Lumbar Instability: Looking Beyond the Spine

1 Sep

While an episode of low back pain may begin after lifting, sleeping in an awkward
position, or engaging in physical activity, these events often act as triggers rather than the
underlying cause. In many cases, the factors that make the lower back vulnerable have been
present for months or even years. One such factor is lumbar instability, which occurs when agerelated changes, muscle weakness, or repetitive mechanical stress reduce the ability of the
ligaments, intervertebral disks, facet joints, and muscles to stabilize the spine. As a result, the
vertebrae may move excessively, placing greater stress on the pain-sensitive tissues in the lower
back. There is growing evidence that structures beyond the lumbar spine—particularly the
muscles that control the hips and pelvis, including the gluteal muscles and hamstrings—can also
influence lumbar stability.
The gluteal muscles and hamstrings play an important role in supporting healthy
movement and helping maintain proper control of the pelvis during everyday activities. When
these muscles are weak, the pelvis may not remain as stable during walking, bending, lifting, or
climbing stairs. This can alter the way forces are transferred through the pelvis and lower back,
increasing stress on the joints, disks, ligaments, and muscles of the lumbar spine.
The gluteal muscles, particularly the gluteus medius and gluteus maximus, are important
for controlling pelvic position and limiting excessive movement during standing and walking.
Weakness in these muscles may contribute to altered posture and movement patterns that place
greater demands on the lower back. Likewise, weak hamstrings may be less able to help control
hip motion and pelvic movement during activities such as bending, lifting, or climbing stairs.
A December 2025 study provides further support for this concept. Researchers evaluated
129 young adults, including 67 with lumbar instability, to better understand the relationship
between muscle function and low back pain. The investigators found that weaker hamstring
muscles and reduced hip mobility were associated with greater low back pain and higher levels
of disability.
These findings reinforce the notion that the body functions as an interconnected system.
Low back pain may not originate solely from the lumbar spine itself. Instead, weakness or
limited mobility in the muscles and joints surrounding the hips and pelvis can alter posture,
movement, and the way forces are distributed throughout the body. Doctors of chiropractic are
trained to evaluate musculoskeletal conditions and assess how the spine, hips, pelvis, and
surrounding muscles function together. Following a thorough examination, they can develop an
individualized, multimodal treatment plan to address contributing factors, improve function,
relieve pain, and support long-term spinal health.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

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