Prevalence of gluteus medius weakness in people with chronic low back pain

Clinical observation suggests that hip abductor weakness is common in patients with low back pain (LBP). A study from University of Iowa published in European Journal of Spine compared the prevalence of hip abductor weakness in a clinical population with chronic non-specific LBP and a matched sample without LBP.

One hundred fifty subjects with chronic non-specific LBP and a matched cohort of 75 control subjects were recruited. A standardized back and hip physical exam was performed. Specifically tensor fascia lata, gluteus medius, and gluteus maximus strength were assessed with manual muscle testing. Functional assessment of the hip abductors was performed with assessment for the presence of the Trendelenburg sign. Palpation examination of the back, gluteal and hip region was performed to try and reproduce the subject’s pain complaint.

The results showed that Gluteus medius is weaker in people with LBP compared to controls or the unaffected side. The Trendelenburg sign is more prevalent in subjects with LBP than controls.
Furthermore there is more palpation tenderness over the gluteals, greater trochanter, and paraspinals in people with low back pain compared to controls
Statistical analysis demonstrated that gluteus medius weakness, low back regional tenderness, and male sex were predictive of LBP in this study.

The authors concluded that Gluteus medius weakness and gluteal muscle tenderness are common symptoms in people with chronic non-specific LBP.