Chronic back pain is a common problem, especially in older adults. There are many ways a physical therapist can help improve this issue, including exercise, stretching, manual therapy, and modifying activity to allow for improved function while recovering.
While it is very common to focus treatments on the area of pain- the low back, often there are other areas of the body that can contribute to issues. One such area is the hip. There is often weakness or tightness in the hip muscles that contribute to back pain.
One recent study compared two groups of adults 60-85 with two different treatment approaches. The first group received a typical back and spine based approach. the second group received a more hip based treatment. Both groups were seen for twice a week over a two-month period.
The hip treatment group had greater improvements over a quicker period of time than the spine treatment group. Some of the improvements seen in the hip group were better back pain disability scores, better scores on walking and sit to stand tests, and improved pain scores.The spine focused group also improved, but not as much as the hip group.
The physical therapists in the hip group did manual therapy to improve the motion of the hip joint, manual stretches to improve the flexibility of the hip muscles, hip and trunk muscle strengthening. The patients also worked on exercises to stretch and strengthen.
So if you are experiencing back pain, especially if you are an older adult, don't forget to work on those hips.
Hicks GE, George SZ, Pugliese JM, Coyle PC, Sions JM, Piva S, Simon CB, Kakyomya J, Patterson CG. Hip-focused physical therapy versus spine-focused physical therapy for older adults with chronic low back pain at risk for mobility decline (MASH): a multicentre, single-masked, randomised controlled trial. Lancet Rheumatol. 2024 Jan;6(1):e10-e20. doi: 10.1016/S2665-9913(23)00267-9. PMID: 38258673; PMCID: PMC10806342.
Pugliese JM, Coyle PC, Knox PJ, Sions JM, Patterson CG, Pohlig RT, Simon CB, Weiner DK, George SZ, Piva S, Hicks GE. The Manual Therapy and Strengthening for the Hip (MASH) Trial: Protocol for a Multisite Randomized Trial of a Subgroup of Older Adults With Chronic Back and Hip Pain. Phys Ther. 2022 Jan 1;102(1):pzab255. doi: 10.1093/ptj/pzab255. PMID: 34751784; PMCID: PMC8831280.