Joint Association of Occupational and Leisure-Time Physical Activity With Low Back Pain in Korean Adults

This study aimed to examine the effect of the interaction between gender-specific occupational physical activity (OPA) and leisure-time physical activity (LTPA) on low back pain (LBP) risk.

Data were obtained from a large-scale cohort survey of Koreans, comprising a total of 2750 participants recruited during 2011-2012. OPA and LTPA were assessed using validated questionnaires and classified into two groups: "< 150 min/wk" and "≥ 150 min/wk." LBP was defined based on the Oswestry Disability Index (ODI) and visual analogue scale (VAS) criteria. Multiple logistic regression analyses were performed to calculate odds ratios (OR) with 95% confidence intervals (CI), and multiple linear regression analyses were used to estimate β coefficients with 95% CI to assess the associations between OPA, LTPA, and LBP.

The results showed that increased OPA was significantly associated with higher ODI scores (β = 0.02, p = 0.021), whereas increased LTPA was significantly associated with reductions in both ODI (β = -0.07, p = 0.012) and VAS scores (β = -0.01, p = 0.013). Furthermore, engaging in OPA for ≥ 150 min/week was associated with an elevated LBP risk (OR = 1.38, 95% CI = 1.12-1.69), with significant gender differences observed. In contrast, for participants with < 150 min/wk of leisure-related physical activity, LBP risk increased (OR = 1.22, 95% CI = 1.01-1.76), whereas for those with ≥ 150 min/wk, LBP risk decreased (OR = 0.84, 95% CI = 0.66-0.95), a significant effect observed only in females.

These findings suggest that ensuring adequate rest during OPA and promoting leisure-related physical activity may be critical strategies for reducing chronic LBP.