Physical workload may not cause LBP

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Lumbar disc degeneration (LDD) is commonly occurring degenerative musculoskeletal diseases. Despite many efforts, the specific factors responsible for LDD remain unclear. Various environmental factors, such as occupation have been implicated in the etiology and pathogenesis of LDD. Therefore, Physical workplace factors seem to play an important etiological role.

The current study is designed as multicenter, population-based, case-control study aimed to evaluate the potential differences in the “occupational risk profiles” of structural lumbar disc diseases and low back pain (LBP).

The study enrolled a total of 901 patients with structural lumbar disc diseases (disc herniation or severe disc space narrowing) and 233 were recruited as control subjects with “LBP”. Both groups were then compared with 422 control subjects who were free of LBP. All other criteria like case history, pain data, neurological deficits and movement restrictions were documented. The Nordic questionnaire was used to record LBP on musculoskeletal symptoms. An independent study radiologist was involved in inspecting about all MRI, CT and X-rays. The calculation of cumulative physical workload was based on a computer-assisted interview and a biomechanical analysis by the 3-D-dynamic simulation tool. Documentation of occupational exposures for the whole working life was also done.

The outcomes of the study found a positive dose-response relationship between cumulative lumbar load and LBP among men, but not women. The risk of physical occupation was found to be higher for structural lumbar disc diseases (OR 3.7; CI 2.3–6.0) as compared to low back pain (OR 1.9; 95% CI 1.0–3.5).

Overall, the finding of the study estimated potentially different etiological pathways in the heterogeneous disease group of LBPs. Results indicated that every structural disc damage that arises from the physical workload, not always leads to LBP.

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Physical workload may not cause LBP

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