Lumbar motion trends and correlation with low back pain. Part I. A roentgenological evaluation of coupled lumbar motion in lateral bending.
OBJECTIVE
A radiographic study was undertaken to describe the relationship between coupled lumbar motion in lateral bending and the presence of low back pain symptomatology, evaluate trends of coupled motion and determine if these trends were attributable to chance confluence of independent motions.


METHODS
Survey.


METHODS
Chiropractic college student health center and private chiropractic clinic.


METHODS
249 subjects: 114 with low back pain, 29 asymptomatic with no history and 106 asymptomatic with history. Of these, 194 were freshman volunteers and 55 were new private clinic low back pain patients.


METHODS
None.


METHODS
Lumbar segmental coupled motion categories according to the scheme of Cassidy and Grice, as well as a modified scheme.


RESULTS
Statistical analysis demonstrated no significant relationship (p = .01) between coupled lumbar motion and low back pain. When viewed intersegmentally, approximately half of all lumbar motion was type II; symmetric motion was rare and attributable to chance confluence of individual segmental motion.


CONCLUSIONS
This study suggests that back pain is not an indication for the routine use of lateral bending films for the identification of abnormal coupled motion. Furthermore, each segmental categorization appears to be independent of contralateral categorization as well as motion at all other segmental levels. It is also suggested that type II motion cannot be ruled out as a normal variant. Finally, the ubiquity of coupled motion asymmetry suggests that symmetry must be reevaluated as a criterion for normal spinal function.
Haas
M
M
Research Department, Western States Chiropractic College, Portland, OR 97230.
Nyiendo
J
J
Peterson
C
C
Thiel
H
H
Sellers
T
T
Dal Mas
E
E
Kirton
C
C
Cassidy
D
D
D000293:Adolescent; D000328:Adult; D001416:Back Pain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D009068:Movement; D011187:Posture; D011859:Radiography