IS PHYSICAL ACTIVITY A RISK FACTOR FOR THE DEVELOPMENT OF LOW BACK PAIN IN ADOLESCENTS?

Abstract

2023 Increased activity and load on the lumbar spine has been implicated as a cause for low back pain in adolescent athletes. Although there is a higher prevalence of back problems among adolescent athletes than non-athletes, there is conflicting evidence regarding the role of recreational sport and low back pain in teens. The objective of this study was to examine whether physical activity is a risk factor for the development of low back pain in adolescents. A prospective, repeated measures cohort design with urban high school students was conducted in Montreal, Canada; 502 students were evaluated at 3 separate times, 6 months apart. The students completed a questionnaire which addressed health issues of a musculoskeletal nature as well as lifestyle and psychosocial variables. They were also measured for: height, weight, leg and back flexibility, and trunk strength. Low back pain occurring at a frequency of at least once a week within the past 6 months was considered to be substantial and regarded as the outcome. A multivariate analysis modeled the dichotomous repeated measures outcome as a function of the repeated measures variable physical activity (defined as the sum of the time spent in activities per week over the past 6 months) adjusted for age, gender, smoking, growth, flexibility, strength and work. In addition, physical activity was categorized into 4 levels: high, moderate, minimal and none. Physical activity was not shown to be a risk factor for the development of LBP in this cohort of adolescents (RR:1.05; 95% C.I.: 1.00-1.10). However, those subjects who were highly active or moderately active during the first 6-month interval were at a higher risk for developing low back pain. This may support the idea that moderate to high physical activity (possible competitive training) during the school year may serve as an added stress and increase the risk for development of low back pain in adolescents.