Green BN, Johnson CD, Haldeman S, Griffith E, Clay MB, et al. (2018) A scoping review of biopsychosocial risk factors and co-morbidities for common spinal disorders. PLOS ONE 13(6): e0197987.

This week’s blog post goes a little outside the normal topics covered on this blog. Usually we are concerned with mechanical issues or neuromuscular re-education strategies that we can directly influence and effect as physical therapists.  But looking at our client as a whole person, it is important to consider and acknowledge other factors that may be contributing to their pain or functional limitation.  These are factors that may be outside the scope of physical therapy practice, but it is important to recognize their potential contribution to our client’s complaints.

The authors of this paper were interested in determining risk factors, co-morbidities, and prognostic factors associated with the most common spinal disorders. As the authors point out spinal disorders contribute a significant burden on society and these problems have risen sharply in the past three decades. Spinal disorders are the leading cause for years lived with disability throughout the entire world. If spinal disorders have been getting worse and worse it certainly begs the questions, Why? What has changed in society that has led to this dramatic increase over the past 30 years.  The answer seems to be lifestyle.

The authors looked at a number of the most common spinal disorders including joint pain, myofascial pain, radicular pain, trauma, infection, arthritis, and congenital deformities to determine common risk factors associated with these groups of disorders.  The authors found that many of the risk factors associated with spinal disorders are completely modifiable and it all comes back to lifestyle.

Let’s start with the obvious. It is well known that living a sedentary lifestyle and over indulging in poor food can lead to numerous health problems, including spinal disorders. Those who had a higher body mass index and did not participate in regular exercise were at high risk for developing and sustaining spinal pain. What you put in your body, in terms of medication and tobacco, can increase your risk for developing a spinal disorder.  But it is not just diet and exercise.  Work life can be a risk factor for back pain.  A repetitive physically demanding job can increase your risk for back pain just as much as a stressful job or a sedentary job.  Work stress and other forms of psychological stress can increase the risk of developing or sustaining back pain.  There were too many specific risk factors to cover in this blog but it is important to know that the majority of risk factors described in the research are completely modifiable through lifestyle changes.

The take home message here is that there are psychological, nutritional, and physiological changes that we can all make to help reduce the risk of developing and contributing to back pain. We need to continue to champion healthy lifestyle practices that include regular exercise, proper nutrition, healthy work environments, and reduced psychological stress so that we can live healthy, happy, pain free lives.