Background Low back pain (LBP) has an enormous negative economic impact on individuals, families, communities, industries and governments. As such, understanding the aetiology and risk factors for LBP is important in reducing the significant burden of this condition. In an effort to achieve this, epidemiological studies have examined a number of factors, including demographic (age and gender), obesity, and lifestyle factors (physical activity and sedentary lifestyle). The role of lifestyle factors on LBP has become a particular area of importance as they can be modified. Two systematic reviews concluded that there was limited evidence to support an association between physical activity and sedentary behaviour and developing (LBP).
Objectives To examine the associations of physical activity and television viewing time with LBP intensity and disability in community-based adults.
Methods 5,058 participants (44% men) of the Australian Diabetes, Obesity and Lifestyle Study had physical activity and television viewing time measured in 1999–2000, 2004–2005 and 2011–2012, and LBP intensity and disability assessed in 2013–2014 using the Chronic Pain Grade Questionnaire. Logistic regressions were used to estimate the odds ratio for LBP intensity and disability associated with physical activity and television viewing time. Analyses were adjusted for age, education, smoking, dietary guideline index score, body mass index, Mental component summary score. To test whether associations of physical activity or television viewing time with LBP intensity and disability were modified by sex, obesity, or age, interactions were tested using the likelihood ratio test.
Results 81.7% men and 82.1% women suffered from LBP. Most of the men (63.6%) and women (60.2%) had low intensity LBP with a lower proportion having high intensity LBP (18.1% men, 21.5% women). Most of the participants had no LBP disability (74.5% men, 71.8% women) with the remainder reporting low (15.8% men, 15.3% women) or high (9.7% men, 12.9% women) disability due to LBP. Insufficient physical activity (<2.5 hours/week) was not associated with LBP intensity or disability in either men or women. High television viewing time (≥2 hours/day) was associated with greater prevalence of disability due to LBP in women (low disability OR 1.35, 95% CI 1.04–1.73; high disability OR 1.29, 95% CI 1.01–1.72). Women with insufficient physical activity and high television viewing had an increased risk of disability due to LBP (OR 1.42 95% CI 1.07–1.88) compared with women with sufficient physical activity and low television viewing.
Conclusions Our findings indicate that high levels of television viewing, a marker of sedentary behaviour, is associated with an increased risk of LBP disability in women but not in men. Insufficient physical activity was not associated with LBP intensity or disability in either men or women. These findings suggest that targeting time spent watching television and possibly other prolonged sedentary behaviours such as occupational sitting may have the potential to reduce disability due to LBP in community-based adults, particularly in women.
Disclosure of Interest None declared