Is lumbar lordosis related to low back pain development during prolonged standing?

Abstract

Background: An induced-pain paradigm has been used in back-healthy people to understand risk factors for developing low back pain during prolonged standing.

Objectives: The purposes of this study were to (1) compare baseline lumbar lordosis in back-healthy participants who do (Pain Developers) and do not (Non-Pain Developers) develop low back pain during 2 h of standing, and (2) examine the relationship between lumbar lordosis and low back pain intensity.

Design: Cross-sectional.

Method: First, participants stood while positions of markers placed superficial to the lumbar vertebrae were recorded using a motion capture system. Following collection of marker positions, participants stood for 2 h while performing light work tasks. At baseline and every 15 min during standing, participants rated their low back pain intensity on a visual analog scale. Lumbar lordosis was calculated using marker positions collected prior to the 2 h standing period. Lumbar lordosis was compared between pain developers and non-pain developers. In pain developers, the relationship between lumbar lordosis and maximum pain was examined.

Results/findings: There were 24 (42%) pain developers and 33 (58%) non-pain developers. Lumbar lordosis was significantly larger in pain developers compared to non-pain developers (Mean difference = 4.4°; 95% Confidence Interval = 0.9° to 7.8°, Cohen's d = 0.7). The correlation coefficient between lumbar lordosis and maximum pain was 0.46 (P = 0.02).

Conclusion: The results suggest that standing in more lumbar lordosis may be a risk factor for low back pain development during prolonged periods of standing. Identifying risk factors for low back pain development can inform preventative and early intervention strategies.

Keywords: Induced-pain paradigm; Low back pain; Lumbar lordosis; Prolonged standing.

Copyright © 2015 Elsevier Ltd. All rights reserved.

Figures

Figure 1

Participant standing with retroreflective markers superficial to the spinous processes of the first, third, and fifth vertebrae (L1, L3, and L5, respectively). (a) Lumbar curvature angle (α) was calculated as the angle of a vector from L1 to L3 relative to a vector from L3 to L5. (b) The distance of a vector from L1 to L5 (l) and the distance of a vector perpendicular from l to L3 (d).

Figure 2

Scatterplot of lumbar curvature angle and maximum visual analog scale (Max VAS) values in PDs (r = 0.46, P =0.02).