Preventing lower back pain caused by physical activity

Prevalence of lower back pain

There are many types of lower back pain (LBP) where some are non-specific, meaning that it has an unknown or unrecognised cause. Within industrialised countries, the lifetime prevalence of LBP is estimated to be 60–70%. With increasing life expectancy, it’s anticipated that with age, you will experience greater deterioration of the intervertebral discs which can lead to LBP (1). The prevalence typically peaks and increases between the ages of 35 and 55 (2). In this post, we’ll go through a few ways in which you can prevent the likelihood of sustaining an LBP injury from physical activity.

What can you do to prevent it?

With such a wide variety of occupation amongst individuals, there are many factors that could increase your chance of developing LBP. Unsurprisingly, a common theme across the research suggests that lifting heavy loads can increase this risk regardless of how frequently or how long you are lifting these loads. However, this risk can be altered by individual traits like age, sex, history of LBP, level of strength, and fitness (3). One of the most effective ways to prevent LBP is exercise and relevant education. These alone have been shown to be more effective than using a combination of ‘supportive’ equipment like shoe soles and back belts (4). Equipment cannot solve the underlying problem but merely reduce its effect; hence, educating yourself on healthy posture and exercise techniques could have longer-lasting effects.

On the other hand, when considering the use of exercise, it’s important to understand that you could cause more damage through incorrect use or poor technique. For instance, click here to read my previous post on the effects of using deeper and shallower squats on lower back injuries, and how or when to use it appropriately. Contrastingly, from a comprehensive research review of the effectiveness of LBP interventions like exercise and education, only modest changes were reported (5). It was concluded that no single intervention would likely reduce the prevalence of LBP significantly. Additionally, education may also be ineffective in workplaces. The correct form for lifting objects requires bending of the knees rather than the back. However, even if workers were taught this, they would typically use the inappropriate technique when unsupervised (6).

Experimenting with different forms of exercise could help you decide which are suited for your capabilities and needs. For example, yoga proved to be an effective form of relieving LBP after 12 weeks through classes or self-guided practise (7). Hence, yoga may be appropriate if you seek a lower intensity form of training. Other forms of exercise prevention could also include strength and aerobic-based training with recommendations of 2–3 times a week for reasonable results (8).

Key points to take away

To effectively prevent the likelihood of developing LBP. You should do some form of exercise with a focus on the technique and appropriateness for your goals. However, it’s also crucial that you are consistent with the training; therefore, doing exercises that you enjoy. Training that has been shown to prevent LBP includes yoga, strength, and aerobics. Using correct lifting techniques like ‘bending the knees, and not the back’ to pick up items can also help, or try and think much about your posture throughout the day.

References

1. Fehlings M, Tetreault L, Nater A, Choma T, Harrop J, Mroz T, Santaguida C, Smith J. The aging of the global population: the changing epidemiology of disease and spinal disorders. Neurosurgery. 2015; 77(suppl_1): S1–S5. Available from: https://doi.org/10.1227/NEU.0000000000000953.
2. Andersson G. Epidemiology of low back pain. Acta Orthopaedica Scandinavica. 1998; 69(sup281): 28–31. Available from: https://doi.org/10.1080/17453674.1998.11744790.
3. Garg A, Moore J. Epidemiology of low-back pain in industry. Occupational Medicine. 1992; 7(4): 593–608. Available from: https://europepmc.org/article/med/1411850.
4. Steffens D, Maher C, Pereira L, Stevens M, Oliveira V, Chapple M, Teixeira-Salmela L, Hancock . Prevention of low back pain: a systematic review and meta-analysis. JAMA Internal Medicine. 2016; 176(2): 199–208. Available from: https://doi.org/10.1001/jamainternmed.2015.7431.
5. Burton A. How to prevent low back pain. Best Practice and Research Clinical Rheumatology. 2005; 19(4): 541–55. Available from: https://doi.org/10.1016/j.berh.2005.03.001.
6. Maher C. A systematic review of workplace interventions to prevent low back pain. Australian Journal of Physiotherapy. 2000; 46(4): 259–69. Available from: https://doi.org/10.1016/S0004-9514(14)60287-7.
7. Tilbrook H, Cox H, Hewitt C, Kang'ombe A, Chuang L, Jayakody S, Aplin J, Semlyen A, Trewhela A, Watt I, Torgerson D. Yoga for chronic low back pain: a randomized trial. Annals of Internal Medicine. 2011; 155(9): 569–78. Available from: https://doi.org/10.7326/0003-4819-155-9-201111010-00003.
8. Shiri R, Coggon D, Falah-Hassani K. Exercise for the prevention of low back pain: systematic review and meta-analysis of controlled trials. American Journal of Epidemiology. 2018; 187(5): 1093–101. Available from: https://doi.org/10.1093/aje/kwx337.