No long-term disability risks with physical activity in people with low back pain

Physical activity appears to pose transient risks of low back pain (LBP) flares but not functional limitations in the long term, according to a prospective, longitudinal case-crossover study.

Researchers recruited 416 adults (mean age 47.5 years, 75 percent male) with recent healthcare visits for LBP at outpatient clinics in Veterans Affairs primary care. All participants completed surveys inquiring about the number of hours engaged in the listed activities (eg, lifting ≥10 lb, pushing or pulling, bending, climbing, twisting, squatting, crawling, sitting, standing, and walking) in the past 24 h.

Outcomes of interest were the presence of a participant-reported LBP flare and LBP-related functional limitations at 1-year follow-up.

The participants completed 9,757 surveys during the follow-up. The odds of subsequent participant-reported LBP flares significantly increased with each additional hour in the past 24 h spent lifting ≥10 lb (odds ratio [OR], 1.05, 95 percent confidence interval [CI], 1.03–1.07), pushing or pulling (OR, 1.06, 95 percent CI, 1.03–1.09), bending (OR, 1.06, 95 percent CI, 1.03–1.08), twisting (OR, 1.06, 95 percent CI, 1.03–1.08), and squatting (OR, 1.05, 95 percent CI, 1.03–1.08).

Conversely, total duration of sitting was associated with reduced odds of flares (OR per additional hour sitting, 0.96, 95 percent CI, 0.94–0.98).

However, the mean hours spent in each activity during the initial 8 weeks of the study showed no association with long-term functional limitations at 1-year follow-up.