Ann Rehabil Med.  2017 Oct;41(5):786-792. 10.5535/arm.2017.41.5.786.

Association Between Walking and Low Back Pain in the Korean Population: A Cross-Sectional Study

• Kim H
• Min TJ
• Kang SH
• Kim DK
• Seo KM
• Lee SY

• KMID: 2440805
• DOI: http://doi.org/10.5535/arm.2017.41.5.786

Abstract

OBJECTIVE
To investigate if walking is independently associated with low back pain (LBP) in the general population.
METHODS
This cross-sectional study used public data from the Fourth and Fifth Korean National Health and Nutrition Examination Survey. Subjects included 5,982 community-dwelling adults aged ≥50 years. Presence of current LBP was defined as LBP for 1 month or more in the past 3 months. Walking was measured as total walking duration for the past week and subjects were divided into four quartiles. Independent effect of walking on LBP was determined using odds ratios (OR) adjusted for age, sex, osteoporosis, depression or anxiety, and radiographic lumbar spondylosis.
RESULTS
Prevalence of LBP was 26.4% in this population. Older people and women had higher prevalence of current LBP. Prevalence of obesity and osteoporosis was higher in subjects with current LBP and quality of life was poorer in subjects with current LBP. Adjusted logistic regression model revealed that older age (OR, 1.655; p=0.018), female sex (OR, 2.578; p<0.001), radiographic lumbar spondylosis (OR, 2.728; p<0.001), depression or anxiety (OR, 5.409; p<0.001), and presence of osteoporosis (OR, 1.467; p=0.002) were positively associated with current LBP. Walking decreased prevalence of current LBP proportionally (2nd quartile OR, 0.795; 3rd quartile OR, 0.770; and 4th quartile OR, 0.686 compared with the 1st quartile of walking).
CONCLUSION
Walking was negatively associated with LBP. Further studies are needed to reveal causal relationship of this phenomenon.

Keyword

Low back pain; Spondylosis; Walking; Exercise; Cross-sectional studies

MeSH Terms

Adult
Anxiety
Cross-Sectional Studies*
Depression
Female
Humans
Logistic Models
Low Back Pain*
Nutrition Surveys
Obesity
Odds Ratio
Osteoporosis
Prevalence
Quality of Life
Spondylosis
Walking*

Reference

1. Holth HS, Werpen HK, Zwart JA, Hagen K. Physical inactivity is associated with chronic musculoskeletal complaints 11 years later: results from the Nord-Trøndelag Health Study. BMC Musculoskelet Disord. 2008; 9:159. PMID: 19046448.

2. Hildebrandt VH, Bongers PM, Dul J, van Dijk FJ, Kemper HC. The relationship between leisure time, physical activities and musculoskeletal symptoms and disability in worker populations. Int Arch Occup Environ Health. 2000; 73:507–518. PMID: 11100945.

3. Sluka KA, O'Donnell JM, Danielson J, Rasmussen LA. Regular physical activity prevents development of chronic pain and activation of central neurons. J Appl Physiol (1985). 2013; 114:725–733. PMID: 23271699.

4. Bo Andersen L, Wedderkopp N, Leboeuf-Yde C. Association between back pain and physical fitness in adolescents. Spine (Phila Pa 1976). 2006; 31:1740–1744. PMID: 16816772.

5. Morken T, Mageroy N, Moen BE. Physical activity is associated with a low prevalence of musculoskeletal disorders in the Royal Norwegian Navy: a cross sectional study. BMC Musculoskelet Disord. 2007; 8:56. PMID: 17601352.

6. Kim W, Jin YS, Lee CS, Hwang CJ, Lee SY, Chung SG, et al. Relationship between the type and amount of physical activity and low back pain in Koreans aged 50 years and older. PM R. 2014; 6:893–899. PMID: 24780849.

7. Sitthipornvorakul E, Janwantanakul P, Lohsoonthorn V. The effect of daily walking steps on preventing neck and low back pain in sedentary workers: a 1-year prospective cohort study. Eur Spine J. 2015; 24:417–424. PMID: 25208502.

8. Bruce B, Fries JF, Lubeck DP. Aerobic exercise and its impact on musculoskeletal pain in older adults: a 14 year prospective, longitudinal study. Arthritis Res Ther. 2005; 7:R1263–R1270. PMID: 16277679.

9. Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R, et al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA. 2007; 298:2296–2304. PMID: 18029834.

10. Hirsch JA, Moore KA, Clarke PJ, Rodriguez DA, Evenson KR, Brines SJ, et al. Changes in the built environment and changes in the amount of walking over time: longitudinal results from the multi-ethnic study of atherosclerosis. Am J Epidemiol. 2014; 180:799–809. PMID: 25234431.

11. Yamanouchi K, Shinozaki T, Chikada K, Nishikawa T, Ito K, Shimizu S, et al. Daily walking combined with diet therapy is a useful means for obese NIDDM patients not only to reduce body weight but also to improve insulin sensitivity. Diabetes Care. 1995; 18:775–778. PMID: 7555502.

12. Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M, et al. Gait speed and survival in older adults. JAMA. 2011; 305:50–58. PMID: 21205966.

13. Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000; 55:M221–M231. PMID: 10811152.

14. Montesi L, Moscatiello S, Malavolti M, Marzocchi R, Marchesini G. Physical activity for the prevention and treatment of metabolic disorders. Intern Emerg Med. 2013; 8:655–666. PMID: 23657989.

15. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010; 39:412–423. PMID: 20392703.

16. Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999; 354:581–585. PMID: 10470716.

17. Luo X, Pietrobon R, Sun SX, Liu GG, Hey L. Estimates and patterns of direct health care expenditures among individuals with back pain in the United States. Spine (Phila Pa 1976). 2004; 29:79–86. PMID: 14699281.

18. Balague F, Mannion AF, Pellise F, Cedraschi C. Non-specific low back pain. Lancet. 2012; 379:482–491. PMID: 21982256.

19. Walker BF. The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. J Spinal Disord. 2000; 13:205–217. PMID: 10872758.

20. Koes BW, van Tulder MW, Ostelo R, Kim Burton A, Waddell G. Clinical guidelines for the management of low back pain in primary care: an international comparison. Spine (Phila Pa 1976). 2001; 26:2504–2513. PMID: 11707719.

21. Hayden JA, van Tulder MW, Tomlinson G. Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med. 2005; 142:776–785. PMID: 15867410.

22. Lee S, Kim TN, Kim SH. Sarcopenic obesity is more closely associated with knee osteoarthritis than is nonsarcopenic obesity: a cross-sectional study. Arthritis Rheum. 2012; 64:3947–3954. PMID: 23192792.

23. An R, Burd NA. Change in daily energy intake associated with pairwise compositional change in carbohydrate, fat and protein intake among US adults, 1999-2010. Public Health Nutr. 2015; 18:1343–1352. PMID: 25203716.

24. Chun MY. Validity and reliability of korean version of international physical activity questionnaire short form in the elderly. Korean J Fam Med. 2012; 33:144–151. PMID: 22787536.

25. EuroQol Group. EuroQol: a new facility for the measurement of health-related quality of life. Health Policy. 1990; 16:199–208. PMID: 10109801.

26. Brooks R. EuroQol: the current state of play. Health Policy. 1996; 37:53–72. PMID: 10158943.

27. Shiri R, Solovieva S, Husgafvel-Pursiainen K, Telama R, Yang X, Viikari J, et al. The role of obesity and physical activity in non-specific and radiating low back pain: the Young Finns study. Semin Arthritis Rheum. 2013; 42:640–650. PMID: 23270761.

28. Sitthipornvorakul E, Janwantanakul P, Purepong N, Pensri P, van der Beek AJ. The association between physical activity and neck and low back pain: a systematic review. Eur Spine J. 2011; 20:677–689. PMID: 21113635.

29. Hendrick P, Te Wake AM, Tikkisetty AS, Wulff L, Yap C, Milosavljevic S. The effectiveness of walking as an intervention for low back pain: a systematic review. Eur Spine J. 2010; 19:1613–1620. PMID: 20414688.

30. Sculco AD, Paup DC, Fernhall B, Sculco MJ. Effects of aerobic exercise on low back pain patients in treatment. Spine J. 2001; 1:95–101. PMID: 14588388.

31. Krein SL, Kadri R, Hughes M, Kerr EA, Piette JD, Holleman R, et al. Pedometer-based internet-mediated intervention for adults with chronic low back pain: randomized controlled trial. J Med Internet Res. 2013; 15:e181. PMID: 23969029.

32. Torstensen TA, Ljunggren AE, Meen HD, Odland E, Mowinckel P, Geijerstam S. Efficiency and costs of medical exercise therapy, conventional physiotherapy, and self-exercise in patients with chronic low back pain. A pragmatic, randomized, single-blinded, controlled trial with 1-year follow-up. Spine (Phila Pa 1976. 1998; 23:2616–2624. PMID: 9854761.

33. Huang YP, Bruijn SM, Lin JH, Meijer OG, Wu WH, Abbasi-Bafghi H, et al. Gait adaptations in low back pain patients with lumbar disc herniation: trunk coordination and arm swing. Eur Spine J. 2011; 20:491–499. PMID: 21181483.

34. Lamoth CJ, Daffertshofer A, Meijer OG, Beek PJ. How do persons with chronic low back pain speed up and slow down? Trunk-pelvis coordination and lumbar erector spinae activity during gait. Gait Posture. 2006; 23:230–239. PMID: 16399520.