Here’s a surprising fact: the very activities we often blame for back pain might not be as harmful in the long run as we think. But here’s where it gets controversial—while certain physical tasks can trigger short-term low back pain (LBP) flare-ups, they don’t appear to worsen long-term functionality. Let’s dive into what this means for you.
TOPLINE:
A recent study reveals that activities like lifting, bending, and squatting are linked to an increased risk of LBP flares within 24 hours. Conversely, sitting seems to reduce this risk. However, none of these activities were found to cause lasting functional issues after a year. And this is the part most people miss—while short-term pain might be unavoidable, it doesn’t necessarily translate to long-term disability.
METHODOLOGY:
This prospective, longitudinal case-crossover study, nested within a larger cohort, involved over 400 adults (average age: 47.5 years; 75% men; 70% White individuals) who had recently sought outpatient care for LBP at VA primary care clinics between 2021 and 2023. Participants completed detailed surveys three times weekly for the first four weeks, once weekly for weeks 5-8, and bimonthly for months 3-12. They tracked their time spent on 10 common activities—lifting 10 pounds or more, pushing/pulling, bending, climbing, twisting, squatting, crawling, sitting, standing, and walking—and reported any new LBP flares during the year. The study’s primary focus was on participant-reported pain flares and functional limitations at the one-year mark, measured using the Roland-Morris Disability Questionnaire.
TAKEAWAY:
Each additional hour spent pushing, pulling, bending, or twisting increased the risk of LBP flares by 6%, while lifting heavy objects or squatting raised the risk by 5%. Interestingly, sitting for longer periods was associated with a 4% lower risk of flares. Here’s the silver lining—despite these short-term risks, no activity significantly impacted long-term functional limitations. This suggests that while certain movements might cause temporary discomfort, they aren’t likely to leave you worse off in the future.
IN PRACTICE:
The researchers emphasize that individuals with LBP can generally continue these activities without fearing long-term consequences. This is a game-changer for those who’ve been hesitant to stay active due to back pain.
SOURCE:
Led by Pradeep Suri, MD, of the Veterans Affairs (VA) Puget Sound Health Care System in Seattle, the study was published on December 9 in JAMA Network Open. You can explore the full findings here.
LIMITATIONS:
It’s important to note that the study relied on self-reported data, which can introduce biases. Additionally, the participant pool was predominantly male and comprised Veterans, limiting the generalizability of the results to other demographics.
DISCLOSURES:
The study was funded by the Rehabilitation Research and Development Service of the VA Office of Research and Development. Several investigators disclosed grants or honoraria from various agencies, fully detailed in the original article.
Food for Thought:
Does this mean we should rethink how we approach back pain management? Should we encourage more movement, even if it risks temporary discomfort? Share your thoughts in the comments—let’s spark a conversation about what this means for everyday life and healthcare practices.
