Association between sedentary behavior and low back pain; A systematic review and meta-analysis

Background: Sedentariness is a substantial risk for many chronic diseases. We aimed to investigate the correlation of sedentary behavior and its indicators with low back pain (LBP) among adults and children. Methods: Original articles published up to April 28, 2020, using PubMed, Embase, Web of Science and Scopus were evaluated. Odds ratio (OR, 95% CI) was considered the overall effect size for desired associations. Results: We reviewed 49 English articles with analytical observational study design, of which, 27 studies with cross sectional/survey design were retained in the meta-analysis. Among adults, sedentary lifestyle was a considerable risk factor for LBP (OR = 1.24, 1.02-1.5); prolonged sitting time (OR = 1.42, 1.09-1.85) and driving time (OR = 2.03, 1.22-3.36) were the significant risk factors. Sedentary behavior was associated with LBP in office workers (OR = 1.23). Moreover, excess weight (OR = 1.35, 1.14-1.59) and smoking (OR = 1.28, 1.03-1.60) were associated with LBP. Among children, sedentary lifestyle was a remarkable risk factor for LBP (OR = 1.41, 1.24-1.60); prolonged TV watching (OR = 1.23, 1.08-1.41) and computer/mobile using and console playing time (OR = 1.63, 1.36-1.95) were significant risk factors for LBP. Consumption of coffee, however, has yield conflicting results to be considered as a risk factor. Moreover, the researches on the correlation between sedentariness and high-intensity LBP are scarce and inconclusive. Conclusion: Sedentary behavior, whether in work or leisure time, associates with a moderate increase in the risk of LBP in adults, children and adolescents.

Automated summary

Sedentary behavior is moderately associated with low back pain in adults and children, with factors such as sedentary lifestyle, prolonged sitting time, and driving time increasing the risk. Studies on high-intensity low back pain are limited and inconclusive.