Leisure-time physical activity and low back pain in Switzerland: results from the 2022 cross-sectional Swiss Health Survey

BACKGROUND: Low back pain (LBP) affects about 1.2 million individuals in Switzerland. Although regular leisure-time physical activity (PA) is considered a relevant factor in preventing LBP, evidence of its association with LBP is inconsistent. This study investigated the association between leisure-time PA and LBP, as well as the relationship with other factors. METHODS: We analysed data from the cross-sectional 2022 Swiss Health Survey which covered adults aged 18 years and older living in private households in Switzerland. Self-reported LBP in the previous four weeks was grouped as no, a little or strong. Multinomial logistic regression models were used to analyse LBP in relationship to predictors and sociodemographic characteristics of respondents. We report crude and adjusted odds ratios (OR) with 95% confidence intervals (CI). RESULTS: Complete data from 13,418 individuals (mean age: 51.01 ± 16.32 years, 53.7% female) was analysed. Any LBP in the previous four weeks was reported by 40% of men and 50% of women. Strong LBP was more prevalent among men who were physically inactive in leisure time (13%) and women (17%) than among individuals who were physically trained in leisure time (men: 4.3%, women: 5.8%). Leisure-time PA was associated with lower odds of experiencing strong LBP, with the strongest protective association observed in physically trained individuals (adjusted OR = 0.35, 95% CI = [0.26; 0.49]). Associations with a little LBP were weaker and largely not statistically significant, except in women (adjusted OR = 0.73, 95% CI = [0.55; 0.97]). In the sex-specific models, moderate sleeping disorders and mild to moderate depression were associated with both a little and strong LBP in both sexes. Strong social relationships reduced the odds of both levels of LBP in women, while alcohol consumption increased the odds of a little LBP and smoking increased the odds of strong LBP in men. CONCLUSION: Respondents with increased levels of leisure-time PA had lower odds of strong LBP. Lifestyle factors such as sleep quality, social relationships, alcohol consumption and mental health contributed to the association with LBP, with sex-specific differences. Promoting leisure-time PA and other lifestyle factors may help to reduce the burden of LBP in the Swiss population. Further, ideally, prospective cohort studies are needed to confirm these results. TRIAL REGISTRATION: Swiss Federal Statistical Office consent (Ref. 240286).