Difference between upper and lower lumbar spine lordosis on the basis of the hip extension range

Abstract

Decrease in the hip extension range of motion (HE-ROM) can cause lumbar hyperlordosis. Hyperlordosis is one of the mechanisms underlying low back pain. A diagnosis of low back pain from hyperlordosis can be used to detect the area in which hyperlordosis occurs more easily-the upper or lower lumbar spine. Twenty-one men were recruited for this study. HE-ROM was measured manually. Lumbar alignment was measured on a bed in a prone position. We extended the subject's hip by bending the bed at 4 angles (0°, 10°, 15°, 30°) and measured the spinal alignment by using a SpinalMouse. The results showed that lumbar lordosis increased at the bed angles of 15° and 30°. Only when the bed angle was changed from 0° to 30, the increased angle of the lumbar spine was negatively correlated to the HE-ROM (r=-0.46, p<0.05), particularly that of the lower lumbar spine (r=-0.47, p<0.05). These findings suggested that lower lumbar lordosis tends to increase in individuals with poor HE-ROM. Additionally, increase in lower lumbar lordosis is attributed to the tendency to have low back pain in the lower lumbar spine.