Are Long Hours Behind the Wheel Increasing Your Risk for Low Back Pain?
Low back pain (LBP) is an exceedingly prevalent ailment affecting more than 540 million individuals worldwide annually. This condition not only poses a significant challenge to those who suffer from it but also represents a considerable burden on healthcare systems globally. The multifaceted nature of LBP, encompassing both acute and chronic forms, necessitates a comprehensive understanding of its underlying causes, risk factors, and the populations most at risk.
Drivers constitute a high-risk group for occupational LBP owing to their exposure to various potential pathogenic factors, including
whole-body vibration (WBV), which can lead to microtrauma in the spinal structures over time, increasing the likelihood of developing pain.
prolonged periods of sitting, as extended sedentary behaviour can contribute to muscle stiffness, reduced blood circulation, and decreased spinal flexibility, ultimately leading to discomfort and pain.
the lifting of heavy objects, which places additional strain on the lumbar region and can exacerbate existing conditions or lead to new injuries if not performed with proper technique.
and extended working hours, which can result in fatigue and decreased attention to proper ergonomics, further increasing the risk of injury.
Research shows that drivers in the USA experience low back pain at a rate of 80%, which is significantly higher than the general working population. This alarming statistic highlights the urgent need for targeted interventions to mitigate the risk factors associated with LBP in this demographic.
How long does it take for low back pain to start?
Driving for long periods is particularly concerning, as it's not recommended that we sit for more than 6 hours a day. Studies indicate that 39% of drivers will start experiencing pain after just one week of continuous driving, and this figure rises to 53% within 12 months of regular driving. These statistics underscore the importance of addressing LBP proactively, particularly for those whose jobs require them to spend long hours behind the wheel.
Factors that lead to low back pain when driving
age ≥ 41 years, as the natural aging process contributes to changes in spinal structure and function, making older individuals more susceptible to LBP.
alcohol consumption, which can impair coordination and judgment, potentially leading to accidents or poor posture while driving.
inadequate exercise, as a lack of physical activity weakens core muscles that support the spine, increasing the risk of injury during driving.
sleeping < 6 h/night, which can lead to fatigue and decreased pain tolerance, exacerbating the effects of physical stress on the back.
the manual handling of heavy objects, which can place excessive strain on the lower back and contribute to the development of pain.
working > 10 h/day, leading to increased pressure on the lumbar discs, impaired nutrition, enhanced release of neuropeptides, and muscle fatigue, all of which can contribute to the onset of pain.
> 5 years of driving experience, as prolonged exposure to the driving environment can accumulate wear and tear on the spine.
uncomfortable seating, which fails to provide adequate lumbar support, can lead to poor posture and increased stress on the back.
absence of seat back support, which is crucial for maintaining proper spinal alignment during long periods of sitting.
poor driving posture, which can place additional strain on the spine and surrounding muscles, leading to discomfort and pain.
high work-related stress, which can contribute to muscle tension and exacerbate pain symptoms.
job dissatisfaction, which can lead to mental stress that manifests physically, often resulting in increased pain perception.
Depression and anxiety: Emotionally unstable states can stimulate the release of corticotropin-releasing hormone by the hypothalamic neurons, influencing endocrine and immune metabolic processes at the biological and behavioural levels. This relationship is particularly concerning as chronic emotional distress can lead to heightened sensitivity to pain.
Moreover, this can trigger immune-cell activation in the central and peripheral nervous systems, leading to the secretion of pro-inflammatory cytokines that can breach the blood-brain barrier, causing a detrimental cycle that significantly impacts LBP development and progression. The interplay between psychological factors and physical health is crucial in understanding the complexities surrounding LBP.
How common is low back pain in the general population?
A study of healthy female subjects undergoing magnetic resonance imaging revealed that around 30% of individuals in their twenties experienced LBP, a figure that escalated to 90% among those in their seventies.
This stark contrast illustrates how the prevalence of low back pain increases with age, emphasizing the importance of early intervention and preventive measures.
The reason is that intervertebral disc degeneration was identified as a key risk factor for LBP, with degeneration levels increasing with age, particularly among the elderly.
As the discs lose hydration and elasticity over time, their ability to absorb shock diminishes, leading to increased stress on the vertebrae and surrounding structures, ultimately resulting in pain and discomfort. This age-related degeneration is a significant factor contributing to the high incidence of low back pain in older adults, highlighting the need for targeted strategies to maintain spinal health throughout the lifespan.
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Reference
Jia J, Zhang M, Cao Z, Yang Z, Hu X, Lei S, Zhang Y, Leng W, Kang X. Prevalence of and risk factors for low back pain among professional drivers: a systematic review and meta-analysis. J Orthop Surg Res. 2024 Sep 9;19(1):551. doi: 10.1186/s13018-024-04999-z. PMID: 39252054; PMCID: PMC11382477.
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