The Role of Movement Dysfunction in Lower Back Pain: What You Need to Know

Lower back pain can interfere with everyday activities, physical performance, and overall quality of life. One factor researchers have investigated is movement dysfunction, which involves difficulty coordinating or controlling movements of the lower back and pelvis. Understanding these patterns may help healthcare professionals identify physical limitations that deserve attention during an evaluation.

The relationship between spinal stability and movement control has been explored for decades. In 1992, Panjabi described the stabilizing system of the spine, providing a framework for understanding how the body maintains spinal stability during movement. Later clinical approaches also emphasized movement pattern assessment and rehabilitation as ways to address functional limitations.

In 2008, Luomajoki and colleagues investigated differences in movement control between people experiencing non-specific lower back pain and healthy individuals. Their research examined six movement tests designed to assess control of the lumbopelvic region. The findings offer insight into why evaluating movement quality may be a useful component of a broader assessment, although movement dysfunction is not necessarily the cause of every case of back pain.

These test to examine faulty movement are excellent examples of those performed at Cole Pain Therapy Group.

Comparison of correct vs. incorrect performance in low back movement control tests including Waiter’s Bow, Pelvic Tilt, One Leg Stance, and Sitting Knee Extension.
Two physical therapy tests demonstrating low back movement control using quadruped and prone positions. Test 5 involves hip rocking to assess lumbar stability; Test 6 involves knee flexion to assess pelvic control.

Can movement dysfunction contribute to lower back pain?

Movement dysfunction may be associated with lower back pain, particularly when a person has difficulty controlling movement of the lumbar spine and pelvis. Research has identified differences in movement control between people experiencing back pain and healthy individuals. However, these findings do not establish that abnormal movement is the sole cause of symptoms. A comprehensive clinical evaluation can help determine whether specific movement limitations are relevant to an individual’s condition.

What are movement control tests for lower back pain?

Movement control tests examine how well a person coordinates the lower back and pelvis during specific physical tasks. The six tests evaluated in the 2008 study were the waiter’s bow, standing pelvic tilt, one-leg stance, sitting knee extension, rocking backward and forward on all fours, and prone knee flexion. Trained examiners observed participants performing these movements using standardized instructions. Such assessments can provide information about movement patterns as part of a broader physical examination.

What did the 2008 study find about movement control and lower back pain?

Luomajoki and colleagues studied 210 participants, including 108 people with non-specific lower back pain and 102 healthy controls. The group experiencing back pain averaged 2.21 positive movement control tests, compared with 1.18 among the controls. Participants with chronic symptoms also performed worse than those with more recent pain. These results indicate an association between back pain and reduced movement control, but they do not prove a direct cause-and-effect relationship.

How can movement assessment help guide lower back pain treatment?

Movement assessment can reveal difficulties with coordination, mobility, or stability during particular activities. A healthcare professional can consider these findings alongside symptoms, medical history, and other examination results when determining appropriate care. Depending on individual needs, rehabilitation may involve movement retraining, flexibility work, strengthening, or other therapeutic approaches. The aim is to address relevant functional limitations rather than assume that one treatment suits everyone.

At Cole Pain Therapy Group, we provide care for people experiencing musculoskeletal discomfort and physical limitations. Our team can evaluate movement patterns, flexibility, stability, and functional concerns to help determine appropriate next steps. Depending on your circumstances, care may include therapeutic exercises, rehabilitation, mobility training, or chiropractic services. If back discomfort interferes with work, exercise, or everyday tasks, an individualized evaluation can help identify suitable options for managing your condition.

Related Reads

References:

Luomajok H, Jan K, Eling D, Olavi A, et al. Movement control tests of the low back; evaluation of the difference between patients with low back pain and healthy controls. BMC Musculoskeletal Disorders. 2008; 9: 170.

Panjabi MM. The stabilizing system of the spine, part I: function, dysfunction, adaptation, and enhancement. J Spinal Disorders. 1992; 5: 383-89.

Liebenson C, ed. Rehabilitation of the Spine. 2nd ed. Philedelphia: Lippincott Williams & Wilkins; 2007.

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Richard L. Cole, DC, DACNB, DAIPM, FIACN, FICC
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Bradford J. Cole, DC, MS, CSCS
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Daniel H. Smith, DC
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