title: Is lumbar lordosis related to low back pain development during prolonged standing?
abstract: BACKGROUND
  An induced-pain paradigm has been used in back-healthy people to understand risk factors for developing low back pain during prolonged standing.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  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
  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).
  
  
  CONCLUSIONS
  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.
authors: Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Blvd., Campus Box 8502, Saint Louis, MO 63108, USA. Electronic address: sorensenc@wusm.wustl.edu.
authors: Christopher J
authors: CJ
authors: Sorensen
authors: Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Blvd., Campus Box 8502, Saint Louis, MO 63108, USA. Electronic address: nortonb@wustl.edu.
authors: Barbara J
authors: BJ
authors: Norton
authors: Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada N2L3G1. Electronic address: jack.callaghan@uwaterloo.ca.
authors: Jack P
authors: JP
authors: Callaghan
authors: Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Blvd., Campus Box 8502, Saint Louis, MO 63108, USA. Electronic address: hwangch@wusm.wustl.edu.
authors: Ching-Ting
authors: CT
authors: Hwang
authors: Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Blvd., Campus Box 8502, Saint Louis, MO 63108, USA. Electronic address: vandillenl@wustl.edu.
authors: Linda R
authors: LR
authors: Van Dillen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008141:Lordosis / Q000150:complications*; D017116:Low Back Pain / Q000150:complications*; D008159:Lumbar Vertebrae; D008297:Male; D011187:Posture; D016474:Weight-Bearing
keywords: Induced-pain paradigm; Low back pain; Lumbar lordosis; Prolonged standing
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