What are the lifestyle risk factors for low back pain?

Between 60% and 90% of the population experience back pain at one time or another during their lifetimes. Every year, nearly 15% of American adults visit their doctors because of low back pain episodes. Men and women are equally at risk. Low back pain is second only to upper respiratory infections (such as colds and flus) as the reason for seeing a doctor. In its costs to the country, it is second only to cancer and heart disease.

High-Risk Occupations:
In one study, 16 out of 100 warehouse workers reported back injuries in one year, and in two major food service organizations 30% of all injuries involved the back. A major study of work-related injuries reported that, in 1994, there were nearly 330.000 cases of back injury due to overexertion in handling objects.

Jobs that involve lifting and forceful movements, bending and twisting into awkward positions, and whole-body vibration (usually caused by long-distance truck driving) place workers at particular risk for low back pain. The longer a person is on such jobs, the higher the risk. Some workers wear back support belts, but evidence strongly suggest that they are useful only for people who are currently suffering from low back pain. They offer little added support for the back and do not prevent back injuries. In fact, in one study workers who wore the belt for prevention reported more back pain than the workers who didn’t wear them.

A number of companies are developing programs to protect against back injuries. Although studies are mixed on the effects of company interventions, one analysis suggested that they do have a positive effect. Employers and workers, however, should make every effort to create a safe working environment. Office workers should have chairs, desks and equipment that support the back or help maintain good posture.

Improper or Intense Exercise:
On the other side of the coin, improper or excessive exercise is also an important risk factor for back pain.

  • The effect of high-impact exercise on the back is not entirely clear. Some research suggests that over time, it may increase the risk for degenerative disc disease. A survey of people who played tennis, however, found no increased risk for low back pain or sciatica.
  • Between 30% and 70% of cyclists experience low back pain. (One 1999 study reported that 70% of cyclists reported improvement simply by adjusting the angle of the bicycle seat.)
  • Improper exercise instruction and inattention to mechanics can be sources of sudden trouble. As examples, a single jerky golf swing or incorrect use of exercise equipment (especially free weight, nautilus, and rowing machines) can cause serious back injuries.

Sedentary Lifestyle:
People who do not exercise regularly face an increased risk for low back pain, especially during times when they suddenly embark on stressful unaccustomed activity, such as shoveling, digging, or moving heavy items. Although no definitive studies have been done to prove the relationship between lack of exercise and low back pain, sedentary living is probably a primary nonmedical culprit contributing to this condition. Lack of exercise leads to the following conditions that may threaten the back:

  • Muscle inflexibility (can restrict the back’s ability to move, rotate, and bend).
  • Weak stomach muscles (can increase the strain on the back and can cause an abnormal tilt of the pelvis).
  • Weak back muscles (may increase the load on the spine and the risk for disc compression).
  • Obesity, associated with sedentary lifestyle (may put more weight on the spine and increase pressure on the vertebrae and discs). Studies report only a weak association between obesity and low back pain, however.

Risk factors for Back Pain in Children and Adolescents:
The likelihood of experiencing back pain increases as children age, and pain is more common among girls than boys, according to a 1999 study. A common cause of temporary back pain is carrying backpacks that are too heavy for children (more than 20% of their body weight, or even less for very young children).

Other Risk Factors:
Smokers are at higher risk for back problems, perhaps because smoking decreases blood circulation, but the association may also be due to an unhealthy lifestyle in general.

2001 Nidus Information Services Inc.

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