Can Your Lower Back Be the Key to Fixing Knee Pain? New Research Says Yes!
- Julian Simpson
- 5 days ago
- 4 min read
Can Your Lower Back Be the Key to Fixing Knee Pain? New Research Says Yes!
If you’ve ever felt a dull ache behind the kneecap when walking downstairs, running, squatting or even sitting too long… you’re not alone. This common condition—Patellofemoral Pain Syndrome (PFPS)—accounts for more than half of knee-related injuries and affects active teens, adults, and weekend warriors alike.
At Health Wise Chiropractic, we see PFPS every week. What surprises many patients is this:
👉 Your knee pain may actually be coming from your lower back.
And now, new research backs this up.
What Exactly Is PFPS?
PFPS occurs when the kneecap doesn’t move smoothly in its groove. This can happen due to:
Weak or inhibited quadriceps
Poor biomechanics
Reduced proprioception (your body’s ability to sense joint position)
Changes in muscle control
Increased sensitivity in the nerves surrounding the knee
Left untreated, PFPS can progress to chondromalacia patellae or even early osteoarthritis—so early intervention matters.
Why Chiropractors Are Interested in PFPS
The quadriceps muscle is powered by the femoral nerve, which comes from the L2–L4 levels of the lumbar spine.If these spinal segments aren’t functioning well, they can interfere with:
Pain signalling
Muscle activation
Balance and proprioception
This is why many patients with PFPS also present with lower back stiffness or dysfunction—the knee and spine are partners in movement.
The Study: Can Lumbar Spinal Manipulation Help Knee Pain?
A recent randomized controlled trial explored whether lumbar spinal manipulation (a chiropractic technique) could reduce knee pain and improve muscle function in people with PFPS.
How the Study Worked
30 adults with PFPS
2 groups: spinal manipulation vs. placebo/sham treatment
8 sessions over 4 weeks
Tested pain sensitivity, knee proprioception, balance, and quadriceps strength
The Results: A Big Win for Spinal Manipulation
1. Pain Reduction (Pressure Pain Thresholds)
✔ Both groups improved⭐ Spinal manipulation improved pain sensitivity far more dramatically
This suggests manipulation activates the body’s natural pain-modulating systems and reduces the “volume” of pain signals coming from the knee.
2. Quadriceps Strength
✔ Both groups strengthened⭐ Manipulation group gained DOUBLE the strength improvement
This is huge. PFPS often involves “arthrogenic muscle inhibition”—a brain-to-muscle disconnect caused by pain.Spinal manipulation appears to restore this neural pathway, improving activation and strength.
3. Proprioception (Joint Position Sense)
✔ Improvements at some angles in the manipulation groupNo significant difference compared to placebo
4. Dynamic Balance
✔ Both groups improvedNo significant difference between groups
This is expected—balance often improves simply from repeated testing or increased awareness.
What This Means for Patients at Health Wise Chiropractic
The study confirms what we often see clinically:
When the spine moves better, the knee works better.
Lumbar spinal manipulation can:
Reduce knee pain
Improve quadriceps activation
Support better movement patterns
Enhance rehab outcomes
Accelerate recovery when combined with strengthening exercises
However, it is not a standalone cure.The best results come from combined care, including:
Chiropractic adjustments
Targeted knee and hip strengthening
Footwear/posture assessment
Taping or bracing if needed
Load management strategies
Who Can Benefit?
You may be a great candidate for this approach if you experience:
Pain behind or around the kneecap
Pain during stairs, squats, running or sitting
Clicking, grinding or stiffness
Weakness in the thigh
Knee pain that hasn’t improved with exercise alone
The Takeaway
This new research shows that lumbar spinal manipulation can significantly reduce pain and improve quadriceps strength in people with PFPS. While balance and proprioception improvements were similar between groups, the neurological benefits of manipulation are clear.
At Health Wise Chiropractic, we integrate spinal adjustments with customised rehabilitation programs to help you return to pain-free movement faster—and prevent re-injury long-term.
Ready to Fix Your Knee Pain?
If knee pain is slowing you down, book an appointment with our Health Wise Chiropractic team.Let’s get your spine and knee working together again.
Posture Correction Chiropractor
Q: Can chiropractic correct bad posture?Yes, chiropractic care can help realign the spine and retrain muscles for better posture.
Q: What causes poor posture?Common causes include desk jobs, phone use, weak muscles, and spinal misalignments.
Q: How long does posture correction take?It varies — some patients notice changes within weeks, others need longer-term care.
Q: Can posture correction reduce pain?Yes, correcting posture often reduces back pain, neck pain, and headaches.
For more information about how we can help YOU with your pain and improve your underlying dysfunction so the problem doesn’t come back .
Please call Health Wise Chiropractic 03 9467 7889 or book online to see one of our Chiropractors in Sunbury or Melton/Strathtulloh Today!
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Won J, Lee Y. Effects of lumbar spinal manipulation on pain and quadriceps strength in patellofemoral pain syndrome: A randomized controlled trial. Complement Ther Med. 2025 Dec;95:103301. doi: 10.1016/j.ctim.2025.103301. Epub 2025 Oct 31. PMID: 41177369.
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