Back Pain

Updated 25 January 2017

Risk factors for back pain

Four out of five adults will experience at least one bout of back pain in their life. Risk factors are ageing, a sedentary lifestyle, poor posture, etc.


Back pain is second only to headaches as the most common site of pain. Four out of five adults will experience at least one bout of back pain in their life.

The following factors can increase your risk for back problems:

Ageing: discs begin gradual deterioration from age 30. With age, the discs lose moisture and shrink. This puts more stress on the facet joints which become arthritic, with resultant back pain.

Sedentary lifestyle: being unfit increases your risk for back pain, especially if you attempt an unaccustomed activity. Lack of exercise leads to the following conditions which may threaten your back:

- muscle inflexibility: restricts the back's ability to bend and rotate.

- weak back muscles: increase load on the spine and the risk of disc bulge. 

- weak stomach muscles: increase strain on the back and cause the pelvis to tilt abnormally.

- obesity: increases weight on the spine and pressure on the vertebrae and discs. A large belly pulls the spine forward and out of alignment, increasing the risk of back strain.

Poor posture and spending long periods in one position, such as working at a computer or slouching in front of the TV.

Genetic factors: some people are genetically susceptible to back pain, usually because they inherited spinal structural abnormalities.Mutation of the COL9A2 gene may be linked to about 10% of sciatica cases. This gene plays a role in producing collagen, an important protein component of the discs. The defective gene may cause disc deterioration, leading to sciatica.

Work that stresses the back: risky activities include lifting, forceful movements, bending and twisting into awkward positions, repetitive movements and vibration (as occurs with long-distance truck driving).

Improper body mechanics
during sporting activities can damage the back, e.g. a jerky golf swing or incorrect use of exercise equipment. Cyclists often experience lower back pain, which is often resolved by adjusting the angle of the bicycle seat. Some research suggests that, over time, high-impact exercise such as rugby or aerobics may increase the risk for degenerative disc disease. Hyperextension of the spine as in gymnastics and cricket (especially in the case of bowlers) may lead to a stress fracture (spondylolysis).

makes women prone to back pain due to shifting of abdominal organs, forward redistribution of body weight and loosening of ligaments in the pelvic area prior to delivery.

Smoking: possibly because it decreases blood circulation to the tissues of the back. The association may also be due to a generally unhealthy lifestyle.

Psychological factors: research indicates that in many people, pre-existing depression and feelings of helplessness may have a negative influence on one’s perception of pain and one’s ability to cope with back problems. People with depression are also more likely to have vague physical symptoms, including back pain.

Read more:

Symptoms of back pain

Causes of back pain

Preventing back pain

Reviewed by Dr Pradeep Makan, orthopaedic surgeon, Melomed Gatesville and Life Vincent Pallotti Hospital in Cape Town and part-time lecturer in the department of orthopaedic surgery at the University of Cape Town, 2010


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Susan qualified as a Physiotherapist in 1990, and completed her master’s degree in Physiotherapy in 2013 at the University of Pretoria. She has a special interest in human biomechanics, as well as the interaction between domestic and work-related ergonomics.

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