Physical Factors Associated with Non-Specific Neck Pain: Correlations Among Pain, Disability, Posture, Endurance, and Compensatory Movement.

BACKGROUND This study was conducted to investigate physical risk factors in patients with non-specific neck pain. The correlations among pain intensity, pressure pain threshold, range of motion (ROM), and disability index were analyzed in 50 patients with non-specific neck pain at a hospital in Korea. MATERIAL AND METHODS We enrolled 50 patients diagnosed with non-specific neck pain by a doctor. All subjects were evaluated for pain intensity, pressure threshold, degree of disability, active range of motion (ROM) of the neck, upper cervical rotation ROM, muscular endurance of deep cervical flexor, compensatory movements for neck flexion, forward head posture, shoulder height difference, and rounded shoulder posture. The correlation between each variable was analyzed. RESULTS Pain intensity had a significant correlation between cervical rotation ROM, cervical flexion-rotation ROM, rounded shoulder posture, shoulder height difference, and forward head posture (P<.05). There was a significant correlation between the pressure pain threshold and the cervical extension ROM, cervical flexion-rotation ROM, and rounded shoulder height (P<.05). The disability index had a significant correlation between the cervical rotation ROM, cervical flexion-rotation ROM, rounded shoulder posture, and the compensatory movement of neck flexion (P<.05). CONCLUSIONS Physical risk factors for non-specific neck pain included cervical rotation ROM, upper cervical rotation ROM, rounded shoulder posture, shoulder height difference, and cervical flexion compensatory movements, which can affect pain intensity and pressure pain threshold.

Effects of Pelvic-Tilt Imbalance on Disability, Muscle Performance, and Range of Motion in Office Workers with Non-Specific Low-Back Pain.

Imbalance in the pelvic tilt is considered to be a major variable in low back pain. The purpose of this study was to investigate the effects of pelvic-tilt imbalance on trunk- and hip-muscle performance, range of motion, low-back pain, and the degree of disability in office workers. This was a cross-sectional study conducted in a physical therapy clinic on forty-one office workers diagnosed with non-specific low-back pain. Among the office workers with non-specific low-back pain, 25 were assigned to the pelvic-tilt-imbalance group and 16 to the normal group without pelvic-tilt imbalance. In order to determine the differences according to the imbalance in pelvic tilt, the pain intensity and disability indices were compared between the groups. In addition, the muscle performance and range of motion of the trunk and hip joints and foot pressure were measured and compared. There were differences between the groups in the disability indices and the ratio of internal and external rotation of the hip joint. However, there were no differences in the other variables. Pelvic-tilt imbalance in office workers with non-specific chronic low-back pain may exacerbate the degree of disability and be related to hip-joint rotational range of motion.

Association Between Hamstring Shortness and Asymmetry, Pain Intensity, Disability Index, and Compensatory Lumbar Movement in 60 Patients with Nonspecific Chronic Low Back Pain.

BACKGROUND The correlation between hamstring muscle shortening and nonspecific low back pain and compensatory lumbar movements is still controversial. The purpose of this study was to evaluate the association between hamstring shortness and asymmetry, pain intensity, the disability index, and compensatory lumbar movement in 60 patients with nonspecific chronic low back pain. MATERIAL AND METHODS Sixty patients with nonspecific low back pain participated in this study. The hamstring shortness and asymmetry, pain intensity, the disability index, and compensatory lumbar movement of the patients were assessed. The pain intensity was evaluated using a numeric pain rating scale (NPRS), active knee extension testing was performed to measure the length of the hamstring, and compensatory lumbar movement was assessed using a digital dual inclinometer. Correlation analysis was used for analysis of the obtained data. RESULTS The hamstring length showed a negative correlation with hamstring length asymmetry, NPRS, and disability index (P<0.05). The asymmetry of the hamstring length was positively correlated with NPRS, disability index, and compensatory lumbar rotation (P<0.05). Lumbar flexion was positively correlated with the hamstring muscle length (P<0.05). However, there was a negative correlation between the hamstring length asymmetry, NPRS, and disability index (P<0.05). There was no correlation between the compensatory lumbar rotation, hamstring length, or disability index. CONCLUSIONS Compensatory flexion movements, NPRS, and disability index in patients with nonspecific chronic low back pain were associated with hamstring shortness and asymmetry. These factors should be considered when planning physical therapy for patients with nonspecific low back pain.

Comparison of compensatory lumbar movement in participants with and without non-specific chronic low back pain: A cross-sectional study.

BACKGROUND: Many studies have compared muscle length and muscle activity for low back pain. However, compensatory movement for non-specific low back pain has not yet been studied sufficiently. OBJECTIVE: The purpose of this study was to compare the length of the hip flexor, lumbar extensor endurance and the muscle activity of the erector spinae and gluteus maximus during hip extension, and the compensatory movement of the lumbar in people with or without nonspecific chronic low back pain. METHODS: In this case-control study, 16 participants with non-specific chronic LBP and 17 without LBP were included. Hip flexor length was assessed by the modified Thomas test. Lumbar extensor endurance was assessed by the modified Biering-Sorensen test. Muscle activity of the erector spinae and gluteus maximus during hip extension was measured using a Delsys-Trigno wireless EMG system. Compensatory lumbar movements during hip extension were measured using a digital inclinometer. RESULTS: Muscle activity of the erector spinae and compensatory lumbar movements were significantly higher in the LBP group. (p< 0.05). Hip flexor length, muscle activity of the gluteus maximus and endurance of the lumbar extensor were significantly differences in the LBP group (p< 0.05). CONCLUSIONS: Shortened hip flexors, low gluteus maximus activity, and high erector spinae activity during hip extension, lumbar extensor weak endurance, lumbar compensatory movement are potential factors for non-specific LBP.

Correlations Between Hip Extension Range of Motion, Hip Extension Asymmetry, and Compensatory Lumbar Movement in Patients with Nonspecific Chronic Low Back Pain.

BACKGROUND This study aimed to confirm the correlations among hip extension range of motion, hip extension asymmetry, pain intensity, disability index, and compensatory lumbar movement in patients with nonspecific chronic low back pain. MATERIAL AND METHODS Of 66 patients with nonspecific chronic low back pain and limited hip extension, 59 met the inclusion criteria and were enrolled in the study. Pain intensity, Oswestry Disability Index (ODI), hip range of motion, compensatory lumbar extension, and compensatory lumbar rotation of the subjects were assessed. Pain was measured using a numeric pain rating scale (NPRS), and hip extension range of motion and compensatory lumbar movement were evaluated using a digital dual inclinometer (Dualar IQ, JTech Medical, United States). Correlation analysis was used to analyze the data. RESULTS A strong correlation was observed among hip extension asymmetry, pain intensity, and disability index (P<0.05). However, no correlation was observed among compensatory lumbar rotation and extension, pain intensity, and ODI. A strong correlation also was observed between limited hip extension range of motion and compensatory lumbar rotation (P<0.05) but not between limited hip extension range of motion and compensatory lumbar extension (P>0.05). CONCLUSIONS The results of this study showed that hip extension asymmetry might be a more critical factor than hip extension range of motion. The strong correlation between limited hip extension and compensatory lumbar rotation suggests a risk of micro-trauma due to compensatory lumbar rotation.