Department of Physical Therapy, Temple University, College of Health Professions and Social Work, Philadelphia, PA 19140, USA.
Physiother Theory Pract. 2011 Jul;27(5):384-97. doi: 10.3109/09593985.2010.509382. Epub 2010 Aug 26.
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.
腰椎和髋关节疾病的患病率呈上升趋势；然而，治疗效果并没有改善，这突出表明了识别和治疗正确损伤的难度。本病例报告的目的是描述对继发髋-脊柱综合征患者进行检查和治疗的临床决策。我们的病例研究是一名 62 岁男性，他有腰痛，同时伴有右髋痛。他的 Oswestry 残疾指数（ODI）为 18%，背部数字疼痛评分量表（NPRS）为 4/10，恐惧回避信念问卷（FABQ）工作分量表为 0，FABQ 体力活动分量表为 18，患者特定功能量表（PSFS）为 7.33。体格检查显示继发髋-脊柱综合征的发现。他接受了四次治疗，包括关节松动术/手法治疗和针对臀部的强化运动。出院时，所有标准化的结果测量均完全恢复。存在腰骶髋痛时的临床决策往往很困难。先前的文献表明，一些腰骶髋痛患者对手法治疗和针对脊柱相邻区域的运动治疗反应良好。本病例报告的结果表明，主要抱怨 LBP 伴髋部功能障碍的患者可能受益于减少髋部功能障碍的干预措施。
