Triggers of Acute Low Back Pain

Often as a culture, we have associated lifting heavy things and being in awkward positions as triggers of acute LBP. While these are important factors, the risk of them causing an initial episode of acute LBP is SIGNIFICANTLY increased when combined with psychosocial factors:

“Transient exposure to stress and fatigue triples the odds of developing immediate back pain, whereas distraction increases the odds by a factor of 25” – https://www.ncbi.nlm.nih.gov/pubmed/25665074

Regard recurrent cLBP triggers, a recent study looked at 6 physical factors that play a role in a ‘flare-up’ of LBP and compared them with stress and depression. They looked at the following physical factors:

1) lifting a heavy object (≥35 lbs.) between 1-5 times, or >5 times,

2) running/jogging,

3) vigorous, non-contact sports (i.e. tennis, swimming, cycling, etc.),

4) vigorous contact sports (i.e. football, hockey, soccer),

5) physical trauma such as a fall, motor vehicle accident, or other trauma,

6) prolonged sitting (>6 hours),

7) prolonged standing (>6 hours)

8) physical therapy (PT) for LBP.

Rather than heavy loads and intense activities as triggers of LBP ‘flare-ups’, instead they found “prolonged sitting (>6 hours) and stress or depression triggered LBP flare-ups.”. Good news for those of us in rehab, the data supported that “PT was a deterrent of flare-ups. ” – https://www.ncbi.nlm.nih.gov/m/pubmed/28700451/

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Leonard Van Gelder

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