Does Prescriptive Treatment of the Hips Improve Outcomes in Patients With Low Back Pain? A Randomized Controlled Trial
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Back Pain, Back Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | September 2013 |
| End Date: | June 2016 |
There will be two groups of patients with low back pain (by randomization). Both groups will
receive a pragmatic treatment approach by physical therapists for low back pain. One group
will also receive a prescriptive treatment approach for both hips. The investigators feel
that the additional of a standardized exercise program and stretching for the hips will
improve outcomes in patients with mechanical low back pain.
receive a pragmatic treatment approach by physical therapists for low back pain. One group
will also receive a prescriptive treatment approach for both hips. The investigators feel
that the additional of a standardized exercise program and stretching for the hips will
improve outcomes in patients with mechanical low back pain.
It has been suggested that treatment of the hips should improve outcomes in patients with
mechanical low back pain. This has yet to be studied in a randomized controlled fashion or
in a conservative venue. For this study, there will be two groups of patients with low back
pain (by randomization). For inclusion into the randomized clinical trial, patients will
need to be 18 years of age or older with mechanically producible LBP. They will require a
minimum Modified Oswestry Disability Index score of 20% and a baseline pain score of >2.0/10
on the numeric analog scale for pain, and a within session change (improvement during the
visit) in pain and/or range of motion during the assessment phase of the clinical
examination. This finding has been advocated as an effective mechanism to determine if a
patient is a candidate for manual therapy. Exclusion criteria will include the presence of
any red flags (i.e., tumor, metabolic diseases, rheumatoid arthritis, osteoporosis,
prolonged history of steroid use, etc.), or signs consistent with nerve root compression
(reproduction of low back or leg pain with straight leg raise at less than 45°, muscle
weakness involving a major muscle group of the lower extremity, diminished lower extremity
muscle stretch reflex, or diminished or absent sensation to pinprick in any lower extremity
dermatome). Other exclusion criteria include prior surgery to the lumbar spine and current
pregnancy. Both groups will receive a pragmatic treatment approach by physical therapists
for low back pain. One group will also receive a prescriptive treatment approach for both
hips. The investigators will track the outcomes of disability (Oswestry), Pain (Numeric pain
rating scale), and recovery at baseline, 2 weeks, and discharge. Our aims are to determine
if differences in groups exist, with our primary outcome measure of ODI. The investigators
feel that the additional of a standardized exercise program and stretching for the hips will
improve outcomes in patients with mechanical low back pain.
mechanical low back pain. This has yet to be studied in a randomized controlled fashion or
in a conservative venue. For this study, there will be two groups of patients with low back
pain (by randomization). For inclusion into the randomized clinical trial, patients will
need to be 18 years of age or older with mechanically producible LBP. They will require a
minimum Modified Oswestry Disability Index score of 20% and a baseline pain score of >2.0/10
on the numeric analog scale for pain, and a within session change (improvement during the
visit) in pain and/or range of motion during the assessment phase of the clinical
examination. This finding has been advocated as an effective mechanism to determine if a
patient is a candidate for manual therapy. Exclusion criteria will include the presence of
any red flags (i.e., tumor, metabolic diseases, rheumatoid arthritis, osteoporosis,
prolonged history of steroid use, etc.), or signs consistent with nerve root compression
(reproduction of low back or leg pain with straight leg raise at less than 45°, muscle
weakness involving a major muscle group of the lower extremity, diminished lower extremity
muscle stretch reflex, or diminished or absent sensation to pinprick in any lower extremity
dermatome). Other exclusion criteria include prior surgery to the lumbar spine and current
pregnancy. Both groups will receive a pragmatic treatment approach by physical therapists
for low back pain. One group will also receive a prescriptive treatment approach for both
hips. The investigators will track the outcomes of disability (Oswestry), Pain (Numeric pain
rating scale), and recovery at baseline, 2 weeks, and discharge. Our aims are to determine
if differences in groups exist, with our primary outcome measure of ODI. The investigators
feel that the additional of a standardized exercise program and stretching for the hips will
improve outcomes in patients with mechanical low back pain.
Inclusion Criteria:
- 18 years of age or older
- Mechanically producible LBP.
- Minimum Modified Oswestry Disability Index score of 20%
- Minimum baseline pain score of >2.0/10 on the numeric analog scale for pain
Exclusion Criteria:
- Presence of any red flags
- Signs consistent with nerve root compression
- Prior surgery to the lumbar spine
- Current pregnancy
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