St. Louis Park Chiropractor Best Practices
Hip Strength for Low Back Pain
A review of:
Santamaría G, Rodríguez I, Rodríguez-Pérez V, Cobreros-Mielgo R, Lantarón-Caeiro E, Seco-Casares M, Fernández-Lázaro D. Effect of Hip Muscle Strengthening Exercises on Pain and Disability in Patients with Non-Specific Low Back Pain—A Systematic Review. Sports. 2023; 11(9):167. https://doi.org/10.3390/sports11090167
Research Reviewed by Dr. John Wertish
Summarized Review of Conclusions:
Our St. Louis Park Chiropractors, located in West End, treat joint pain, neck pain and headaches but the biggest issue we see is Low Back Pain. The lumbar spine is biomechanically connected to the pelvic and hip joint, making it difficult to determine the provenance of symptoms in clinical practice. The normal range of movement (ROM) of the hip is often altered in patients with Low Back Pain, making it impossible to correctly transmit the load from the lower limb (LL) to the trunk. The pelvis and hip muscles are involved in supporting the joints and above and below, they are large calorie burning muscles that are involved in most frequent movements. The results presented in this systematic review showed that the inclusion of HMS exercises in an exercise protocol that involves the whole musculature or specifically targets the lower back provides significant improvements in the reduction in pain and disability in patients with Low Back Pain, without causing injury.
Below I have referenced key quotes from this research to help summarize the results.
Quotes from the Article:
“Low back pain (LBP) is an increasingly common condition worldwide, but in practical terms it is estimated that 70–80% of the population from countries of the Western world will suffer LBP at some point in their lives, especially affecting women over 40 years old.”
“Therapeutic exercise in LBP would relieve pain, improve functionality, and reduce the risk of recurrence . It is necessary to consider the entire spectrum of different exercise therapies, including motor control exercises, balance, aerobic training, stretching, and muscle strengthening [”
Introduction to the Research:
The lumbar spine is biomechanically connected to the pelvic and hip joint, making it difficult to determine the provenance of symptoms in clinical practice. The normal range of movement (ROM) of the hip often has imbalance in strength and flexibility in patients with LBP, making it impossible to correctly transmit the load from the lower limb (LL) to the trunk. This is usually due to shortening of the flexor muscles, which limits femur extension and therefore increases lumbar extension, leading to lordosis. On the other hand, it is common to find strength deficiency of the hip abductor and extensor muscles in patients suffering from LBP. This shortage is usually compensated for by overuse of the hamstring muscles, which can lead to their curtailment and increased compensatory movements of the spine. Ignoring the hip as a joint as a whole is assess low back pain can help be a big mistake leading to chronic pain.
This research was a systemic review looking into three databases. These studies were reviewed and gave conclusions to the hypothesis. All the studies obtained in the 3 databases were compared in order to limit the search as much as possible and avoid repetition of studies. A review of all existing meta-analyses and systematic reviews was carried out to avoid losing studies due to lack of data search terms. Full-text articles were retrieved and checked for compliance with inclusion and exclusion criteria.
The search identified 966 potentially relevant studies in the three databases, 325 from PubMed, 92 from PEDro, and 549 from Scopus. After eliminating duplicates and reading the titles, 912 articles were discarded.
All the studies compare HMS exercise programs (IG) and those directed by chest or of general nature (CG). Only the trial by Cai et al. applied HMS as the sole treatment of the IG. In the remaining six studies, the IG, in addition to the HMS exercise program, received the same treatment as the CG, consisting of manual therapy of the lower back and/or hip joint, strengthening and resistance exercises of the trunk muscles, peripheral nervous system (PNS) mobilizations, aerobic exercise, fitness, education, motor control exercises, and lumbar stabilization. Six of the seven studies included in the review measured changes in pain with a total of 230 CG and 222 IG participants. Four studies used the VAS scale to measure pain and the remaining two used the NPRS scale. In all of them, an improvement or even pain relief was observed after the intervention in the IG, but the difference between groups was only statistically significant (p < 0.05) in three, one found non-significant improvements (p > 0.05), and two did not find any difference .
As always with these reviews, these are my takeaways from the article and I encourage you to read the article in its entirety. The references used in this article by the authors of this article are listed here.
We love to help our patients in St. Louis Park stay healthy. We are here to relieve back pain, neck pain and headaches while also teaching about how our diet and stress effects our over all health. By improving these areas of our lives we can become healthier, stay out of pain and reduce risk of diseases. Our Chiropractors located in the West End, near the corner of MN-100 S & Lake Rd./Westside Dr., want to help you stay healthy and out of pain.