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Chiropractic Research Review

Do Personal Characteristics Play a Role in Low Back Pain?

Evidence has suggested that disc degeneration and low back pain (LBP) may develop more as a function of personal characteristics than exposure to physical stresses. This suggestion is reinforced by research showing that only arduous work significantly increases the risk of LBP, whereas moderate labor may actually help strengthen spinal structures.

Four hundred and three health care workers (aged 18-40 and without history of "serious" back pain) participated in a study intended to develop and validate a "multivariate model to predict low back pain." Subjects completed the modified somatic perception questionnaire, the Zung depression scale, and the Health Locus of Control.

A number of physical and functional measures were assessed, including back muscle strength; quadriceps strength; back muscle endurance; lumbar range of motion; lumbar lordosis; sacral inclination; hip range of motion; peak spinal loading during lifting; and body anthropometry. Follow-up questionnaires, administered by mail every six months up to 36 months of follow-up, were used to assess back pain and potential risk factors accounting for pain.

The study results, along with the authors' conclusions, are presented as follows:

* None of the physical risk factors was an important predictor of "any" LBP.

* Consistent predictors of serious first-time LBP included reduced lumbar mobility; reduced lumbar lordosis; a long back; increased psychological distress; and previous nonserious LBP.

* Up to 12% of serious LBP could be explained by various combinations of the physical and psychological factors considered.

* Serious LBP was more common, and the influence of physical risk factors much greater, among those new to the job.

Adams MA, Mannion AF, Dolan P. Personal risk factors for first-time low back pain. Spine, Dec. 1, 1999:24(23), pp2497-2505.

Chiropractic Research Review

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