title: Increased incidence and severity of somatic dysfunction in subjects with chronic low back pain.
abstract: BACKGROUND
  Patients with back pain make more than 14 million office visits per year to US physicians. Many of these patients have chronic low back pain (LBP) and are assumed to have more somatic dysfunction than those without chronic LBP.
  
  
  OBJECTIVE
  To investigate incidence and severity of somatic dysfunction of four lumbar vertebral segments (L1-L4).
  
  
  METHODS
  Sixteen subjects with chronic LBP and 47 subjects without chronic LBP were each evaluated by two blinded examiners using reliable osteopathic palpatory tests. The incidence and severity of somatic dysfunction for each test were then analyzed within and between the study groups.
  
  
  RESULTS
  Resistance to anterior springing (P<.001) and tenderness (P=.002) were found at significantly greater incidence in the chronic LBP group than in the non-LBP group, but there were no significant differences between groups for incidence of tissue texture changes or static rotational asymmetry. Significantly greater severity of tissue texture changes (P=.006), static rotational asymmetry (P=.008), resistance to anterior springing (P<.001), and tenderness (P=.001) were observed in the chronic LBP group than in the non-LBP group.
  
  
  CONCLUSIONS
  When compared with non-LBP subjects, chronic LBP subjects had overall greater severity for each of the four elements of somatic dysfunction evaluated, as well as greater incidence of resistance to anterior springing and tenderness. Somatic dysfunction is more severe in individuals with chronic LBP than in individuals without chronic LBP.
authors: Department of Osteopathic Manipulative Medicine, Kirksville College of Osteopathic Medicine-A.T. Still University, 800 W Jefferson St, Kirksville, MO 63501-1443, USA. ksnider@atsu.edu
authors: Karen T
authors: KT
authors: Snider
authors: Jane C
authors: JC
authors: Johnson
authors: Eric J
authors: EJ
authors: Snider
authors: Brian F
authors: BF
authors: Degenhardt
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D017116:Low Back Pain / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D010808:Physical Examination / Q000379:methods; D011336:Probability; D012016:Reference Values; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D018709:Statistics, Nonparametric