Study Design. A prospective population-based cohort study performed in South Manchester, United Kingdom.
Objectives. To determine whether nonoccupational physical activity and indicators of physical stress on the spine predict low back pain in the short term.
Summary of Background Data. There is evidence that physical activity outside the workplace helps to protect against low back pain in the long term. However, such activity may injure or stress the spine in the short term.
Methods. A baseline survey questionnaire identified 2715 adults, aged 18-75 years, with no low back pain at the time of the survey. Information on potential predictors of low back pain also was obtained. New episodes of back pain were identified during the subsequent year.
Results. A new low back pain episode occurred in 34% of men and 37% of women. Poor general health at baseline was the strongest predictor of a new episode of pain (men: relative risk (RR) 1.5, 95% confidence intervals (CI) 0.8, 2.7; women: RR 2.2, 95% CI 1.2, 4.0). High weight was associated with subsequent low back pain in women (RR 1.4; 95% CI 1.0, 2.0), but neither height nor weight predicted low back pain in men. A self-rated low level of physical activity was not consistently linked with subsequent low back pain, nor were specific nonoccupational physical activities, apart from home-improvement work in men and regular sports in women.
Conclusion. Although some specific activities may be hazardous to the back, physical activity outside the workplace does not increase the short-term risk of low back pain overall. Leisure-time physical activity is not a hazard to the back, whereas poor physical health in both genders and heavier weight in women do increase the risk of new low back pain episodes in the short term.
Most new episodes of low back pain are clinically attributed to mechanical origins. 2 Cross-sectional studies have inconsistently linked broad markers of physical stress on the spine, such as height, weight, and the pressure of chronic coughing on the spine from smoking, to low back pain. 5,6,10 Studies of people in specific occupational settings have shown higher than expected risks of low back pain associated with unusual or prolonged stresses on the back, 4 but no investigations in which prospective study designs were used to investigate the influence of routine physical activities on low back pain have been reported for the general population. Authors of prospective studies can look specifically at whether markers of stress precede low back pain, and whether they signify risks for the population as a whole rather than for specific small occupational subgroups. The current authors conducted a prospective general population study to determine the short-term risks of nonoccupational physical stress for new episodes of low back pain.