Researchers identify modifiable triggers of acute low back pain

Back pain is a leading cause of disability worldwide, and the World Health Organization (WHO) reports that low back pain affects more people than major diseases like diabetes and malaria yet we have not made much progress in preventing it. Now, in a new study, researchers have identified physical and psychosocial triggers that can be modified to prevent acute episodes of low back pain.

Carrying out manual tasks involving awkward postures can increase chance of low back pain by eight times.

The study was conducted by researchers with the George Institute for Global Health and Sydney Medical School at The University of Sydney in New South Wales, Australia.

The researchers describe how they conducted and analyzed their case-crossover study on triggers of acute low back pain episodes in the journal Arthritis Care & Research.

The research team found that carrying out manual tasks involving awkward postures increases the risk of triggering acute low back pain by eight times.

They also found that fatigue and being distracted can also significantly increase the risk of acute low back pain.

First study to look at low back pain and brief exposure to modifiable triggers

The research team says their study is the first to look at how brief exposure to a range of modifiable triggers can lead to low back pain.

Fast facts about low back pain

• Low back pain is the most common spinal disorder
• It affects over 8 in 10 people at some point in their lives
• Many factors - physical, psychological and occupational - help to trigger low back pain.

The researchers focused on episodes of acute low back pain - that is low back pain that comes and goes as opposed to chronic low back pain that does not go away.

For the study, they surveyed nearly 1,000 patients attending clinics in Sydney for episodes of acute low back pain. 

The survey asked the participants about 12 physical or psychosocial factors they may have experienced in the 4 days before the back pain episode began.

The results showed the odds of a new back pain episode was significantly linked to a number of triggers - ranging from a nearly 3 times higher chance following moderate to vigorous physical activity to a 25 times higher chance after being distracted during an activity.

The research team also found that age was a factor in triggering back pain when lifting heavy loads - with younger people being significantly more likely to suffer an episode of acute low back pain after such activity than older people.

Risk of suffering low back pain was highest in the morning

Some of the findings reflect those of previous studies, but a new finding not seen before was that the risk of suffering low back pain was highest between 7 am and noon.

The research team says understanding which factors are likely to trigger back pain and controlling exposure to such risks is an important first step in prevention, and notes:

"Our findings enhance knowledge of low back pain triggers and will assist the development of new prevention programs that can reduce suffering from this potentially disabling condition."

Low back pain is prevalent in the USA, and accounts for 3.15% of all emergency visits, according to a study published in 2012 that looked at incidence and risk factors for US patients with low back pain attending the emergency department.

Reporting on another 2012 study published in the journal Spine, we learned how getting the right advice on how to remain active when on medical leave with low back pain can increase workers' chances of returning to work.

References:

1.  What triggers an episode of acute low back pain? A case-crossover study, Daniel Steffens, et al., Arthritis Care and Research, doi:10.1002/acr.22533, published online 9 February 2015.
2.  Wiley news release, accessed 9 February 2015 via EurekAlert.
3.  WHO Chronic rheumatic conditions, accessed 9 February 2015.