Factors affecting association between pain severity and physical activity among people with low back pain.
Mikhail Saltychev, Henri Hellgren, Juhani Juhola
PMID 37421303WHAT IT FOUND
For most people with low back pain, higher pain means less activity.
But those with moderate or severe disability showed the opposite: worse pain linked to more activity. Age, education, weight and general health also influenced this link, while sex and occupation did not.
Key findings
01Overall, worse low back pain was associated with less physical activity.
02Patients with moderate or severe disability showed a paradoxical association where worsening disability was linked to increasing physical activity.
03Sex, smoking, marital status and occupation did not significantly affect the association between pain and physical activity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was cross-sectional, so it cannot determine whether pain causes low activity or low activity causes pain. All data were self-reported, which risks inaccurate recall of pain levels and physical activity. Patients were recruited from a specialized university clinic, so results may not apply to those treated in primary care. Many patients had musculoskeletal issues other than low back pain, which may have influenced their activity levels. The sample had specific demographic characteristics, limiting generalizability to other populations.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that patients with severe disability and high pain are inactive. This study found the opposite pattern in that specific group, where worse disability correlated with higher activity levels. Pain intensity alone does not predict physical activity in patients with moderate to severe functional limitation.