Examining the lumbar and hip region in patients with LBP
Low back pain (LBP) remains a musculoskeletal disease that is not well understood. Current evidence shows there is no correlation between imaging and the symptoms that patients present in a clinical setting.
LBP can present itself in different pain patterns; this makes it difficult to diagnose accurately, as hip pain can also have the same symptoms. Differentiating these symptoms is important to decide which treatment strategy is suitable for individual patient.
There is growing evidence that intra-articular hip disorders (i.e. hip dysplasia, femoroacetabular impingement or acetabular labral tears) occur together with LBP.
This study collected observational cross-sectional data regarding hip physical examination in patients presenting for evaluation and treatment of LBP. On top of that, it compared pain and function between patients with a positive hip examination and those with negative hip examination findings.
A difference in hip range of motion (ROM) was found between men and women in hip flexion and internal rotation. 65 of 101 had a positive hip impingement test, 60 of 101 had a positive FABER test, and 33 of 101 had a positive log-roll test. This indicates that patients with LBP often also have pain originating from the hip region.
This study suggests that patients with reduced hip ROM and positive hip tests have worse LBP symptoms in comparison to patients with LBP and no reported hip pain. Since this is often an unrecognized symptom, it is important that the possible presence of hip pain is taken into account when a patient reports LPB. If hip pain is taken in to account during LPB recovery, patients are more likely to obtain their daily activities faster.
> From: Prather et al., J Orthop Sports Phys Ther 47 (2017) 163-172(Epub ahead of print). All rights reserved to Journal of Orthopaedic & Sports Physical Therapy. Click here for the online summary.