Abstract

IntroductionAlthough physical inactivity has been associated with numerous chronic musculoskeletal complaints, few studies have examined its associations with spinal structures. Moreover, previously reported associations between physical activity and low back pain are conflicting. This study examined the associations between physical inactivity and intervertebral disc height, paraspinal fat content and low back pain and disability.MethodsSeventy-two community-based volunteers not selected for low back pain underwent magnetic resonance imaging (MRI) of their lumbosacral spine (L1 to S1) between 2011 and 2012. Physical activity was assessed between 2005 and 2008 by questionnaire, while low back pain and disability were assessed by the Chronic Pain Grade Scale at the time of MRI. Intervertebral disc height and cross-sectional area and fat content of multifidus and erector spinae were assessed from MRI.ResultsLower physical activity levels were associated with a more narrow average intervertebral disc height (β −0.63 mm, 95% confidence interval (CI) −1.17 mm to −0.08 mm, P = 0.026) after adjusting for age, gender and body mass index (BMI). There were no significant associations between physical activity levels and the cross-sectional area of multifidus or erector spinae. Lower levels of physical activity were associated with an increased risk of high fat content in multifidus (odds ratio (OR) 2.7, 95% CI 1.1 to 6.7, P = 0.04) and high-intensity pain/disability (OR = 5.0, 95% CI 1.5 to 16.4, P = 0.008) after adjustment for age, gender and BMI.ConclusionsPhysical inactivity is associated with narrower intervertebral discs, high fat content of the multifidus and high-intensity low back pain and disability in a dose-dependent manner among community-based adults. Longitudinal studies will help to determine the cause and effect nature of these associations.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-015-0629-y) contains supplementary material, which is available to authorized users.

Highlights

  • Physical inactivity has been associated with numerous chronic musculoskeletal complaints, few studies have examined its associations with spinal structures

  • The majority of participants in the study were female (68.1%), and the average body mass index (BMI) was in the overweight category (29.2 kgm−2)

  • There were no significant associations between physical activity levels and the cross-sectional area (CSA) of multifidus or erector spinae

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Summary

Introduction

Physical inactivity has been associated with numerous chronic musculoskeletal complaints, few studies have examined its associations with spinal structures. Previously reported associations between physical activity and low back pain are conflicting. Physical inactivity has been associated with numerous chronic musculoskeletal complaints [2], two systematic reviews have shown the evidence linking physical activity and low back pain to be conflicting [3,4]. While one systematic review of 15 studies [3] found only one study demonstrating a significant positive relationship between physical inactivity and low back pain [5], the populations investigated were diverse, comprising both school children and adults. A more recent systematic review of 17 studies concluded that the relationship between physical activity and low back pain was too heterogeneous to reach any conclusion [4].

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