Preventing Back Pain: It’s the Thought That Counts

By Stephen Janz – Clinic Director, Kenmore Centre for Health, Brisbane

I am often asked by patients how to avoid a recurrence of back pain. It’s not helpful to discover that the single biggest factor to determine if a person will have an episode of low back pain is if they’ve had it before! What is helpful is research led by Daniel Steffens from the University of Sydney that has identified nine controllable triggers for low back pain.

The study found that the single biggest risk factor for acute low back pain is psychological, not physical. Distraction during activity attracted 3 times the risk of developing acute low back pain compared to the next biggest risk factor which was an awkward posture. Moving down the list the triggers are: not holding objects close to the body; manual tasks involving people or animals; instability, being unbalanced or difficulty grasping loads; heavy loads; vigorous physical activity; fatigue; and moderate physical activity. Other findings noted the risk of acute low back pain was greater between 7am and 10am in the morning, and that low back pain from heavy loads was 4 times more likely for a 20 year old than a 60 year old. While the authors aren’t sure why low back pain has a morning association, they believe the different risk with age relates to older people having learnt to lift better than younger people.

This research is valuable in understanding how to avoid low back pain which will affect approximately 80% of Australians at some point in their life. The single biggest issue is to be focused on the task at hand. This brings the practice of ‘mindfulness’ out of the domain of helping manage conditions such as anxiety and depression for which it is well known, and into the domain of avoiding serious physical injury as well. It may be that focusing on the task at hand reduces the chance of using a poor lifting technique or attempting an awkward load, in effect avoiding so many of the other physical risk factors.

This study looked at triggers for an episode of acute low back pain – not how to treat it when it occurs (more on that can be found here). What it tells us is that preventing low back pain starts with an awareness of the moment we are living in – pretty good advice for healthy living!


Mark Hancock, Chris G Maher, Peter Petocz, John Magnussen.Risk factors for a recurrence of low back pain. July 2015. The spine journal: official journal of the North American Spine Society 15(11) DOI 10.1016/j.spinee.2015.07.007