title: Clinical decision making in a patient with secondary hip-spine syndrome.
abstract: The prevalence of lumbar and hip pathology is on the rise; however, treatment outcomes have not improved, highlighting the difficulty in identifying and treating the correct impairments. The purpose of this case report is to describe the clinical decision making in the examination and treatment of an individual with secondary hip-spine syndrome. Our case study was a 62-year-old male with low back pain with concomitant right hip pain. His Oswestry Disability Index (ODI) was 18%, back numeric pain rating scale (NPRS) was 4/10, fear avoidance beliefs questionnaire (FABQ) work subscale was 0, FABQ physical activity subscale was 18, and patient specific functional scale (PSFS) was 7.33. Physical examination revealed findings consistent with secondary hip-spine syndrome. He was treated for four visits with joint mobilization/manipulation and strengthening exercises directed at the hip. At discharge, all standardized outcome measures achieved full resolution. Clinical decision making in the presence of lumbopelvic-hip pain is often difficult. Previous literature has shown that some patients with lumbopelvic-hip pain respond favorably to manual therapy and exercise targeting regions adjacent to the lumbar spine. The findings of this case report suggest that individuals with a primary complaint of LBP with hip impairments may benefit from interventions to reduce hip impairments.
authors.affiliation: Department of Physical Therapy, Temple University, College of Health Professions and Social Work, Philadelphia, PA 19140, USA. scott.burns@temple.edu
authors.forename: Scott A
authors.initials: SA
authors.lastname: Burns
authors.forename: Paul E
authors.initials: PE
authors.lastname: Mintken
authors.forename: Gary P
authors.initials: GP
authors.lastname: Austin
mesh_terms: D018771:Arthralgia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D001696:Biomechanical Phenomena; D004185:Disability Evaluation; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D020127:Recovery of Function; D055070:Resistance Training / Q000009:adverse effects*; D013577:Syndrome; D013997:Time Factors; D016896:Treatment Outcome