Is lumbar lordosis related to low back pain development during prolonged standing?

Man Ther. 2015 Aug;20(4):553-7. doi: 10.1016/j.math.2015.01.001. Epub 2015 Jan 14.


Background: An induced-pain paradigm has been used in back-healthy people to understand risk factors for developing low back pain during prolonged standing.

Objectives: The purposes of this study were to (1) compare baseline lumbar lordosis in back-healthy participants who do (Pain Developers) and do not (Non-Pain Developers) develop low back pain during 2 h of standing, and (2) examine the relationship between lumbar lordosis and low back pain intensity.

Design: Cross-sectional.

Method: First, participants stood while positions of markers placed superficial to the lumbar vertebrae were recorded using a motion capture system. Following collection of marker positions, participants stood for 2 h while performing light work tasks. At baseline and every 15 min during standing, participants rated their low back pain intensity on a visual analog scale. Lumbar lordosis was calculated using marker positions collected prior to the 2 h standing period. Lumbar lordosis was compared between pain developers and non-pain developers. In pain developers, the relationship between lumbar lordosis and maximum pain was examined.

Results/findings: There were 24 (42%) pain developers and 33 (58%) non-pain developers. Lumbar lordosis was significantly larger in pain developers compared to non-pain developers (Mean difference = 4.4°; 95% Confidence Interval = 0.9° to 7.8°, Cohen's d = 0.7). The correlation coefficient between lumbar lordosis and maximum pain was 0.46 (P = 0.02).

Conclusion: The results suggest that standing in more lumbar lordosis may be a risk factor for low back pain development during prolonged periods of standing. Identifying risk factors for low back pain development can inform preventative and early intervention strategies.

Keywords: Induced-pain paradigm; Low back pain; Lumbar lordosis; Prolonged standing.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Humans
  • Lordosis / complications*
  • Low Back Pain / complications*
  • Lumbar Vertebrae*
  • Male
  • Posture
  • Weight-Bearing*