What are the risk factors for lumbar (lower back) strain?

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From the Guidelines

Lumbar strain risk factors include occupations requiring heavy lifting, repetitive bending, or prolonged sitting, as well as individual factors such as obesity, poor physical conditioning, and previous back injuries. These factors are crucial to identify and address in order to prevent lumbar strain and its potential progression to chronic pain and disability. According to the American College of Physicians and the American Pain Society, risk factors predict the risk for chronic disabling back pain 1. Key risk factors to consider include:

  • Occupations that involve heavy lifting, repetitive bending, or prolonged sitting
  • Obesity and poor physical conditioning
  • Previous back injuries
  • Improper lifting techniques
  • Age, as the spine naturally degenerates over time
  • Smoking, which reduces blood flow to spinal tissues and weakens disc structures
  • Psychological factors like stress, anxiety, and depression, which can increase muscle tension and pain perception
  • Structural abnormalities such as scoliosis or excessive lordosis, which can create biomechanical disadvantages. Prevention strategies should focus on maintaining proper body mechanics, regular exercise, weight management, ergonomic adjustments, and smoking cessation, as these can help reduce the risk of lumbar strain and its associated morbidity, mortality, and impact on quality of life 1.

From the Research

Lumbar Strain Risk Factors

  • The following are some of the risk factors associated with lumbar strain:
    • Abdominal obesity, which increases the risk of low back pain (LBP) 2
    • General obesity, which increases the risk of lumbar radicular pain 2
    • Smoking, which increases the risk of both LBP and lumbar radicular pain 2, 3
    • Strenuous physical work, which increases the risk of both LBP and lumbar radicular pain 2, 3
    • Using vibrating tools, which increases the risk of lumbar radicular pain 2
    • Poor general health, physical and psychological stress, and characteristics of the person, which increase the risk for a future episode of LBP or sciatica 3
  • Some studies suggest that walking or cycling to work may reduce the risk of LBP, particularly LBP for more than 30 days 2
  • There is low-quality evidence that greater lumbar spine flexion during lifting is not a risk factor for LBP onset/persistence or a differentiator of people with and without LBP 4
  • Muscle strain usually causes acute pain and occurs during strenuous activity, and muscles that are frequently involved cross two joints, act mainly in an eccentric fashion, and contain a high percentage of fast-twitch fibers 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Risk factors for low back pain and sciatica: an umbrella review.

The spine journal : official journal of the North American Spine Society, 2018

Research

Muscle strain injury: diagnosis and treatment.

The Journal of the American Academy of Orthopaedic Surgeons, 1999

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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