Hip capsular pattern and chronic non-specific low back pain -A case controlled prospective study

Background: Individuals with chronic nonspecific low back pain (CNLBP) presents with altered lumbosacral biomechanics, potentially stemming from compromised hip joint mobility. The objective of our study was to assess hip range of motion (ROM) and hamstring flexibility in individuals with CNLBP to ascertain the presence of a hip capsular pattern in relation to age-matched controls.

Methods: This study was conducted at a tertiary hospital between July 2017 and September 2018, with approval from the institutional review board (JIP/IEC/2017/0044). Inclusion criteria encompassed axial or non-radiating pain primarily in the back for more than 3 months with no definitive pathology. A group of individuals with CNLBP (n = 27) and a control group (n = 30) of age-matched healthy volunteers were included. The observers were blinded to grouping. Bilateral hip range of motion and hamstring flexibility were measured.

Results: Individuals with CNLBP exhibited a significant mean reduction in hip adduction (9.68 & 8.8^o) and internal rotation (7.19 & 7.09°) of the right and left hips, respectively. Additionally, there was a mean increase in flexion (7.68 & 7.71°), extension (6.99 & 8.64°), abduction (7.08 & 8.02°), and external rotation (20.4 & 20.1°) of the right and left hips, respectively, compared to controls (p < 0.01). Notably, hamstring flexibility did not show a significant difference (P > 0.05).

Conclusion: Based on this study, it is plausible that individuals with CNLBP may exhibit a hip capsular pattern (FABER), with the exception of flexion, when compared to age-matched normal individuals. Also, it was also noted that hamstring tightness did not accompany CNLBP.