[Physical movement - is it good for the back? Nationwide representative study on different effects of physical...

Physical activity is an important component of primary and secondary prevention of orthopedic complaints such as back pain as well as for many other syndromes. This epidemiologic research project investigated the multifactorial interaction between physical leisure activities and back pain and also the question whether regular physical activity at the workplace can be equated with the effect of regular leisure activity. From a patients point of view this could be construed as an"excuse" to refrain from leisure and fitness sports. Within the framework of a cooperative project between the Orthopedic University Clinic in Heidelberg and the Robert-Koch Institute in Berlin, representative data were gathered for the first time in Germany on physical activity at the workplace and in leisure time as well as the prevalence of back pain. Within the first national health survey a random sample of 3,488 employed German citizens aged 18-69 years old was investigated with multiple logistic regression analyses.The prevalence of 7-day back pain in Germany was 34% and the prevalence for 1-year was 60%. Physical activity at the workplace was associated with a significantly higher risk for back pain whilst leisure sport activity was accompanied by a lower prevalence of back pain. Although 39% of all persons who were inactive in sport and physical activities claimed to have felt back pain at least once in a retrospective 7-day period, the corresponding values for persons active in sport were 33% (1-2 h sport/week), 27% (2-4 h sport/week) and 30% (>4 h sport/week).This study provides population-based epidemiologic data on the prevalence of back pain among employed German citizens for the first time since the reunification. Although causal conclusions cannot principally be derived from cross-sectional data, the results of this analysis allow the multifactorial conditional structure to be unraveled. Our data demonstrate that manual physical employment does not represent a substitute for fitness leisure sports, but physically demanding working conditions themselves represent a significant risk factor for back pain.