronic), so findings may not apply to acute cases. The study was cross-sectional with no follow-up, so it cannot show that hip problems cause back pain or that treating the hip improves back pain. No adjustment was made for multiple statistical comparisons, increasing the chance that some significant findings occurred by chance. Biopsychosocial factors known to influence low back pain were not assessed.
Declared interests
The text does not report funding sources or conflicts of interest.
The easy way to misread this
Do not conclude that treating the hip will resolve low back pain. This study only shows an association: patients with hip findings reported worse pain and function. It did not test any treatment, so the benefit of hip-specific intervention for low back pain remains unproven.