Treating the Hip in Patients with Low Back Pain
Low back pain is the most common reason patients seek out the care of their primary care physician and Physical Therapist. Physical Therapy has been shown to be an effective first line treatment for both managing the symptoms of low back pain, as well as, preventing their recurrence. Manual therapy techniques performed by Physical Therapists including manipulation, mobilization, and dry needling have been shown to help reduce short term pain and disability. Conversely, long term effectiveness and reduced recurrence has been shown with strengthening exercises. In our experience, treating the hip, in addition to the spine, with manual therapy and exercise accelerates a patient's recovery from an episode of low back pain.
A recent randomized controlled trial was conducted to determine if the addition of hip treatments including manual therapy and exercise augmented the recovery of patients with low back pain over lumbar treatments alone (Bade et al. J Eval Clin Pract. 2017). Both groups of patients' lumbar spines were treated based on the clinician's clinical reasoning, but one group received additional prescribed treatments to their hips. The authors found improved outcomes and patient satisfaction in the group receiving this combined treatment. Clinicians are encouraged to examine the treat the hip region in addition to the lumbar spine in patients with low back pain.