The association of hip range of movement, and its side-to-side asymmetries, and non-specific lower back pain in adults aged 40 years and older

Q3 Medicine North American Spine Society Journal Pub Date : 2025-01-08 DOI:10.1016/j.xnsj.2025.100581

Kevin Ermann PT, Benita Olivier PT PhD

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Abstract

Background

The hip joint's close association and coupling with the lumbar spine may influence its axes of rotation during closed-chain movement. Consequently, altered hip range of movement (ROM) may potentially foment the symptoms of non-specific lower back pain (NSLBP), warranting its investigation. A quantitative, cross-sectional, analytical design was employed to determine whether NSLBP has an association with altered hip ROM and dominance-aligned hip side-to-side asymmetries.

Methods

Ninety-three convenience sampled participants with and without NSLBP were enrolled. These were assigned to the Lumbar Pain Group (LPG), comprising 61 individuals, 32 males and 29 females or the Control Group (CG), consisting of 32 pain-free volunteers, 18 males and 14 females. Individuals with hip conditions were excluded from the study. Participants completed a Baecke questionnaire and their BMI, Beighton score and leg dominance was established. The following asymptomatic, dominance aligned hip ROM was measured with an Inertial Measurement Unit (IMU): hip flexion ROM in supine; hip extension ROM in prone; Modified Thomas Test (MTT) with knee extension; straight leg raise (SLR); abduction in supine; adduction in supine and hip internal (IR) and external rotation (ER) in prone, sitting and supine in 30° flexion using a framework.

Results

The LPG and CG showed similar hip ROM. However, significant hip side-to-side asymmetries presented in the LPG's sagittal, frontal and transverse planes but only presented in the CG's transverse plane hip ranges. The dominant side usually displayed the smaller range.

Conclusions

Without further evidence, it is unlikely that symmetrically atypical coupled hip ranges should be ignored in the treatment of NSLBP, but a stronger case exists for attention to the hip ROM side-to-side asymmetries. Compounded, multi-planar hip ROM side asymmetries may be one of the causes of NSLBP.

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