Does low back pain improve following supervised patient education and exercise therapy targeting hip osteoarthritis symptoms? a longitudinal cohort study of 5,014 patients

Objective To compare clinical characteristics of patients seeking primary care for hip osteoarthritis (OA) with and without concurrent low back pain (LBP), to evaluate changes in LBP intensity following participation in a supervised exercise therapy and patient education program targeting hip OA, and to assess whether hip OA responders experience greater LBP improvement. Design This longitudinal analysis included patients from the Good Life with osteoArthritis in Denmark (GLA:D®) program with symptoms primarily related to hip OA. The intervention included supervised education and neuromuscular exercise delivered over 8 weeks. Baseline demographic and clinical characteristics were compared between patients with and without LBP. Changes in LBP intensity (0–10 Numeric Rating Scale) at 3- and 12-month follow-up were analyzed using mixed-effects models. Hip OA pain responder status (≥15-point improvement on the HOOS-12 pain subscale) and its association with change in LBP intensity was assessed via multivariable linear regression analysis. Results Among 5,014 patients with hip OA, 3,079 (61%) reported comorbid LBP. Compared to patients without LBP, those with LBP had higher BMI, worse HOOS-12 pain and function scores, and greater analgesic use. Adjusted analyses showed significant reductions in LBP intensity at 3 months (19% improvement from baseline) and 12 months (21% improvement from baseline). Hip OA responders experienced greater LBP reductions than non-responders at both time points. Conclusions Patients with hip OA and comorbid LBP represent a subgroup with higher hip pain and lower function. Participation in the GLA:D® program was associated with statistically significant LBP improvement, particularly among hip OA responders.