Physical Therapy Management of Patients with Chronic Low Back Pain and Hip Abductor Weakness

Peterson S, Denninger T. Physical Therapy Management of Patients With Chronic Low Back Pain and Hip Abductor Weakness. J Geriatr Phys Ther. 2019;42(3):196-206. doi:10.1519/JPT.0000000000000148

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Article Reviewed by Kelly Beaudoin, MSPT

This case study demonstrates the effectiveness of physical therapy intervention in the treatment of chronic low back pain. Many of the patients that we see at Balance Solutions Physical Therapy with complaints of chronic low back pain present with weakness in the hip abductors muscles.

Targeted strengthening for the gluteus medius muscle is crucial in reducing chronic hip and low back pain. Approximately 35% of LBP cases have coexisting gluteal tendinopathy; treatment of the gluteal tendon pain in conjunction with strengthening has led to improved functional outcomes.

This case study focuses on three different older adults with complaints of chronic low back pain, the exercises prescribed, and the functional outcome measures.

Study details include:

  • Background and purpose: Describe the physical therapy management and outcomes of 3 patients with chronic low back pain matching a previously identified subgroup characterized by substantial hip abductor weakness.

    Chronic Low Back Pain Treatment

    Strengthening the hip muscles decreases chronic low back pain

  • Intervention: Patients were treated using a targeted exercise approach consisting mostly of hip abductor strengthening for 11 to 17 visits over 8 to 10 weeks.
  • Outcomes: By discharge, all patients had made clinically important improvements in;
    • Pain (3- to 7-point reduction on the Numeric Pain Rating Scale)
    • Function (10- to 16-point change on the Modified Oswestry Disability Index)
    • Perceived improvement (6-7 on Global Rating of Change Scale).
    • Lumbar range of motion was painless
    • Hip abductor strength was improved from 2+/5 to 3+/5 in all 3 patients.

Although this case study consisted of only 3 individuals with chronic low back pain, the results are a common finding that we see here at Balance Solutions Physical Therapy.  Incorporating a targeted exercise approach consisting of hip abductor strengthening in conjunction with manual therapy intervention and core stabilization is effective in reducing pain and improving function in patients with chronic low back pain.

Whether the pain is acute or chronic, skilled Physical Therapy intervention is a highly effective non-surgical treatment option for lower back pain relief. A skilled therapist will perform a comprehensive evaluation to assess all factors contributing to your condition before you begin your lower back physical therapy intervention.

Call to schedule an appointment with a physical therapist today.  Balance Solutions Physical Therapy is here to help, offering advanced manual therapy and physical therapy for low back pain, “changing the quality of life one patient at a time” TM

Balance Solutions Physical Therapy is located at Commerce Park in Beachwood Ohio, just on the outskirts of Cleveland. Services offered include physical therapy, massage, myofascial release, Integrative Dry Needling, as well as Pilates mat and reformer private and class lessons.