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Many Lower Back Problems a Consequence of Body Shape -- Except Among Smokers

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Dec. 28, 1999 (Atlanta) -- Personal characteristics are most often to blame for lower back pain, rather than strenuous labor, concludes a new study from the United Kingdom. However, another new study, this one from Canada, shows that at least one physical act can cause lower back pain, especially in adolescents: lifting a cigarette. Both studies appear in the December issue of the journal Spine.

In the first study, researchers from the University of Bristol in the United Kingdom and the Schulthess Clinic in Zurich, Switzerland studied 400 health care workers. None of the volunteers suffered from serious back pain causing them to miss work or seek medical attention. The volunteers completed questionnaires and underwent a thorough physical examination and test. The subjects' spines and hips were examined for curvature and mobility. Also, their legs and backs were tested for strength. The volunteers then completed six follow-up questionnaires over the next 3 years.

According to lead researcher Michael Adams, PhD, personal risk factors accounted for only 12% of low back pain. "We found that certain physical factors -- a long, stiff, and flat lumbar spine -- are better predictors of first-time 'severe' low back pain than the psycho-social factors studied," Adams tells WebMD.

The study confirms previous research in many respects, but it also breaks new ground. Adams tells WebMD that the study shows for the first time that a stiff back (low range of bending movement, or low mobility) is an important risk factor for low back pain. "Previous studies had given conflicting results on this issue, probably because they used inaccurate 'clinical' measures of lumbar mobility," says Adams. "We used an accurate electromagnetic tracking device to measure lumbar mobility."

Adams says a second major finding is that physical risk factors have more influence in those people who are starting out in a physically demanding new job. "This had not been studied before," Adams tells WebMD. He believes more research needs to be done to determine if people are more likely to develop back pain when starting a new job based on their physical characteristics, including trunk length, back muscle strength, and mobility. Adams is a senior research fellow at Bristol University.

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