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  Predisposing Factors  
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Many factors increase the risk of developing low back pain. Some of these factors are important risk factors for the development of persistent back pain.

  • Occupational - Prolonged standing, prolonged sitting, lifting heavy objects and working with vibrating tools may all be contributing factors to back problems.

  • Age - Studies have shown that the risk of low back pain increases as a patient gets older, but once one reaches the age of about 65 the risk stops increasing. Back pain is the most frequent cause of the limitation of activity in people younger than 45 years of age.

  • Alcohol and Drug Abuse - Alcohol and illicit drug use have been shown to increase one's risk for low back pain.

  • Family History - A family history of back pain has been shown to increase one's risk.

  • Gender - The evidence here is confusing: Some studies have shown that males are at greater risk for low back pain, while other studies suggest that females are more likely to develop this type of pain. Women who have had two or more pregnancies have a higher risk of developing low back pain.

  • Level of Activity (Physical Fitness) - The strength and endurance of the back and abdominal muscles have been shown to be related to the development of back pain. Studies have shown that physical fitness and conditioning may help to prevent back injuries.

  • Obesity - While not conclusive, several studies have shown an increase in back pain in obese patients, especially in women.

  • Poor Posture and Alignment - Poor posture or improper alignment may predispose individuals to developing back pain over time as this can cause undue stress on certain areas of the back.

  • Previous Back Injury - The single best predictor of back pain is a previous back injury. As noted previously, relapses are common after a significant episode of low back pain.

  • Psychological, Social and Spiritual Factors - It is increasingly recognized that a wide variety of psychological and social factors can increase the risk of low back pain. Research has shown that anxiety, depression, stressful responsibility, job dissatisfaction, mental stress at work, and substance abuse can place people at increased risk for developing chronic low back pain. Fear of pain, negative beliefs, sexual abuse, fear-avoidance and somatization symptoms (feeling sick without an actual disease) can also increase risk. Studies have also shown that single working mothers are at higher risk for low back pain. Spiritual factors, including a lack of meaning in life or lack of inner peace, may also predispose an individual to chronic back pain.

  • Smoking - Studies have shown that smokers have a 1.5 to 2.5 times greater risk of developing low back pain than nonsmokers. It is thought this may be due to reduced oxygen supply to disks and decreased blood oxygen from the effects of nicotine on constriction of the arteries.

  • Sports - Sports such as skiing, snowboarding, sledding, tobogganing, gymnastics, wrestling and contact sports such as football and rugby increase the risk for developing low back pain as a result of injuries. These injuries can result in back pain whether through direct injury to the low back, or through injury to other parts of the body that cause abnormal stress on the low back.

  • Other factors - Other factors may play a part in the development of acute and chronic low back pain. These include underlying spinal conditions such as osteoporosis, spondylolysis, discogenic disease, degenerative joint disease (osteoarthritis) of the spine, osteoporosis, and scoliosis



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