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Investigating The Bidirectional Relationship Between Low Back Pain, Hip Pain, Knee Pain, And Gait Abnormalities: A
Jun Zhou1, Xiaoming Xie2, Kuayue Zhang3
1Center of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University; Beijing Key Laboratory of Digital Intelligent Acupuncture; Beijing Key Laboratory of Acupuncture Neuromodulation.
Journal of Visualized Experiments : Jove
|June 15, 2026
Summary
This study used genetic data to explore causal links between back, hip, and knee pain and gait abnormalities. It found limited evidence suggesting low back pain and hip pain may increase the risk of gait issues.
Area of Science:
- Orthopedics
- Genetics
- Epidemiology
Background:
- Gait abnormalities are linked to impaired lower-limb biomechanics in musculoskeletal disorders.
- Observational studies suggest connections between low back, hip, and knee pain and gait issues, but causality is unclear.
Purpose of the Study:
- To investigate potential causal relationships between site-specific pain (low back, hip, knee) and gait abnormalities using a bidirectional Mendelian randomization approach.
Main Methods:
- Utilized genome-wide association study (GWAS) data for genetic instruments.
- Employed inverse-variance weighted (IVW) method as primary analysis for forward and reverse Mendelian randomization.
- Conducted sensitivity analyses to assess heterogeneity, horizontal pleiotropy, and robustness.
Main Results:
- Genetically predicted low back pain (OR=1.53) and hip pain (OR=1.55) showed a statistically significant association with increased risk of gait abnormalities in IVW analyses.
- Genetically predicted knee pain was not significantly associated with gait abnormalities (OR=2.15).
- Reverse MR analyses found no evidence that gait abnormalities causally influence low back, hip, or knee pain.
Conclusions:
- Provides limited genetic evidence suggesting low back pain and hip pain may be associated with gait abnormalities.
- Findings require cautious interpretation and validation with larger GWAS datasets and refined phenotypes.
- No causal link was found from gait abnormalities to site-specific pain in this study.
