Uncovering the Link Between Sedentary Behavior and Back Pain
Swapnil R Mishra
The prevalence of back pain in the United States is alarming, with a significant portion of the population suffering from this debilitating condition. Certain individuals, including those who are overweight, older or experiencing stress-related conditions, are at a heightened risk of developing back pain. In response, experts are seeking to identify the most effective lifestyle interventions to mitigate back pain.
Research published in BMJ Open reveals that modest reductions in sedentary behaviour can significantly impact back pain management. Over six months, participants who substituted 40 minutes of daily sitting with 20 minutes of moderate to vigorous activity exhibited reduced back pain progression.
The study’s findings underscore the potential benefits of incorporating minor modifications into daily activities to alleviate back pain.
Reducing sedentary behaviour for better back pain outcomes
This study aimed to investigate the complex relationships between back pain, sedentary behaviour reduction, insulin sensitivity, disability and paraspinal muscle fat fraction, acknowledging the documented associations between paraspinal muscle fat and insulin resistance with back pain.
This investigation represents a secondary analysis of a randomized controlled trial, incorporating data from a cohort of 64 adults exhibiting elevated body mass indexes.
As per the trusted source, the 64 adults in the study had several factors that increased their risk of back pain and related health issues. They were overweight or obese, with body mass indexes (BMIs) above healthy levels. Additionally, they engaged in limited physical activity, averaging less than two hours of moderate to vigorous exercise per week. Their sedentary behaviour was also a concern, with most spending 10 or more hours sitting daily or at least 60% of their time wearing accelerometers. Furthermore, they had metabolic syndrome, a condition that raises the risk of diabetes and heart disease.
Moreover, the study targeted 64 adults exhibiting metabolic syndrome, characterized by central obesity, hypertension, dyslipidemia and impaired glucose regulation, thereby increasing their susceptibility to type 2 diabetes and cardiovascular disease. To maintain study integrity, researchers systematically excluded participants with pre-existing diabetes, those engaging in excessive alcohol consumption and tobacco users.
Before initiating the trial, researchers conducted a one-month baseline assessment of participants’ physical activity and sedentary behaviour utilizing accelerometer technology. Subsequently, participants were randomly assigned to either a control group or an intervention group, with the latter undergoing a six-month intervention program.
In a randomized controlled trial, researchers evaluated the effectiveness of reducing sedentary behaviour. Intervention participants targeted a daily reduction of one hour in sitting time. Compared to the control group, intervention participants achieved a Significant 20-minute increase in moderate to vigorous physical activity and
Notable 40-minute decrease in sedentary behaviour
A subsample of 44 participants underwent PET and MRI scans to assess paraspinal muscle glucose uptake and fat fraction. The study revealed that the intervention group, which reduced sedentary behaviour, exhibited no significant changes in back pain. However, the control group, maintaining their usual lifestyle, experienced a statistically significant increase in back pain.
Researchers made several key discoveries in a study exploring the relationship between physical activity, sedentary behaviour and back pain. They found that taking more daily steps was associated with improved paraspinal muscle glucose uptake. However, both the intervention and control groups experienced increased pain-related disability, with no significant difference between the two.
Notably, changes in back pain intensity were not directly linked to alterations in physical activity, sedentary behaviour, paraspinal muscle fat fraction or glucose uptake. These findings suggest that even simple changes in activity levels may provide benefits for individuals experiencing back pain, offering hope for effective and straightforward management strategies.
JooaNorha, physiotherapist and doctoral researcher, emphasised to Medical News Today: “Back pain affects millions, and research suggested sitting contributes to its development. Our groundbreaking study investigates the effects of decreasing sitting time, providing valuable insights into back pain management.”
“Norha emphasizes: “Reducing sitting time is key to preventing back pain. Rather than focusing on a specific threshold, aim for gradual improvements – even 1-2 hours less sitting daily – to positively impact your spinal well-being.
Less sitting, less pain
Back pain continues to pose significant clinical challenges. The findings underscore the potential of a simple yet effective intervention – decreased sitting time – to yield improved outcomes in clinical practice and substantially enhance individual well-being
Medhat Mikhael, MD, pain management specialist and medical director at MemorialCare Orange Coast Medical Center’s Spine Health Center, shares valuable perspectives on back pain
“Back pain is a ubiquitous issue affecting 80-90% of Americans at some point in their lives. Its prevalence increases with age, with statistics showing a notable progression: 28% of 18-29-year-olds, 35% of 30-45-year-olds, 45% of 45-64-year-olds and 46% of those 65 and above experience back pain. This upward trend is attributed to factors such as degenerative disease progression, sedentary lifestyles, lack of physical activity and the development of chronic diseases. By acknowledging these contributing factors and adopting preventive measures like exercise, stretching and maintaining a healthy lifestyle, individuals can mitigate their risk of back pain.”
Personalized treatment plans, crafted in collaboration with healthcare professionals, are essential for individuals coping with back pain. Research reinforces the benefits of increased physical activity in alleviating symptoms.
According to Michael Wheeler, MD, orthopaedic spine surgeon at Texas Orthopaedic Associates, ‘Healthcare providers can help prevent back pain escalation by recommending reduced sitting, especially for those with mild symptoms. For optimal outcomes, combine this approach with enhanced physical activity, strength training and effective emotional response management
“Reducing sitting time not only alleviates back pain but also yields broader health advantages. Our bodies are built for movement, and incorporating physical activity into daily life is crucial for overall wellness.
Study limitations
This study’s findings on reducing sitting time to alleviate back pain are promising, but limitations exist. The small sample size and relatively short duration of the original trial restrict generalizability.
Additionally, the Finnish-only participant pool lacks diversity, and non-random sampling may have decreased statistical power. Reliance on self-reported data introduces potential bias, while disappointment among control group participants may have impacted pain intensity. Furthermore, the benefits of increased physical activity may have contributed to the observed results.
Future research should address these limitations through larger, diverse participant groups, extended study durations, randomized sampling and objective measurement tools to refine understanding of physical activity’s role in back pain management.
This study’s limitations include potential group assignment bias, neglecting pain history, limited assessments, non-validated questions and lack of specific eligibility criteria. Future research should address these methodological shortcomings
Norha noted the following areas for continued research:
“Our study showed reducing sitting time alleviates mild back pain. However, future research should explore its effectiveness for moderate to severe pain. I hypothesize that individuals with greater pain require more substantial reductions in sitting time (over 1 hour/day) paired with strenuous activities and strengthening exercises.”
