Association between sitting and occupational LBP
PainSci summary of Lis 2007?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★★☆?4-star ratings are for bigger/better studies and reviews published in more prestigious journals, with only quibbles. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
This review of 25 studies found that “sitting alone was not associated with the risk of developing low back pain,” but vibration and awkward postures are, as exemplified in helicopter pilots, who tolerate long hours of intense vibration while frequently twisting in their seats.
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Low back pain (LBP) has been identified as one of the most costly disorders among the worldwide working population. Sitting has been associated with risk of developing LBP. The purpose of this literature review is to assemble and describe evidence of research on the association between sitting and the presence of LBP. The systematic literature review was restricted to those occupations that require sitting for more than half of working time and where workers have physical co-exposure factors such as whole body vibration (WBV) and/or awkward postures. Twenty-five studies were carefully selected and critically reviewed, and a model was developed to describe the relationships between these factors. Sitting alone was not associated with the risk of developing LBP. However, when the co-exposure factors of WBV and awkward postures were added to the analysis, the risk of LBP increased fourfold. The occupational group that showed the strongest association with LBP was Helicopter Pilots (OR=9.0, 90% CI 4.9-16.4). For all studied occupations, the odds ratio (OR) increased when WBV and/or awkward postures were analyzed as co-exposure factors. WBV while sitting was also independently associated with non-specific LBP and sciatica. Vibration dose, as well as vibration magnitude and duration of exposure, were associated with LBP in all occupations. Exposure duration was associated with LBP to a greater extent than vibration magnitude. However, for the presence of sciatica, this difference was not found. Awkward posture was also independently associated with the presence of LBP and/or sciatica. The risk effect of prolonged sitting increased significantly when the factors of WBV and awkward postures were combined. Sitting by itself does not increase the risk of LBP. However, sitting for more than half a workday, in combination with WBV and/or awkward postures, does increase the likelihood of having LBP and/or sciatica, and it is the combination of those risk factors, which leads to the greatest increase in LBP.
related content
- “Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies,” an article in Spine (Phila Pa 1976), 2009.
- “Sedentary lifestyle as a risk factor for low back pain: a systematic review,” an article in Int Arch Occup Environ Health, 2009.
- “Is sitting-while-at-work associated with low back pain? A systematic, critical literature review,” an article in Scand J Public Health, 2000.
These four articles on PainScience.com cite Lis 2007 as a source:
- PS The Trouble with Chairs — The science of being sedentary and how much it does (or doesn’t) affect your health and back pain
- PS A Guide to Sciatica Treatment for Patients — A guide to buttock and leg pain (which may or may not involve the sciatic nerve)
- PS Save Yourself from Low Back Pain! — Low back pain myths debunked and all your treatment options reviewed
- PS Morning Back Pain — A thorough review of possible causes for this frustrating symptom
