Effectiveness of Kinetic Chain Stretching in the Management of Discogenic Low Back Pain: A Prospective Clinical Study

Abstract

Background: Discogenic low back pain is a common musculoskeletal condition associated with
pain, functional disability, restricted lumbar mobility, and reduced flexibility. Kinetic chain
stretching (KCS) aims to improve flexibility and mobility of interconnected lumbopelvic and lower-
limb structures and may help reduce pain and functional limitation. The present study evaluated the
effectiveness of KCS in patients with discogenic low back pain.
Methods: A prospective single-group clinical study was conducted among 25 participants aged 20–
50 years with clinically and radiologically diagnosed discogenic low back pain. Participants
underwent a structured 4-week kinetic chain stretching programme targeting the hamstrings, hip
flexors, quadriceps, gastrocnemius/soleus, piriformis, gluteal muscles, and thoracolumbar fascia,
along with selected mobility and stabilization exercises. Pain intensity was assessed using the Visual
Analog Scale (VAS), while functional disability was assessed using the Oswestry Disability Index
(ODI). Lumbar flexion and extension range of motion, active knee extension (AKE), and straight leg
raise (SLR) were also assessed before and after intervention.
Results: The mean age of participants was 37.56 ± 8.93 years, with 13 males (52.0%) and 12
females (48.0%). Mean VAS decreased significantly from 7.20 ± 0.82 to 4.24 ± 1.20, representing a
mean reduction of 2.96 points (p<0.001). ODI improved from 47.32 ± 3.94% to 26.44 ± 4.05%,
with a mean improvement of 20.88 percentage points (p<0.001). Lumbar flexion increased from
42.16 ± 5.38° to 55.28 ± 5.64°, while extension increased from 18.24 ± 3.42° to 26.36 ± 3.68° (both
p<0.001). AKE and SLR also showed significant improvement.
Conclusion: A four-week KCS programme was associated with significant improvements in pain,
functional disability, lumbar mobility, and hamstring flexibility among patients with discogenic low
back pain. KCS may therefore be a useful physiotherapy intervention for improving clinical and
functional outcomes.