Physical Activity Important In Low Back Pain

This 2017 study suggests that people who are active for 75 minutes of vigorous-intensiy activity, or 150 minutes of moderate-intensity activity per week have reduced risk of reporting back pain.

Examples of Vigorous Intensity:
Race walking, jogging, or running.
Swimming laps.
Tennis (singles)
Aerobic dancing.
Bicycling 10 miles per hour or faster.
Jumping rope.
Heavy gardening (continuous digging or hoeing)
Hiking uphill or with a heavy backpack.

Examples of Moderate Intensity:
Walking briskly (3 miles per hour or faster, but not race-walking)
Water aerobics
Bicycling slower than 10 miles per hour
Tennis (doubles)
Ballroom dancing
General gardening

The Spine Journal
Volume 17, Issue 6, June 2017, Pages 845–854
Joshua Robert Zadro, BAppSc (Phty) (Hons)


Despite a large amount of research investigating physical activity (PA) levels in people with chronic low back pain (LBP), no study has investigated whether people with chronic LBP are meeting the World Health Organization (WHO) PA guidelines. Furthermore, with genetics and the early shared environment substantially influencing the presence of LBP and PA engagement, these factors could confound the association between LBP and PA and need to be controlled for.


This study aimed to investigate the association between chronic LBP and meeting the PA guidelines, while controlling for the effects of genetics and early shared environment.


This is a cross-sectional co-twin control study.

Patient Sample

A cross-sectional analysis was performed on 1,588 twins from the Murcia Twin Registry in Spain with available data on LBP and PA from the 2013 data collection wave.

Outcome Measures

The exposure and outcome variables in our study were self-reported. Twins reporting a history of chronic LBP were asked follow-up questions to inform on the presence of recent LBP (within the past 4 weeks), previous LBP (no pain within the past 4 weeks), and persistent LBP (no pain-free month in the last 6 months). These were our exposure variables. Our outcome variable was meeting the WHO PA guidelines, which involved at least 75 minutes of vigorous-intensity PA, or at least 150 minutes of moderate-intensity PA per week.


To investigate the association between chronic LBP and meeting the PA guidelines, we first performed a multivariate logistic regression on the total sample of twins. Co-variables entered the model if the univariate association between the co-variable, and both the exposure and the outcome reached a significance of p


There was a significant inverse association between recent LBP and meeting the PA guidelines (odds ratio [OR]=0.71, p=.034). When controlling for genetics and early shared environment, this association disappeared. There was no association between previous (OR=0.95, p=.779) or persistent LBP (OR=0.78, p=.192) and meeting the PA guidelines.


Twins with recent LBP are less likely to meet the PA guidelines than those with no history of chronic LBP, highlighting the importance of incorporating PA promotion in the treatment of these individuals. Genetics and early shared environment appear to be confounding the association between LBP and PA, although this needs to be further tested in larger twin samples.

Journal Abstract