Physical Activity, Sedentary Behaviour & Low Back Pain Trajectory…Get your patients moving!

Clinician assisting an elderly female patient with a quadruped exercise on the floor

Low back pain (LBP) is a common condition which affects approximately 40% of people worldwide at some time during their lives. LBP often results in physical disability and contributes to the number of years lived with disability (YLDs) more than any other condition. There are huge costs to society resulting from LBP which are estimated to be 1% to 2% of the gross national product in Western countries. 

Clinical guidelines ALL recommend physical activity (PA) and exercise as effective in the management of patients with LBP, although diverse durations and intensities of PA have been shown to affect LBP differently. For example, one metanalysis showed that participants with a medium level of PA had a 10% lower risk of developing an initial episode of LBP as compared to those engaged in low levels of PA. However, the risk for developing chronic LBP has been shown to be higher among those engaged in strenuous PA as compared to those engaged in lower moderate intensity PA, and a sedentary lifestyle as compared to moderate levels of PA has been shown to be associated with a three-fold increase in the odds of recurrent non-specific LBP.

Many studies have investigated a variety of factors that predispose individuals to have different trajectory patterns of LBP, such as a previous history of LBP, presence of leg pain, work status, depression or anxiety, and patients’ expectations of recovery. However, no study to date has considered PA or sedentary behaviour as factors which could influence the trajectory of LBP. Hence, this study investigated the association between different amounts of PA and sedentary behaviour and the trajectory of LBP.

Comment from Dr. Thistle:

This study showed us that people with a history of LBP had a lower probability of developing a severe LBP trajectory if they engaged in higher levels of moderate-to-vigorous intensity, but the same protective effect was not seen with light physical activity or (obviously) sedentary behavior. The message here is simple – get your patients moving in a way that is challenging for them!

RESEARCH REVIEW: Physical Activity, Sedentary Behaviour & Low Back Pain Trajectory

This paper was published in The Spine Journal 2023

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