# Associations of physical activity and sedentary behavior with chronic low back pain in middle-aged and older adults: a cross-sectional study

## TL;DR

This study finds that physical activity reduces chronic low back pain risk, while sedentary behavior increases it in middle-aged and older adults.

## Contribution

The study identifies physical activity and sedentary behavior as modifiable risk factors for chronic low back pain in older populations.

## Key findings

- Meeting physical activity guidelines is linked to a 78% lower risk of chronic low back pain.
- Sedentary behavior is associated with a 2.7-fold higher risk of chronic low back pain.
- Associations remained consistent across subgroups like sex and chronic diseases.

## Abstract

To investigate the associations between physical activity levels, sedentary behavior, and the risk of chronic low back pain (CLBP) among middle-aged and older adults.

A cross-sectional survey was conducted among 472 community-dwelling adults aged ≥45 years recruited from communities in Binhai County, Yancheng City, Jiangsu Province, China. Physical activity and sedentary behavior were assessed using the IPAQ-short form. CLBP was defined as low back pain occurring almost daily for ≥3 months. Sociodemographic, lifestyle, and health-related factors were collected as covariates. Associations were examined using chi-square tests and multivariable logistic regression models.

The prevalence of CLBP was 16.1%. Individuals who met physical activity guidelines had a significantly lower risk of CLBP (adjusted OR = 0.218, 95% CI: 0.116–0.410). Sedentary behavior was independently associated with a higher risk of CLBP (adjusted OR = 2.720, 95% CI: 1.562–4.738). Stratified analyses showed consistent associations across subgroups defined by sex, residence, marital status, lifestyle factors, and chronic diseases, with no significant interaction effects.

Insufficient physical activity and sedentary behavior are major modifiable risk factors for CLBP in middle-aged and older adults. Replacing sedentary time with regular moderate-intensity physical activity and interrupting prolonged sitting may be effective strategies for CLBP prevention and healthy aging.