ASSOCIATION OF NON-SPECIFIC LOW BACK PAIN AND DISABILITY INDEX WITH LOWER EXTREMITY ALIGNMENT FACTORS

Abstract

Background: An array of risk factors contributes to non-specific low back pain. Apart from age, female gender, low educational status, obesity, occupation and psychological factors, postural variations (including variations in the lower extremity) play a significant role in predisposing an individual to low back pain. Hence, while evaluating/examining a patient with back pain, the alignment of the lower extremity should be taken into consideration rather than restricting the evaluation to the lumbosacral region. Methods: 36 subjects (12 Males, 24 Females) with non-specific low back pain were assessed for pain and disability using the Oswestry Disability Index (ODI). The measurements for lower extremity alignment factors (Pelvic angle, Angle of torsion of the femur, Quadriceps angle, Tibial torsion and Navicular drop) were recorded bilaterally. Results: There was a positive correlation of non-specific low back pain and disability index with the right pelvic angle (p=0.0012, r=0.51 and p=0.0003, r=0.56 respectively). Non-specific low back pain and disability index had no correlation with left pelvic angle (p=0.9101, r=0.01 and p=0.9794, r=0.00 respectively). Non-specific low back pain and disability index had a positive correlation with angle of torsion (AOT) of femur (Rt: p=0.0027, r=0.48, Lt: p=0.0084, r=0.43 and Rt: p=0.0039, r=0.46, Lt: p=0.0023, r=0.49 respectively), quadriceps angle (Q-angle) (Rt: p=0.0020, r=0.49, Lt: p=0.0014, r=0.51 and Rt: p=0.0019, r=0.49, Lt: p=0.0024, r=0.49 respectively) and navicular drop (Rt: p=<0.0001, r=0.61, Lt: p=0.0053, r=0.45 and Rt: p=0.0002, r=0.58, Lt: p=0.0048, r=0.46 respectively) bilaterally. Non-specific low back pain had no correlation with right tibial torsion (p=0.9269, r=0.01). Disability index had a positive correlation (not significant) with right tibial torsion (p=0.2427, r=0.19). There was a positive correlation (not significant) of non-specific low back pain and disability with left tibial torsion (p=0.1757, r=0.23 and p=0.0703, r=0.30 respectively). Conclusion: There was an association of non-specific low back pain and disability index with lower extremity alignment factors.