Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2020; 11(3): 158-166
Published online Mar 18, 2020. doi: 10.5312/wjo.v11.i3.158
Lumbar interspinous pressure pain threshold values for healthy young men and women and the effect of prolonged fully flexed lumbar sitting posture: An observational study
Martin Petersson, Allan Abbott
Martin Petersson, Department of Physiotherapy Gripen, Värmland Country Council, Karlstad SE-65224, Sweden
Martin Petersson, Allan Abbott, Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping SE-58183, Sweden
Author contributions: Petersson M and Abbott A contributed to the study conception, design and data acquisition, data analysis, interpretation of data, drafting, critical revision and final approval of the manuscript.
Institutional review board statement: The study was reviewed and approved by the ethics board of second cycle education at Linkoping University, Sweden.
Informed consent statement: All study participants, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: The authors have no conflict of interests. The authors have no financial interests.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at allan.abbott@liu.se. Participants gave informed consent for data sharing of anonymized data.
STROBE statement: This manuscript complies with the STROBE statement for reporting of observational studies.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Allan Abbott, BSc, MHSc, PhD, Associate Professor, Physiotherapist, Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, Sandbäcksgatan 7, Linköping SE-58183, Sweden. allan.abbott@liu.se
Received: November 8, 2019
Peer-review started: November 8, 2019
First decision: December 4, 2019
Revised: February 26, 2020
Accepted: March 5, 2020
Article in press: March 5, 2020
Published online: March 18, 2020
Abstract
BACKGROUND

Low back pain (LBP) is a common condition with large burden worldwide. Exposure to prolonged sitting with a flexed lumbar posture has been suggested in the literature to be a potential risk factor for self-reported LBP. No study has previously investigated whether exposure to prolonged flexed sitting posture provokes discomfort/pain and decreased interspinous pressure pain thresholds for healthy young men and women without back pain, despite this being a suggested risk factor for LBP.

AIM

To investigate whether sitting in a prolonged flexed lumbar posture provokes discomfort and lowers interspinous pressure pain thresholds in the lumbar spine for healthy young men and women without previous LBP.

METHODS

This is a an observational before and after study of 26 participants (13 men, 13 women) between 20-35 years old. Algometry was used to examine the pain threshold for pressure applied between spinous processes of the lumbar spine L1-L5. Pressure algometer measures were performed in prone before and after participants were instructed to sit in a fully flexed posture for a maximum of 15 min or until discomfort was experienced in the low back (Borg CR10 = 7/10). Wilcoxon signed-rank test was used for analyze values from the before and after test conditions. Mann-Whitney U test was used to investigate potential gender difference.

RESULTS

Fully flexed lumbar spine sitting posture up to 15 min provoked temporary discomfort but the proportion of participants experiencing discomfort 7/10 in the low back was 62%. For all pain pressure threshold locations tested, there was a significant difference for the study population with moderate-large decreased (r = -0.56) pressure pain threshold after exposure to prolonged flexed sitting posture (P < 0.01). Comparisons between gender did not show any significant difference.

CONCLUSION

The result showed that exposure to fully flexed lumbar sitting posture for up to 15 min produced temporary discomfort in the low back in young healthy adults with no previous history of LBP and significantly reduced lumbar interspinous pressure pain thresholds. No gender-based differences were observed.

Keywords: Low back pain, Pain pressure threshold, Algometer, Posture, Spine, Pain mechanism

Core tip: Fully flexed lumbar sitting posture for a maximum of 15 min causes discomfort and significantly reduced lumbar interspinous pain pressure thresholds.