European Spine Journal

, Volume 20, Issue 6, pp 826–845 | Cite as

Physical activity and low back pain: a systematic review of recent literature

  • Hans Heneweer
  • Filip Staes
  • Geert Aufdemkampe
  • Machiel van Rijn
  • Luc Vanhees
Review Article


The objective of the study is to systematically evaluate the available evidence on the association between physical activity (i.e. occupational load and non-occupational physical activities) and low back pain (LBP). A systematic approach was used to explore the literature between 1999 and 2009. Studies were selected for inclusion following a comprehensive search of Medline, Embase and CINAHL. The methodological quality of each study was assessed. Studies were considered to be of ‘high quality’ if they met the cut-off criterion of 60% of the maximum available quality score. Thirty-six cohort or case–control studies were retrieved. Heavy workload and the accumulation of loads or frequency of lifts were moderate to strong risk factors for LBP. Strong associations were found for flexed, rotated and the awkward positions of the lumbar spine. Inconsistent results were found for leisure time physical activities, sports and physical exercise. Studies focusing on daily habitual physical activities (e.g. domestic activities and commuting) in association with LBP are lacking. In conclusion, the occurrence of LBP is related to the nature and intensity of the physical activities undertaken. However, physical activities can be subdivided into separate types and intensities and the ultimate physical load is the sum of all these activities. This makes it difficult to designate one particular activity as the cause of LBP.


Back pain Case–control Cohort Aetiology Human activities Longitudinal study Review Risk 


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Hans Heneweer
    • 1
  • Filip Staes
    • 2
  • Geert Aufdemkampe
    • 1
  • Machiel van Rijn
    • 3
  • Luc Vanhees
    • 1
    • 2
  1. 1.Research Department Lifestyle and HealthUniversity of Applied SciencesUtrechtThe Netherlands
  2. 2.Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation SciencesKatholieke Universiteit LeuvenLeuvenBelgium
  3. 3.Centre for Human Movement Studies, Master Physical TherapyUniversity of Applied SciencesUtrechtThe Netherlands

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