Biological risk indicators for recurrent non-specific low back pain in adolescents

Objectives: A matched case-control study was carried out to evaluate biological risk indicators for recurrent non-specific low back pain in adolescents. Methods: Adolescents with recurrent non-specific low back pain ( symptomatic; n = 28; mean (SD) age 14.9 (0.7) years) and matched controls ( asymptomatic; n = 28; age 14.9 ( 0.7) years) with no history of non-specific low back pain participated. Measures of stature, mass, sitting height, sexual maturity ( Tanner self assessment), lateral flexion of the spine, lumbar sagittal plane mobility ( modified Schober), hip range of motion ( Leighton flexometer), back and hamstring flexibility ( sit and reach), and trunk muscle endurance ( number of sit ups) were performed using standardised procedures with established reliability. Backward stepwise logistic regression analysis was performed, with the presence/absence of recurrent low back pain as the dependent variable and the biological measures as the independent variables. Results: Hip range of motion, trunk muscle endurance, lumbar sagittal plane mobility, and lateral flexion of the spine were identified as significant risk indicators of recurrent low back pain ( p< 0.05). Follow up analysis indicated that symptomatic subjects had significantly reduced lateral flexion of the spine, lumbar sagittal plane mobility, and trunk muscle endurance ( p< 0.05). Conclusions: Hip range of motion, abdominal muscle endurance, lumbar flexibility, and lateral flexion of the spine were risk indicators for recurrent non- specific low back pain in a group of adolescents. These risk indicators identify the potential for exercise as a primary or secondary prevention method.