For the patient with low back pain, guidelines recommend seeking treatment in the acute state of the condition instead of waiting for it to become chronic. While it’s generally easier and faster to achieve a satisfactory outcome in the earliest stages of a back pain condition, there’s another reason: to reduce the risk for additional injury. To see how this is the case, let’s look at the effect low back pain has on walking.
In a February 2020 study, researchers examined the lower limb kinematics (function) in 40 subjects, half of whom had chronic back pain, using a special seven-camera system that tracked the movements of the pelvis, hip, knees, and ankle joints during walking. The data show that individuals with chronic low back pain had significantly altered movement in all three joints of the lower extremities.
Another recent study used a marker-based motion capture system to examine the spinal kinematics of 22 adults (half with chronic low back pain) while walking by breaking down the spine into four sections: upper and lower lumbar (UL and LL) and thoracic (UT and LT). This experiment also revealed significant movement differences between the two groups.
Using a sophisticated assessment method called statistical parametric mapping (SPM) to capture a 3D analysis of subjects (20 with vs. 20 without low back pain), yet another study identified altered movement patterns among those with low back pain.
These studies demonstrate that individuals with back pain exhibit altered walking kinematics, which may be a response by the body to avoid pain. But doing so may place added stress on other parts of the body, like the hips, knees, and ankles, which could lead to secondary conditions. On the other hand, there’s the possibility that pre-existing dysfunction in the lower extremities resulted in abnormal motion which led to a lower back condition.
Either way, these findings underscore the importance of examining the whole patient to identify any and all issues that may contribute to their low back pain, something which doctors of chiropractic are trained to do in order to achieve the best possible outcome for each patient.
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