Is Reduced Spinal Range of Motion a Prognostic Factor for Pain Intensity, Disability, and Global Recovery in People With Specific or Non–Specific Spinal Pain? A Systematic Review

OBJECTIVE: To determine if a reduced range of motion (ROM) of the spine is a prognostic factor for pain intensity, disability, and global recovery outcomes in patients with specific or non-specific spinal pain.

DESIGN: Prognostic factor systematic review.

LITERATURE SEARCH: PubMed, Embase, and CINAHL were searched from inception to February 10, 2026.We also performed forward and backward citation tracking.

STUDY SELECTION CRITERIA: Studies of adults with spinal pain where ROM was assessed as a prognostic factor.

DATA SYNTHESIS: Risk of bias was assessed using the “Quality in Prognostic Studies” (QUIPS) tool. The certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Given heterogeneity in the results, a narrative synthesis was conducted.

RESULTS: Thirty-seven studies were included: 11 of non-specific acute low back pain (LBP), 11 of non-specific chronic or unspecified-duration LBP, 4 of non-specific chronic neck pain, 2 of lumbar spinal stenosis, 8 of whiplash-associated disorders (WAD), and 1 of cervical myelopathy. All studies were rated at high risk of bias. Across conditions and follow-ups, findings were inconsistent. Most studies of acute and chronic LBP reported no clear association between reduced ROM and outcomes. Similar inconsistencies were observed for chronic neck pain, lumbar stenosis, WAD, and cervical myelopathy. When associations were found, they were often unadjusted and based on low-quality analyses. The certainty of the evidence was consistently very low.

CONCLUSION: Due to the very low certainty of evidence, it is unclear whether reduced spinal ROM independently predicts pain, disability, and/or global recovery in people with spinal pain.