Now that we know that low back pain is common and that most people are going to recover, one big question might be on everyone’s mind: how do I prevent it in the first place? What are the risk factors? If I sat for 3 days working on a puzzle during the coronavirus pandemic is that going to ruin my back for the rest of my life? Those are all great questions, with answers that unfortunately are not so clear.
There are no clearly defined, strong risk factors that predict the development or prognosis of low back pain. How many times have we heard phrases like these: “You should get a stand up desk, it’s better for your back,” or “Here, try sitting on a swiss ball it will give you a stronger core so you don’t have back pain,” or “My back pain came from all those years of playing football in high school,” or “my job is going to kill me because of all the lifting I have to do.” Well in a study by Bakker et al, they found no relationship between work-related lifting, prolonged sitting, and/or participation in sporting activities on the recovery of LBP. Essentially all ideas that have been pervasive in our culture as risk factors for back pain had no bearing at all! Now you might think well, what does this Bakker guy know anyways, they probably only looked at a handful of people… Nope! They had over 24,000 subjects and found no strong evidence of any of these things or anything else that had predictive value for people developing low back pain.
So, it must all be from your genes, right? Well not really. Even though there is a higher risk for developing specific disorders such as degenerative disc disease, there is no link between hereditary development of low back pain. Basically, yes you may be more likely to have arthritis in your back because grandpappy had arthritis, but it doesn’t mean you are more likely to have it be painful.
Here are some bullets of some of the other research articles summary findings.
- There is some evidence that certain lifestyle factors (smoking, obesity, high blood pressure) are associated with sciatica.
- There is some evidence to suggest that being fearful of hurting your back more can influence pain becoming persistent.
- Distress/depression may play an important role at the early stages of back pain so minimizing this can be helpful.
- Higher levels of pain are associated with worse outcomes.
- Active coping methods have better outcomes.
- Height, weight, body mass, spine flexibility, and core weakness had no association with back pain.
- Adolescent girls have a higher prevalence of back pain than boys.
To summarize here are two quotes “The only thing we have to fear is fear itself”, and “we are born with only two innate fears: the fear of falling and the fear of loud sounds.”
Don’t fear your back pain