Back strains and sprains most likely in the morning
“The results of this study are unique, demonstrating for the first time that even brief exposure
to a range of physical and psychosocial factors can considerably increase the risk of back
pain.”
Sudden attacks of back pain are more likely to begin in the morning than later in the day, Australian
researchers have unexpectedly found.
Back pain is also more likely to be triggered when fatigued or tired or when distracted while
performing a manual task.
The study is the world’s first study of immediate back pain triggers, and ranks causes of back pain by
degree of risk.
Study leader Associate Professor Manuela Ferreira, of the George Institute for Global Health and
Sydney Medical School, The University of Sydney, said around 40% of sprains and strains in the
study occurred from 8-11am.
“We’re not sure why people are more likely to trigger an episode of back pain in the morning. It was
unexpected.
“Spinal discs swell with fluid overnight, potentially leaving them more susceptible to stresses when
loaded.”
Each day back pain affects approximately 25% of the world’s population, and is one of the 10 leading
causes of disease burden globally. Back pain is, however, unique amongst this list of 10 diseases
because there has been little or no progress in identifying effective prevention strategies.
Associate Professor Ferreira said: “Most of us will have back pain at some point. This study shows
that it’s not just long-term stresses on the back that lead to back pain.
“The results of this study are unique, demonstrating for the first time that even brief exposure to a
range of physical and psychosocial factors can considerably increase the risk of back pain.
“Just as importantly, this study shows there are several things we can do to prevent back pain – it’s
not just something we’re prone to because we have been lifting heavy loads or inactive for a long
time.
“The key message is that people should be careful when lifting: even brief exposure to heavy loads,
awkward postures or being distracted can trigger an episode of back pain.”
George Institute Musculoskeletal research leader Professor Chris Maher, a senior author on the
paper, said previous back pain risk studies have only examined long-term exposure to factors such as
smoking and inactivity. Investigations on short-term exposure to transient risk factors occurring
immediately before back pain were lacking.
Additionally, no research had ever evaluated whether distraction or fatigue, identified as important
factors for other musculoskeletal conditions, trigger back pain.
“Our results have identified factors that trigger back pain and, importantly, which ones are more
dangerous. For example being fatigued triples the odds of developing immediate back pain, whereas
distraction increases the odds by a factor of 25,” Professor Maher said.
Back pain triggers included (ranked from most risky down):
1.
2.
3.
4.
5.
6.
7.
8.
Distraction during a task
Manual tasks involving awkward postures
Manual tasks involving objects not close to the body
Manual tasks involving people or animals
Manual tasks involving unstable or unbalanced objects
Manual tasks involving heavy loads
Moderate or vigorous physical activity
Fatigue/tiredness
The study also busted popular myths: activities that were not found to trigger back pain included:
1. Alcohol consumption
2. Sexual activity
Professor Maher said these results add to our understanding of how to prevent back pain.
“There are really three things people can do to reduce their risk of back pain. Firstly use your back
wisely and we have shown here that even brief exposures can be harmful. Secondly adopt a healthy
lifestyle: smoking, being overweight, prolonged sitting and/or and being physically inactive are bad for
back health. And lastly stress, either at home or work, seems to increase your chances of getting
back pain.
The study looked at 999 patients aged 18 years or older in New South Wales, and was published in
Arthritis Care & Research.
.
MEDIA ENQUIRIES
Maya Kay, Communications Manager Australia
The George Institute for Global Health
P: + 61 424 195 878
E: mkay@georgeinstitute.org.au
The George Institute for Global Health
The George Institute for Global Health is improving the lives of millions of people worldwide through innovative
health research. Working across a broad health landscape, the Institute conducts clinical, population and health
system research aimed at changing health practice and policy worldwide. The Institute has a global network of
medical and health experts working together to address the leading causes of death and disability worldwide.
Established in Australia and affiliated with The University of Sydney, the Institute today also has offices in China,
India and the United Kingdom, and is also affiliated with Peking University Health Science Centre, the University
of Hyderabad and the University of Oxford.
The George Institute prioritises clinical and population health research that produces outcomes that are easily
translated into practice, and effect real change within a short period of time to health policy and practice. The
Institute has been ranked among the top 10 global institutes for impact for the last several years, and its research
has resulted in changes to medical guidelines and ways of thinking about some of the most common medical
treatments around the world. Examples include developing a new treatment for stroke, showing that blood
pressure lowering reduces the risk of cardiovascular disease in people with diabetes, and providing safer fluid
options for patients in intensive care. Developing better methods for delivering health care are a priority for the
Institute. Follow us on Facebook at thegeorgeinstitute and on Twitter @georgeinstitute