Sedentary lifestyle as a risk factor for low back pain: a systematic review
From: Int Arch Occup Environ Health. 2009 Mar 20. [Epub ahead of print]
To review systematically studies examining the association between sedentary lifestyle and low back pain using a comprehensive definition of sedentary behaviour including prolonged sitting both at work and during leisure time. Journal articles published between 1998 and 2006 were obtained by searching computerized bibliographical databases. Quality assessment of studies employing a cohort or case-control design was performed to assess the strength of the evidence.
Low back pain is a common musculoskeletal problem that affects most people at some point in their lifetime. Slow recovery in some individuals with low back pain can impact on the person’s physical and psycho-social functions and increase the socio-economic burden. In contextual concepts of the International Classification of Functioning, Disability and Health (ICF) model, both environmental and individual factors affect the development of lolw back pain. Lifestyle is a factor that could affect an individual’s health. Sedentary lifestyle is associated with obesity, which in turn is linked to chronic health problems. Modern living increases the tendency to have a more sedentary lifestyle that involves sitting. From a biomechanical perspective, sitting is an easy and more stable posture with low-energy consumption, lower centre of mass and larger base of support.
Using pre-determined keywords, the authors identified 1,778 titles of which 1,391 were considered irrelevant. Then, 20 of the remaining 387 publications were scrutinized for full review after an examination of all the 387 abstracts. Finally, 15 studies (10 prospective cohorts and 5 case-controls) were included in the methodological quality assessment, of which 8 (6 cohorts and 2 case-controls; 53%) were classified as high-quality studies. One high-quality cohort study reported a positive association, between low back pain and sitting at work only; all other studies reported no significant associations. Hence, there was limited evidence to demonstrate that sedentary behaviour is a risk factor for developing low back pain. The present review confirms that sedentary lifestyle by itself is not associated with low back pain.
