Does Joint Dysfunction Cause Muscle Imbalance, or Is Muscle Imbalance the Precipitator of Joint Dysfunction on People with Back Pain?

One of the most common ailments people suffer from is lower back pain. approximately 8 out of 10 people will have to deal with back pain at some point in their life. the current research was carried out to investigate the effect of hold relax technique (hrt) on female subjects with history of back pain. the sample examined comprised of 112 female housewives (56 patient females with a year history of back pain and 56 females healthy subjects). both groups were randomly subdivided in to an experimental group (n=28) and a control group (n=28). each subject received a total of 12 sessions of hrt (three times per week) with each session lasting 90 min. only subjects with hamstring tightness, i. e. passive, unilateral straight leg raise (slr) of the dominant hamstring < 70° or if it were less than there was no evidence sciatic roots neurological pain. in both patient and healthy subjects comparing first session with session 12, there were significant (po.05) increases in the unassisted range of the hip angle motion with before hrt treatment, immediately after hrt , after 10 minutes and after 60 minutes. the same pattern was also seen in assisted movement. analysis of the results for patients indicates that the slope of the hip angle for the 6 to 16 second treatment period data set over all 12 sessions showed no significant difference in change in hip angle (p> 0.05). analysis of the results for patients and healthy treated indicates that the slope of the hip angle for the 6 to 16 second treatment period data set over all 12 sessions showed significant difference in change in hip angle between any of the sessions with (p< 0.05. analysis of the patient and healthy treated groups data the intercept between hip angle and treatment session for the period of the hrt treatment showed a significant increase in hip angle p< 0.05 over all 12 sessions. the statistical analysis of the back extension and flexion angle (out come measure) showed a positive correlation between improvement in back angle extension and flexion and the number of sessions in both patient and healthy treated group. we also found a significant difference p< 0.05 between before and after treatment in each group separately indicating that a greater forward flexion and extension was achieved. the use of hrt may play a role in pain reduction, restoration of normal function of the body, as well as possible prevention of future recurrence of back pain. our investigation indicated that hrt is capable to improving range of motion in hip joint flexion over a 4-week treatment period. the hrt produced a significantly greater improvement in myotatic stretch reflex involving the muscle spinal gto, and the gamma system. in conclusion the reduction of pain in the lumbar region improves balance between tight iliopsoas, lower erector spinae and tight hamstrings which are associated with inhibited lower abdominals and gluteals in lumbar syndrome.