Is lumbar lordosis related to low back pain development during prolonged standing?
Christopher J Sorensen, Barbara J Norton, Jack P Callaghan, Ching-Ting Hwang, Linda R Van Dillen
Author Information
Christopher J Sorensen: Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Blvd., Campus Box 8502, Saint Louis, MO 63108, USA. Electronic address: sorensenc@wusm.wustl.edu.
Barbara J Norton: Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Blvd., Campus Box 8502, Saint Louis, MO 63108, USA. Electronic address: nortonb@wustl.edu.
Jack P Callaghan: Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada N2L3G1. Electronic address: jack.callaghan@uwaterloo.ca.
Ching-Ting Hwang: Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Blvd., Campus Box 8502, Saint Louis, MO 63108, USA. Electronic address: hwangch@wusm.wustl.edu.
Linda R Van Dillen: Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Blvd., Campus Box 8502, Saint Louis, MO 63108, USA. Electronic address: vandillenl@wustl.edu.
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.
