# Chronic low back pain is associated with a reduction in lumbar movement – a prospective cohort study

## TL;DR

People with chronic low back pain move their lower back less than those without pain, and women show different movement patterns compared to men.

## Contribution

This study is the first to quantify lumbar movement differences in daily life between asymptomatic individuals and those with chronic low back pain.

## Key findings

- Chronic LBP participants had significantly fewer flexion/extension and rotation movements compared to asymptomatic individuals.
- Females showed significantly more large flexion/extension movements (>15°) than males.
- Age correlated weakly with movement frequency in both LBP and asymptomatic groups.

## Abstract

Recent research has increasingly highlighted the role of movement behavior in the onset and persistence of low back pain (LBP). However, little is known about the lumbar spine’s movement patterns in daily life. This study investigated the number of lumbar movements in asymptomatic individuals and those with chronic LBP (lasting ≥ 12 weeks) over a 24-hour period. Lumbar movements were measured with the Epionics SPINE system. Movements ≥ 5° were grouped into movement sizes of > 15°, 10–15°, and 5–10°. Data were analyzed using the Student’s t-test, two-way analysis of variance, or the Pearson’s correlation coefficient. This study included 208 asymptomatic participants and 106 LBP participants. Participants with LBP exhibited a significantly lower number of both flexion/extension (15,564 ± 8,078 vs. 20,521 ± 7,160, p < 0.001) and rotation movements (4,724 ± 3,995 vs. 7,368 ± 4,223, p < 0.001). Females showed significantly more flexion/extension movements > 15° compared to males. Participants were significantly older than asymptomatic participants (40.3 ± 14.0 vs. 50.9 ± 13.9 years, p < 0.001). The correlation between age and the number of flexion/extension movements was weak in both the LBP (r=-0.290, p = 0.003) and the asymptomatic (r=-0.179, p = 0.010) groups. In summary, individuals with chronic LBP exhibit fewer lumbar spine movements than their asymptomatic counterparts, and distinct sex differences in movement patterns were observed, with females showing a different movement profile compared to males.

The online version contains supplementary material available at 10.1038/s41598-025-04851-2.