What are the risk factors for low back pain (LBP) and sciatica?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Answer

LBP is most prevalent in industrialized societies. Genetic factors that predispose persons of specific ethnicity or race to this disorder have not been clearly identified with respect to mechanical, diskogenic, or degenerative causes. Men and women are affected equally, but in those older than 60 years, women report LBP symptoms more often than men. The incidence of LBP peaks in middle age and declines in old age when degenerative changes of the spine are universal. Sciatica usually occurs in patients during the fourth and fifth decades of life; the average age of patients who undergo lumbar diskectomy is 42 years.

Epidemiological data suggest that risk factors, including extreme height, cigarette smoking, and morbid obesity, may predispose an individual to back pain. However, research studies have not clearly demonstrated that height, weight, or body build are directly related to the risk of back injury. Weakness of the trunk extensor muscles, compared with flexor strength, may be a risk factor for sciatica. Fitness may be correlated with the time to recovery and return to work after LBP; however, in prospective studies controlled for age, isometric lifting strength and the degree of cardiovascular fitness were not predictive of back injury.

Occupational risk factors are difficult to define because exposures to specific causative influences are unclear, mechanisms of injury may be confusing, and the research supporting these findings is variable and conflicting for most environmental risks. Furthermore, job dissatisfaction, work conditions, legal and social factors, financial stressors, and emotional circumstances heavily influence back disability. Although many experts agree that heavy physical work, lifting, prolonged static work postures, simultaneous bending and twisting, and exposure to vibration may contribute to back injuries, the medical literature provides conflicting support for most of these proposed risk factors.


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