TOPLINE:

Physical activities such as lifting, bending, and squatting were associated with an increased risk for low back pain (LBP) flares within 24 hours, whereas sitting was linked to a reduced risk, a new study showed. However, none of the activities were associated with functional limitations at 1-year follow-up.

METHODOLOGY:

• A prospective, longitudinal case-crossover study nested within a cohort study included more than 400 adults (mean age, 47.5 years; 75% men; 70% White individuals) with recent outpatient visits for LBP at VA primary care clinics from 2021 to 2023.
• Participants completed surveys three times weekly for weeks 1-4, once weekly for weeks 5-8, and bimonthly for months 3-12.
• All self-reported time spent during the previous 24 hours participating in 10 common activities: lifting at least 10 lb, pushing or pulling, bending, climbing, twisting, squatting, crawling, sitting, standing, and walking. They could also report new LBP flares during the 1-year follow-up.
• Primary outcomes included participant-reported LBP flares (defined as pain worsening that lasted hours to weeks) and LBP-related functional limitations at 1 year, as measured by the Roland-Morris Disability Questionnaire.

TAKEAWAY:

• Each additional hour in the previous 24 hours spent pushing or pulling, bending, or twisting (adjusted odds ratio [aOR] for all three, 1.06) or lifting at least 10 lb or squatting (both: aOR, 1.05) was associated with a higher risk for subsequent LBP flares (P < .001 for all).
• Each additional hour spent sitting was associated with a lower risk for flares (aOR, 0.96; P = .003).
• Time spent doing the physical activities during the first 8 weeks was not significantly associated with functional limitations at the 1-year follow-up.
• None of the activities associated with an increased flare risk or protective effects showed significant impact on long-term functional limitations.

IN PRACTICE:

“These findings support that people with LBP can generally engage in these activities, with the knowledge that they are not associated with worse long-term outcomes,” the investigators wrote.

SOURCE:

This study was led by Pradeep Suri, MD, Veterans Affairs (VA) Puget Sound Health Care System, Seattle. It was published online on December 9 in JAMA Network Open.

LIMITATIONS:

This study relied on self-reported pain measures and activity levels. Additionally, participants were predominantly men and Veterans which limited generalizability of the findings to broader populations.

DISCLOSURES:

This study was funded by a grant from the Rehabilitation Research and Development Service, VA Office of Research and Development. Several investigators reported receiving grants or honoraria from multiple agencies, which are fully listed in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.