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Criticizing lumbar spine flexion for low back pain: A narrative review

Harmanpreet Kaur, Saikripa Raman

Background: Low Back Pain (LBP) is a severe musculoskeletal issue that may affect an individual’s health and daily life activities. Whenever a patient gets LBP due to any cause whether it occurs due to any injury or muscle spasm, the health care providers criticize the lumbar flexion for low back pain and suggest patients to avoid the movement immediately. We summarized the evidence for solely criticizing lumbar flexion as a relevant issue in low back pain patients. Methods: Two reviewers independently analyzed articles that evaluated about the disc space and height during flexion movement, exposure of spine to risk at flexion/rotation movement and pain related fear in patients with LBP. The aim of this study is to investigate the effects of lumbar spine flexion on LBP. Results: There was no significant difference observed between the anterior and posterior disc heights from neutral to flexion at the same level while identifying the segment-dependent changes in lumbar intervertebral disc space height during motion. Pain related fear was observed in patients with LBP that ultimately lead to reduction in mobility and muscle activity. Moreover, there was decrease in lumbar flexion movement due to pain in patient with LBP. Conclusion: The health care suggests patient not to flex the trunk, which is still unclear about its suggestion to the patients. Studies show no correlation between pain and flexion. Less studies has been conducted related to the pain and spinal flexion that shows no pain in case of spinal flexion with patient suffering from LBP and future researches are required to prove this fact.