What is the pathophysiology of mechanical low back pain?

Updated: Mar 06, 2018
  • Author: Everett C Hills, MD, MS; Chief Editor: Stephen Kishner, MD, MHA  more...
  • Print
Answer

Mechanical low back pain (LBP) generally results from an acute traumatic event, but it may also be caused by cumulative trauma. [9] The severity of an acute traumatic event varies widely, from twisting one's back to being involved in a motor vehicle collision. Mechanical LBP due to cumulative trauma tends to occur more commonly in the workplace.

Using data from the 2015 National Health Interview Survey, a study by Peng et al indicated that overweight and obesity are risk factors for low back pain (LBP). Compared with persons of normal weight, the adjusted odds ratios for LBP in persons with overweight or obesity were 1.21 and 1.55, respectively. However, the link between body mass index and LBP appeared to be impacted by sex and race/ethnicity. For example, the adjusted odds ratios for nonwhite men and women of normal weight were lower than the LBP risk for normal-weight white men. [10]

In a systematic study review, Chen et al investigated whether a sedentary lifestyle (which the authors defined as including sitting for prolonged periods at work and during leisure time) is a risk factor for LBP. [11] Examining journal articles published between 1998 and 2006, they identified 8 high-quality reports (6 prospective cohort and 2 case-control studies). While 1 of the cohort studies reported a link between sitting at work and the development of LBP, the other investigations did not find a significant connection between a sedentary lifestyle and LBP. Chen and coauthors concluded that a sedentary lifestyle alone does not lead to LBP.

In a birth cohort study from 1980-2008, Rivinoja et al investigated whether lifestyle factors, such as smoking, being overweight or obese, and participating in sports, at age 14 years would predict hospitalizations in adulthood for LBP and sciatica. [12] The authors found that 119 females and 254 males had been hospitalized at least once because of LBP or sciatica. Females who were overweight had an increased risk of second-time hospitalization and surgery. Smoking in males was linked with an increased risk of first-time nonsurgical hospitalization and second-time hospitalization for surgical treatment.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!