Is lumbar lordosis related to low back pain development during prolonged standing?

• We measured lumbar lordosis during normal standing in back-healthy participants.
• Participants then stood for 2 h while rating their LBP intensity throughout.
• Twenty four of 57 participants developed LBP during standing.
• People who developed LBP had larger lumbar lordosis than people who did not.
• Baseline lumbar lordosis was related to LBP intensity in people who developed LBP.

BackgroundAn induced-pain paradigm has been used in back-healthy people to understand risk factors for developing low back pain during prolonged standing.ObjectivesThe purposes of this study were to (1) compare baseline lumbar lordosis in back-healthy participants who do (Pain Developers) and do not (Non-Pain Developers) develop low back pain during 2 h of standing, and (2) examine the relationship between lumbar lordosis and low back pain intensity.DesignCross-sectional.MethodFirst, participants stood while positions of markers placed superficial to the lumbar vertebrae were recorded using a motion capture system. Following collection of marker positions, participants stood for 2 h while performing light work tasks. At baseline and every 15 min during standing, participants rated their low back pain intensity on a visual analog scale. Lumbar lordosis was calculated using marker positions collected prior to the 2 h standing period. Lumbar lordosis was compared between pain developers and non-pain developers. In pain developers, the relationship between lumbar lordosis and maximum pain was examined.Results/findingsThere were 24 (42%) pain developers and 33 (58%) non-pain developers. Lumbar lordosis was significantly larger in pain developers compared to non-pain developers (Mean difference = 4.4°; 95% Confidence Interval = 0.9° to 7.8°, Cohen's d = 0.7). The correlation coefficient between lumbar lordosis and maximum pain was 0.46 (P = 0.02).ConclusionThe results suggest that standing in more lumbar lordosis may be a risk factor for low back pain development during prolonged periods of standing. Identifying risk factors for low back pain development can inform preventative and early intervention strategies.