The role of spinal and hip mobility in disability among patients with chronic low back pain

Background Chronic low back pain (cLBP) imposes substantial functional limitations and contributes significantly to healthcare costs worldwide. Identifying factors associated with disability is crucial for developing targeted strategies. Thus, this study aims to determine the relationship between mobility impairments and disability in individuals with cLBP. Methods In this cross-sectional study, a adults aged 18-64 were enrolled from the general population, stratified by pain status: no LBP, intermediate LBP, and chronic LBP. Disability and pain intensity were evaluated using the Roland-Morris Disability Scale and the von Korff Chronic Pain Grade Questionnaire. Multivariable regression models examined the associations between the mobility parameters, disability, and pain intensity, adjusting for age, sex, body mass index (BMI), physical activity level, work status and smoking. Results 1,239 participants (55.8% female) were included. Disability was significantly associated with spinal and hip mobility impairments in the cLBP group but not in those with intermediate LBP or no LBP. In specific, lower lumbar sagittal (beta: -0.04, 95% CI: -0.07- -0.01, p = 0.009) and coronal mobility (beta: -0.06, 95%CI: -0.08 - -0.03, p < 0.001), as well as hip rotational (beta: -0.06, 95%CI: -0.09 - -0.03, p < 0.001) and coronal mobility (beta: -0.05, 95%CI: -0.07 - -0.02, p < 0.001), were associated with higher disability scores. In contrast, most mobility parameters showed no significant association with pain. Conclusions This study demonstrates that both spinal and hip mobility impairments are independently associated with disability in individuals with cLBP. Notably, hip mobility was equally relevant as spinal mobility, underscoring the need for comprehensive mobility assessments in clinical practice.