title: Elimination of intermittent chronic low back pain in a recreational golfer following improvement of hip range of motion impairments.
abstract: BACKGROUND
  The biomechanical relationship between the hip and low back is well described and impairment of hip range of motion is thought to affect lumbar spine function, possibly leading to increased loading and subsequent symptoms. However therapy for low back pain (LBP) patients is commonly directed solely to the low back area overlooking possible hip impairment.
  
  
  METHODS
  A 56-year-old male recreational golfer presented with a chronic golf-related low back complaint. Previous conservative therapy targeting the spine did not result in complete symptom relief. A working diagnosis of L4-S1 facet joint irritation and lower lumbar segmental instability secondary to bilateral hip ROM impairment was established. A trial of therapy strictly addressing the hip ROM impairments was initiated and following 2 treatment sessions, a complete resolution of symptoms was achieved and maintained at a 2-month follow-up.
  
  
  CONCLUSIONS
  This case demonstrated a complete and rapid relief of un-resolving low back pain with a management strategy focused on hip ROM impairments. Clinicians should remember to look beyond the local area of complaint and appreciate the interdependent nature of the musculoskeletal system.
authors.affiliation: Faculty of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada. Electronic address: plejkowski@cmcc.ca.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Lejkowski
authors.forename: Erik
authors.initials: E
authors.lastname: Poulsen
mesh_terms: D002908:Chronic Disease; D006055:Golf; D006615:Hip; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular
keywords: Golf-related; Hip; Hypomobility; Low back pain; Regional interdependence