Determinants of sciatica and low-back pain.

Several factors were studied for their association with the prevalence of chronic low-back syndromes, sciatica, and unspecified low-back pain (LBP) in 2,946 women and 2,727 men (age range, 30-64 years) participating in the Mini-Finland Health Survey, a project aimed at comprehensive evaluation of the population's health. On the basis of a standardized clinical examination, a physician diagnosed sciatica in 5.1% and LBP in 11.6% of the subjects. Those with a previous traumatic back injury had a 2.5-fold risk of having sciatica or LBP. The fractions of sciatica and LBP attributable to such back injuries were estimated to be 16.5% and 13.7%, respectively. Sum indices of both physical and mental stress at work were found to be directly proportional to the prevalence of sciatica and LBP. Smokers had an increased risk of LBP, and body height was related positively to the prevalence of sciatica. These associations, however, were inconsistent between sex and age subgroups. In the presence of osteoarthritis in the knee, hip, or hand, LBP was prevalent (adjusted odds ratio [OR], 5.3; 95% confidence interval [CI], 4.1-6.9), but sciatica was not (OR, 1.1; 95% CI, 0.7-1.7). Diabetics were found to have a significantly decreased prevalence of LBP (OR, 0.4; 95% CI, 0.3-0.8). Many factors, independent of each other, determine the occurrence of chronic low-back syndromes. The determinants of sciatica and LBP are different to some extent.     

Causal assessment of awkward occupational postures and low back pain: results of a systematic review

Background contextLow back pain (LBP) is a prevalent and costly musculoskeletal disorder that often occurs in the working-age population. Although numerous physical activities have been implicated in its complex etiology, determining causation remains challenging and requires a methodologically rigorous approach.PurposeTo conduct a systematic review of the scientific literature focused on establishing a causal relationship between awkward occupational postures and LBP.Study designSystematic review of the literature using MEDLINE, EMBASE, CINAHL, Cochrane Library, and Occupational Safety and Health database, gray literature, hand-searching occupational health journals, reference lists of included studies, and experts. Evaluation of methodological quality using a modified Newcastle-Ottawa Scale for observational studies. Summary levels of evidence for each of the Bradford Hill criteria for causality for each category of awkward occupational posture and type of LBP.SampleStudies reporting an association between awkward occupational postures and LBP.Outcome measuresNumerical association between different levels of exposure to awkward occupational postures and the presence or severity of LBP.MethodsA systematic review was performed to identify, evaluate, and summarize the literature related to establishing a causal relationship, according to Bradford Hill criteria, between awkward occupational postures and LBP.ResultsThis search yielded 2,766 citations. Eight high-quality studies reported on awkward occupational postures and LBP. Three were case-control studies, one was cross-sectional, and four were prospective cohort studies. There was strong evidence for consistency of no association between awkward occupational postures and LBP, with only two studies demonstrating significant associations in most of their risk estimates compared with six studies reported mainly nonsignificant associations. Two studies assessed dose response, with one study demonstrating a nonsignificant dose-response trend. Three studies were able to assess temporality, but all demonstrated nonsignificant risk estimates. Biological plausibility was discussed by two studies. There was no available evidence to assess the experiment criterion for causality.ConclusionsThere was strong evidence from six high-quality studies that there was no association between awkward postures and LBP. Similarly, there was strong evidence from three high-quality studies that there was no temporal relationship. Moreover, subgroup analyses identified only a handful of studies that demonstrated only weak associations and no evidence for other aspects of causality in certain specific subcategories. It is therefore unlikely that awkward occupational postures are independently causative of LBP in the populations of workers studied.     

Symptomatology of recurrent low back pain in nursing and administrative professions

The aim of the present study was to explore if (a) recurrent low back pain (LBP) has different symptomatologies in cases from occupations with predominantly sitting postures compared to cases from occupations involving dynamic postures and frequent lifting and (b) if in the two occupational groups, different factors were associated with the presence of recurrent LBP. Hundred and eleven female subjects aged between 45 and 62 years with a long-standing occupation either in administrative or nursing professions, with and without recurrent LBP were examined. An extensive evaluation of six areas of interest (pain and disability, clinical examination, functional tests, MR examination, physical and psychosocial workplace factors) was performed. The variables from the six areas of interest were analyzed for their potential to discriminate between the four groups of subjects (administrative worker and nurses with and without recurrent LBP) by canonical discriminant analysis. As expected, the self-evaluation of physical and psychosocial workplace factors showed significant differences between the two occupational groups, which holds true for cases as well as for controls (P < 0.01). The functional tests revealed a tendency for rather good capacity in nurses with LBP and a decreased capacity in administrative personnel with LBP (P = 0.049). Neither self completed pain and disability questionnaires nor clinical examination or MR imaging revealed any significant difference between LBP cases from sedentary and non-sedentary occupations. When comparing LBP cases and controls within the two occupational groups, the functional tests revealed significant differences (P = 0.0001) yet only in administrative personnel. The clinical examination on the other hand only discriminated between LBP cases and controls in the nurses group (P < 0.0001). Neither MRI imaging nor self reported physical and psychosocial workplace factors discriminated between LBP cases and controls from both occupational groups. Although we used a battery of tests that have broad application in clinical and epidemiological studies of LBP, a clear difference in the pattern of symptoms between LBP cases from nursing and hospital administration personnel could not be ascertained. We conclude that there is no evidence for different mechanisms leading to non-specific, recurrent LBP in the two occupations, and thus no generalizable recommendations for the prevention and therapy of non-specific LBP in the two professions can be given.     

Risk factors for low back pain and sciatica: an umbrella review

Background

Low back pain (LBP) is a highly prevalent condition and it is associated with significant disability and work absenteeism worldwide. A variety of environmental and individual characteristics have been reported to increase the risk of LBP. To our knowledge, there has been no previous attempt to summarize the evidence from existing systematic reviews of risk factors for LBP or sciatica.

Lumbar high-intensity zones on MRI: imaging biomarkers for severe,prolonged low back pain and sciatica in a population-based cohort

BACKGROUND CONTEXTThere is often discrepancy between clinical presentation and lumbar magnetic resonance imaging (MRI) findings.PURPOSEThe purpose of this study was to assess the relationship of high-intensity zones (HIZs) on MRI with low back pain (LBP), sciatica, and back-related disability.STUDY DESIGNCross-sectional, population-based Southern Chinese cohort study.PATIENT SAMPLEOf 1,414 possible participants, data from 1,214 participants (453 males, 761 females; mean age of 48.1±6.3 years) were included.OUTCOME MEASURESPresence of single-level, homogeneous multilevel (same type HIZs of morphology and topography) and heterogeneous multilevel (mixed type HIZs of morphology and topography) HIZs and other MRI phenotypes were assessed at each level with T2-weighted 3T sagittal MRI of L1–S1. Associations with LBP, sciatica and Oswestry Disability Index were correlated with HIZ profiles.RESULTSIn all, 718 individuals had HIZs (59.1%). Disc degeneration/displacement were more prevalent in HIZ individuals (p<.001). HIZ subjects experienced prolonged severe LBP more frequently (39.6% vs. 32.5%; p<.05) and had higher Oswestry Disability Index scores (10.7±13.7 vs. 8.9±11.3; p<.05). Posterior multilevel HIZ were significantly associated with prolonged severe LBP (OR: 2.18; 95% CI:1.42–3.37; p<.05) in comparison to anterior only, anterior/posterior or other patterns of HIZ. Multilevel homogeneous or heterogeneous HIZs were significantly associated with prolonged, severe LBP (OR: 1.53–1.57; p<.05). Individuals with homogeneous HIZs had a higher risk of sciatica (OR: 1.51, 95% CI: 1.01-2.27; p<.05).CONCLUSIONSThis is the first large-scale study to note that lumbar HIZs, and specific patterns therein, are potentially clinically-relevant imaging biomarkers that are independently and significantly associated with prolonged/severe LBP and sciatica. HIZs, especially homogenous multilevel HIZ, should be noted in the global pain imaging phenotype assessment.     

Self-reported low back symptoms in urban bus drivers exposed to whole-body vibration.

The prevalence of self-reported low back symptoms was investigated by a postal questionnaire in a group of 234 urban bus drivers exposed to whole-body vibration and postural stress and in a control group of 125 maintenance workers employed at the same bus municipal company. The average vertical whole-body vibration magnitude measured on the seat pan of the buses was 0.4 m/s2. After controlling for potential confounders, the prevalence odds ratios for the bus drivers compared to the controls significantly exceeded 1 for several types of low back symptoms (leg pain, acute low back pain, low back pain). The occurrence of low back symptoms increased with increasing whole-body vibration exposure expressed in terms of total (lifetime) vibration dose (years m2/s4), equivalent vibration magnitude (m/s2), and duration of exposure (years of service). The highest prevalence of disc protrusion was found among the bus drivers with more severe whole-body vibration exposure. Frequent awkward postures at work were also related to some types of low back symptoms. It is concluded that bus driving is associated with an increased risk for low back troubles. This excess risk may be due to both whole-body vibration exposure and prolonged sitting in a constrained posture. The findings of this study also indicated that among the bus drivers low back symptoms occurred at whole-body vibration exposure levels that were lower than the health-based exposure limits proposed by the International Standard ISO 2631/1.     

Longer sitting time and low physical activity are closely associated with chronic low back pain in population over 50 years of age: a cross-sectional study using the sixth Korea National Health and Nutrition Examination Survey

Background Context

There is increasing evidence supporting an association between sitting time and low back pain (LBP). However, the degree of the association between the total daily sitting time and LBP in the general population is poorly understood.

Study of wrist posture, loading and repetitive motion as risk factors for developing carpal tunnel syndrome.

Occupational risk factors of carpal tunnel syndrome (CTS) are popular current research targets, with main emphasis put on wrist posture and dynamics. In this study, we do not intend to pinpoint individual occupations, but aim to identify high risk wrist postures and actions which may occur across various occupations. It is hoped that prevention can thus be instituted in a general population by directing at the particular causative wrist actions rather than exclusively targeting isolated occupations. We performed a case-control study with 166 cases and 111 controls recruited from different hospitals in Hong Kong in 2004. All cases and controls completed the survey on their general health condition, smoking status, wrist posture and motion as well as psychosocial status at the time of diagnosis of CTS. Frequent flexion OR = 4.436 (95% CI: 1.833-10.734), frequent extension OR = 2.691 (95% CI: 1.106-6.547) of the wrist were found to be associated with CTS. Frequent sustained forceful motion of the wrist OR = 2.588 (95% CI: 1.144-5.851) was also found to be associated with CTS. Neutral wrist position and repetitive wrist motion were not associated with CTS. Adjustment was made for age, sex, BMI, smoking and psychosocial stress. Our study confirms that frequent flexion, extension and sustained force of the wrist increase the risk of developing CTS.     

Epidemiological aspects and risk factors for low back pain in 38-year-old men and women: a 25-year prospective cohort study of 640 school children

This study is based on data gathered by means of a postal questionnaire from a cohort of 640 38-year-old subjects. At the age of 14 years these subjects had been interviewed by their school doctor to ascertain whether any of them had a history of low back pain (LBP), and X-rays of the thoracic and lumbar spine were taken. The questionnaire contained related groups of questions, with LBP as the main topic. We wanted to identify probable risk factors in developing LBP. The results show a cumulative life-time prevalence of LBP of 70%, a 1-year prevalence of 63% and a point prevalence of 19%, independent of gender. Women reported a higher incidence of LBP than men during the month and week before they filled out the questionnaire, they also reported a higher incidence of sciatica and greater use of the health care system and analgestics over the previous year. Heavy manual work was associated with LBP and sciatica, and smoking (more than 16 cigarettes per day) was more common among unemployed and sick-listed subjects, Severe LBP was associated with increased morbidity, reduced work capacity, deterioration in social life, mental and sexual problems, and increased smoking. A stepwise logistic regression analysis of early independent variables indicated that severe LBP is positively correlated with low social class for men and with menstruation and pregnancy for women.     

Low back pain in a cohort of 622 Tunisian schoolchildren and adolescents: an epidemiological study

Low back pain (LBP) in children was considered for many years to be a rare condition revealing a serious disease, but in the last two decades, epidemiological studies have shown that the prevalence of nonspecific LBP in children is high. This study was aimed at analyzing the prevalence, severity, consequences and associated factors of LBP in children. A cross-sectional study was undertaken in two preparatory schools in the city of Monastir, Tunisia, in April 2002. This study included a total of 622 children and adolescents—326 females and 296 males—with a mean age of 14 years (range: 11–19 years). They completed the questionnaire in the presence of the physician. For the first 201 questionnaires collected, the corresponding children and adolescents underwent a spine medical examination, with evaluation of pain by visual analog scale if LBP was present. A stepwise logistic regression analysis was carried out to determine the risk factors associated with LBP and chronic LBP. The cumulative lifetime prevalence of LBP was 28.4%. Eight percent of the subjects suffered from chronic LBP. LBP was responsible for 23% of school absenteeism and 29% for sports absenteeism. Medical care requirement was observed in 32.2% and psychological symptoms in 75%. Stepwise logistic regression analysis showed that three factors were associated with LBP: school failure (held back 1 year), odds ratio (OR) =2.6 (95% confidence interval [CI], 1.96–3.44), family history of LBP (parental or sibling LBP), OR=3.80 (95% CI, 2.94–5.92), dissatisfaction with school chair (in height and comfort), OR=3.40 (95% CI, 2.24–5.29). Two factors were associated with chronic LBP: dissatisfaction with school chair, OR=1.62 (95% CI, 1.46–3.32) and football playing, OR=3.07 (95% CI, 2.15–5.10). The prevalence of LBP among Tunisian schoolchildren and adolescents is high. This requires preventive measures and longitudinal studies, which are very important from the standpoint of public health.     

An improved method of stature measurement for quantitative determination of spinal loading. Application to sitting postures and whole body vibration.

A refined procedure for measuring stature is described; this provides a reproducibility error of 0.4 mm. The procedure accommodates the natural diurnal change in stature and permits estimation of the net stature change caused by a change in spinal loading. A series of measurements done with a cohort of 20 young and middle-aged persons showed that stature decrease was related linearly to the quasi-static load on the spine. The coefficient of proportionality between load and height loss was inversely proportional to the cross-sectional area of the lumbar discs. This method was used to investigate sitting postures and whole-body vibration to demonstrate the applicability of the procedure to quantify spinal strain (and, therefore, estimate comparative loading) in applied ergonomics. Sitting invariably led to an increase in stature, regardless of the type of chair used or the posture maintained. Whole-body vibration did not induce any loss of stature. Thus, this novel approach was able to enhance understanding of spinal behavior under different loading conditions.     

Low-back pain in nurses and some loading factors of work

Questionnaires were sent to qualified nurses (QNs) and nursing aides (NAs) to study the prevalence of low-back pain (LBP) and sciatica in relation to age, work-load, free time activities, menstruation, pregnancies and number of children. LBP and sciatica severe enough to make them unfit for daily tasks were significantly more common in NAs. Back injury and disability pension due to sciatic symptoms were also more common in NAs. Occupationally, NAs had twice the amount of lifting, bending, and rotation, while QNs reported more sitting and standing at work. Under the age of 30, the heaviness of the work was related to LBP in both NAs and QNs. It was concluded that prevention should be directed to improvements in the occupational work load, particularly for younger nurses.     

Endplate defects,not the severity of spinal stenosis,contribute to low back pain in patients with lumbar spinal stenosis

BACKGROUND CONTEXTIt is controversial whether lumbar spinal stenosis (LSS) itself contributes to low back pain (LBP). Lower truncal skeletal muscle mass, spinopelvic malalignment, intervertebral disc degeneration, and endplate abnormalities are thought to be related to LBP. However, whether these factors cause LBP in patients with LSS is unclear.PURPOSETo identify factors associated with LBP in patients with LSS.STUDY DESIGN/SETTINGCross-sectional design.PATIENT SAMPLEA total of 260 patients (119 men and 141 women, average age 72.8 years) with neurogenic claudication caused by LSS, as confirmed by magnetic resonance imaging (MRI).OUTCOME MEASURESRatings of LBP, buttock and leg pain, and numbness on a numerical rating scale (NRS), 36-Item Short Form Survey (SF-36) scores, muscle mass measured by bioelectrical impedance analysis, and radiographic measurements including slippage and lumbopelvic alignment. The severity of LSS, endplate defects, Modic endplate changes, intervertebral disc degeneration, and facet joint osteoarthritis were assessed on MRI.METHODSThe presence of LBP was defined as an NRS score ≥3. The demographic data, patient-reported outcomes, and radiological and MRI findings were compared between patients with and without LBP. Multivariate logistic regression analysis was used to identify the factors that were independently associated with the presence of LBP.RESULTSThere were significant differences between patients with and without LBP for buttock and leg pain and numbness on the NRS, general health on the SF-36, presence of endplate defects, presence of Modic changes, disc degeneration grading, and disc height grading (all p < .05). Multivariate logistic regression analysis showed significant associations between LBP and diabetes (OR 2.43; 95% CI 1.07–5.53), buttock and leg numbness on the NRS (OR 1.34; 95% CI 1.17–1.52), general health on the SF-36 (OR 0.97; 95% CI 0.95–0.99), and the presence of erosive endplate defects (OR 3.04; 95% CI 1.51–6.11) (all p < .05).CONCLUSIONSThese results suggest that LBP in patients with LSS should be carefully assessed not only for spinal stenosis but also clinical factors and endplate defects.     

Magnetic resonance imaging and stadiometric assessment of the lumbar discs after sitting and chair-care decompression exercise: a pilot study

BackgroundSitting is associated with loss of the lumbar lordosis, intervertebral disc (IVD) compression, and height loss, possibly increasing the risk of lower back pain. With a trend toward more sitting jobs worldwide, practical strategies for preventing lumbar flattening and potentially associated low back pain (LBP) are important.PurposeThe purpose of this study was to determine the feasibility of using upright magnetic resonance imaging (MRI) and stadiometry to measure changes in height and configuration of the lumbar spine before and after normal sitting and a seated unloading exercise intervention.Study Design/SettingThis is a hospital-based pilot study involving pre-post assessments in a single group.Patient SampleThe sample comprises six asymptomatic hospital employees involved in either general patient care or research writing/data collection.Outcome MeasuresThe outcome measures were lumbar total midsagittal cross-sectional IVD area, vertical height, lordotic angle derived from digitized MRI examinations, and seated body height measured directly with a stadiometer.MethodsMidsagittal MRI scans were performed before sitting, after 15 minutes of relaxed sitting (“postsitting”), immediately after seated unloading exercises, and approximately 7 minutes after exercise. Subsequently, seated stadiometry assessments were performed after 10 minutes of supine recumbency, 15 minutes of relaxed sitting, and every 10 seconds after seated unloading exercises until three consecutive height measurements were identical. Digitized midsagittal images were used to derive MRI-based outcome measures. Measurements at postsitting were compared with the corresponding ones at other time points using multiple paired t-tests. The Bonferroni method was used to adjust for multiple pairwise comparisons.Main ResultsAfter 15 minutes of sitting, mean total IVD area, lordotic angle, and vertical height of the lumbar spine decreased 18.6 mm², 6.2°, and 12.5 mm, respectively, whereas after seated unloading exercises, these parameters increased by 87.9 mm², 5.0°, and 21.9 mm, respectively. Similarly, mean seated height on stadiometry decreased by 6.9 mm after 15 minutes of sitting and subsequently increased by 5.7 mm after unloading exercises.ConclusionsSeated upright MRI and stadiometry, as performed in this study, appear to be feasible methods for detecting compressive and decompressive spinal changes associated with normal sitting and, alternately, seated unloading exercises. Larger studies are encouraged to determine normative values of our study measurements and to determine if morphological changes induced by seated unloading predict treatment response and/or reductions in the incidence of sitting-related LBP.     

Anal sphincter lacerations and upright delivery postures—a risk analysis from a randomized controlled trial

Objective To evaluate obstetric sphincter lacerations after a kneeling or sitting position at second stage of labor in a multivariate risk analysis model. Materials and methods Two hundred and seventy-one primiparous women with normal pregnancies and spontaneous labor were randomized, 138 to a kneeling position and 133 to a sitting position. Medical data were retrieved from delivery charts and partograms. Risk factors were tested in a multivariate logistic regression model in a stepwise manner. Results The trial was completed by 106 subjects in the kneeling group and 112 subjects in the sitting group. There were no significant differences with regard to duration of second stage of labor or pre-trial maternal characteristics between the two groups. Obstetrical sphincter tears did not differ significantly between the two groups but an intact perineum was more common in the kneeling group (p<0.03) and episiotomy (mediolateral) was more common in the sitting group (p<0.05). Three grade IV sphincter lacerations occurred in the sitting group compared to none in the kneeling group (NS). Multivariate risk analysis indicated that prolonged duration of second stage of labor and episiotomy were associated with an increased risk of third- or fourth-degree sphincter tears (p<0.01 and p<0.05, respectively). Delivery posture, maternal age, fetal weight, use of oxytocin, and use of epidural analgesia did not increase the risk of obstetrical anal sphincter lacerations in the two upright postures. Conclusion Obstetrical anal sphincter lacerations did not differ significantly between a kneeling or sitting upright delivery posture. Episiotomy was more common after a sitting delivery posture, which may be associated with an increased risk of anal sphincter lacerations. Upright delivery postures may be encouraged in healthy women with normal, full-term pregnancy. Presented in part at the Royal College of Obstetricians and Gynecologists, 6th International Scientific Meeting, Cairo, Egypt, 050926-050930. Summary Kneeling and sitting upright during delivery does not differ significantly in pelvic floor lacerations or immediate post-partum morbidity.     

Comparison of two self-reported measures of physical work demands in hospital personnel: A cross-sectional study

Background  

Low back pain (LBP) is a frequent health complaint among health care personnel. Several work tasks and working postures are associated with an increased risk of LBP. The aim of this study was to compare two self-reported measures of physical demands and their association with LBP (the daily number of patient handling tasks and Hollmann's physical load index).     

Prevalence of low back pain among health sciences students

Aim

To determine the prevalence of low back pain (LBP) among health sciences students and to identify the associated factors.

Methods

Cross-sectional study was conducted among 1163 students from five health sciences colleges during the academic year 2016–2017. Self-administered questionnaire was conducted and included 4 sections: demographic characteristics, risk factors, Nordic musculoskeletal questionnaire and Oswestry disability questionnaire. Data were analyzed using SPSS.

Results

Mean age was 20.74 ± (1.59 years). 70.9% of students were female. Lifetime prevalence of LBP was 56.6%, 12-month prevalence 48.8%, and point prevalence 21.2%. Dentistry students had highest lifetime prevalence of LBP (67.6%) with significant p value (<0.001). Male were found to have higher lifetime prevalence compared to female (p ≤ 0.001). Spending more than 10 h on computer or tablet was significantly associated with LBP (OR 2.19; 95% CI 1.30–3.70; p = 0.003). Feeling discomfort on bed was associated with LBP (OR 1.81; 95% CI 1.38–2.38; p ≤ 0.001). Uncomfortable college furniture was associated with LBP (OR 1.40; 95% CI 1.09–1.79; p = 0.008). Using heavy backpack was found to be associated with LBP (OR 1.49; 95% CI 1.01–2.03; p = 0.011). Most of students LBP (90.3%) found to cause minimal disability on Oswestry scale.

Conclusion

This study has shown high prevalence of LBP among future healthcare provider. These risk factors should be well established to minimize the prevalence of LBP among future health sciences students. Dentistry students at higher risk of developing LBP compared to other students.

     

Lumbar interspinous pressure pain threshold values for healthy young men and women and the effect of prolonged fully flexed lumbar sitting posture:An observational study

BACKGROUND Low back pain(LBP) is a common condition with large burden worldwide.Exposure to prolonged sitting with a flexed lumbar posture has been suggested in the literature to be a potential risk factor for self-reported LBP.No study has previously investigated whether exposure to prolonged flexed sitting posture provokes discomfort/pain and decreased interspinous pressure pain thresholds for healthy young men and women without back pain,despite this being a suggested risk factor for LBP.AIM To investigate whether sitting in a prolonged flexed lumbar posture provokes discomfort and lowers interspinous pressure pain thresholds in the lumbar spine for healthy young men and women without previous LBP.METHODS This is a an observational before and after study of 26 participants(13 men,13 women) between 20-35 years old.Algometry was used to examine the pain threshold for pressure applied between spinous processes of the lumbar spine L1-L5.Pressure algometer measures were performed in prone before and after participants were instructed to sit in a fully flexed posture for a maximum of 15 min or until discomfort was experienced in the low back(Borg CR10 = 7/10).Wilcoxon signed-rank test was used for analyze values from the before and after test conditions.Mann-Whitney U test was used to investigate potential gender difference.RESULTS Fully flexed lumbar spine sitting posture up to 15 min provoked temporary discomfort but the proportion of participants experiencing discomfort 7/10 in the low back was 62%.For all pain pressure threshold locations tested,there was a significant difference for the study population with moderate-large decreased(r =-0.56) pressure pain threshold after exposure to prolonged flexed sitting posture(P 0.01).Comparisons between gender did not show any significant difference.CONCLUSION The result showed that exposure to fully flexed lumbar sitting posture for up to15 min produced temporary discomfort in the low back in young healthy adults with no previous history of LBP and significantly reduced lumbar interspinous pressure pain thresholds.No gender-based differences were observed.