Association of aerobic and muscle-strengthening activity with chronic low back pain: population-based study

Yuanpeng Zhu; Haoran Zhang; Qing Li; Terry Jianguo Zhang; Nan Wu

doi:10.1016/j.spinee.2024.09.009

Association of aerobic and muscle-strengthening activity with chronic low back pain: population-based study

Spine J. 2024 Sep 27:S1529-9430(24)01028-3. doi: 10.1016/j.spinee.2024.09.009. Online ahead of print.

Authors

Yuanpeng Zhu¹, Haoran Zhang¹, Qing Li¹, Terry Jianguo Zhang¹, Nan Wu²

Affiliations

¹ Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing, 100730, China; Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China; Key Laboratory of Big Data for Spinal Deformities, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences; Beijing, 100730, China.
² Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing, 100730, China; Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China; Key Laboratory of Big Data for Spinal Deformities, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences; Beijing, 100730, China. Electronic address: [email protected].

PMID: 39343241
DOI: 10.1016/j.spinee.2024.09.009

Abstract

Background context: Chronic low back pain (CLBP) is a significant global health burden, primarily affecting the middle-aged and older; However, there is a lack of clear, evidence-based guidelines for leisure-time physical activity aimed at preventing CLBP.

Purpose: This study sought to delineate the association between aerobic physical activity (APA) and muscle strengthening activities (MSA) and the prevalence of CLBP.

Study design: This was a population-based study conducted across the United States.

Patient sample: This nationwide study utilizes deidentified data from 22 consecutive rounds of the National Health Interview Survey (NHIS) from 1997 to 2018.

Outcome measures: The primary outcome was self-reported CLBP.

Methods: We analyzed the prevalence of CLBP in a representative sample of 324,793 middle-aged and older people. Among 263,871 individuals, we used multiple logistic regression to investigate individual and joint association between the amount of APA and MSA with CLBP.

Results: In total, 263,871 participants (mean age, 59.0 years; SD, 9.7) were included in the final analysis. From 1997 to 2018, the prevalence of CLBP was approximately 32%, with an annual increase. Engaging in APA for 75 to 150 minutes weekly was associated with a modest reduction in CLBP risk (OR [95% CI] = 0.97 [0.97-0.98]). Similar benefits were seen with 150 to 225, 225 to 300, and >300 minutes. Engaging in MSA 2 to 3 times and 4 to 5 times weekly also reduced CLBP risk (0.98 [0.98-0.99] and 0.98 [0.97-0.99], respectively). Optimal reductions of CLBP risk may be associated with balanced levels of APA and MSA, with recommended amounts being 225 to 300 min/w of APA and 4 to 5 times/w of MSA (0.92 [0.89-0.95]).

Conclusions: The study found engaging in over 75 minutes of APA and 2 to 5 weekly MSA sessions is associated with a reduced risk of CLBP. Furthermore, a balanced combination of APA and MSA may correspond to the greatest reduction in CLBP risk.

Keywords: Aerobic physical activity; Chronic low back pain; Guideline; Muscle strengthening activity; Pain prevention; Physical activity.