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Daily spinal mechanical loading as a risk factor for acute non-specific low back pain: a case–control study using the 24-Hour Schedule

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Abstract

A case–control study was conducted to assess the daily loading of the spine as a risk factor for acute non-specific low back pain (acute LBP). Acute LBP is a benign, self-limiting disease, with a recovery rate of 80–90% within 6 weeks irrespective of the treatment type. Unfortunately, recurrence rates are high. Therefore, prevention of acute LBP could be beneficial. The 24-Hour Schedule (24HS) is a questionnaire developed to quantify physical spinal loading, which is regarded as a potential and modifiable risk factor for acute and recurrent low back pain. A total of 100 cases with acute LBP and 100 controls from a primary care setting were included. Cases and controls completed questionnaires regarding acute LBP status and potential risk factors. Trained examiners blinded to subjects’ disease status (acute LBP or not) assessed spinal loading using the 24HS. The mean difference of 24HS sum-scores between groups was statistically significant (P < 0.0001). After multivariate regression analysis, previous episode(s), the 24HS and the Nottingham Health Profile were associated with the presence of acute LBP. High 24HS scores, indicating longer and more intensive spinal loading in flexed position, are strongly associated with acute LBP.

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Acknowledgments

The authors highly appreciate the financial support for this study by the Regional Society of Physiotherapy Randstad West and AZIVO Health Insurance; Emiel van Trijffel, MSc, for his critical appraisal; Adam Weir, MD, for his language editing; A.A.M. Hart, MSc, for his help in analysing data; and all involved health professionals in the region, The Hague, for their help. The procedures followed in this study were approved by the Medical Ethics Committee of the Erasmus Medical Centre (Rotterdam, The Netherlands), and in accordance with the Research Code of the Academic Medical Centre, (Amsterdam, The Netherlands).

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Authors and Affiliations

  1. Department of General Practice, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands

    Eric W. P. Bakker, Arianne P. Verhagen & Bart W. Koes

  2. Department of Clinical Epidemiology and Biostatistics, Amsterdam Medical Centre, Amsterdam, The Netherlands

    Cees Lucas & Rob J. de Haan

  3. Physiotherapy Centre, Prins Hendrikstraat 184, 2518 HZ, The Hague, The Netherlands

    Hans J. C. M. F. Koning

Authors
  1. Eric W. P. Bakker
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  2. Arianne P. Verhagen
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  3. Cees Lucas
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  4. Hans J. C. M. F. Koning
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  5. Rob J. de Haan
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  6. Bart W. Koes
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Corresponding author

Correspondence to Eric W. P. Bakker.

Appendix

Appendix

Figure 2.

Fig. 2
figure 2

The 24HS registration form

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Bakker, E.W.P., Verhagen, A.P., Lucas, C. et al. Daily spinal mechanical loading as a risk factor for acute non-specific low back pain: a case–control study using the 24-Hour Schedule. Eur Spine J 16, 107–113 (2007). https://doi.org/10.1007/s00586-006-0111-2

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  • DOI: https://doi.org/10.1007/s00586-006-0111-2

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