Back pain: not a couch potato problem

• May 25, 2024 • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Most people believe that sedentariness is a huge risk factor for back pain, but a new study says “nope!” And I for one am glad to hear it! As I wrap up another long week mostly in my chair.

Lemmers et al. studied a few hundred back pain patients for a year, measuring activity levels with questionnaires (maybe not ideal, but the main one here has been validated with accelerometry). And they found that sedentariness at the start was clearly not linked to disability a year later, not even a little bit. More or less sedentary just didn’t make a difference.

Screenshot of abstract for Lemmers et al. 2024, with several passages highlighted, most notably in the conclusions: “Habitual SB was not associated with LBP disability trajectories” and “High levels of habitual PA at baseline were associated with improved recovery in LBP disability trajectory, but the finding is not clinically relevant.”

Prospective? No study is perfect, but prospective is good for this. And the results are a bit startling.

The other side of this coin: people also assume that extra exercise will improve the prognosis, but … nope again! Not in this data.

To be more precise, they did kinda find a benefit to higher initial activity levels, but only a tiny bit… so little that “the finding is not clinically relevant.” So not exactly a strong win for those who choose to exercise with back pain — although there are, of course, always other good reasons to exercise.

For more on this topic, see The Trouble with Chairs: The science of being sedentary and how much it does (or doesn’t) affect your health and back pain.