Analysis of the association between low back and neck pain with cardiovascular risk factors according to different domains of physical activity: longitudinal study

Physical activity (PA) is promoted for treating and preventing low back and neck pain and cardiovascular risk factors, but which specific levels and domains are associated with cardiovascular risks in these individuals remain unclear. The aim of this study is to evaluate the association between individuals with persistent low back pain and neck pain (pain in baseline and follow-up) and cardiovascular risk factors, considering different domains and levels of PA. This prospective cohort study with a 2-year follow-up analyzed the association between different levels and domains of PA and cardiovascular risk factors in 331 adults followed longitudinally with persistent low back and/or neck pain. Data were collected through in-person interviews covering age, sex, socioeconomic status, PA, low back and neck pain, and self-reported cardiovascular risk factors. PA was assessed using a validated questionnaire and participants were categorized as persistently active, persistently inactive, or inactive at one time point (baseline or follow-up) across different PA domains. Binary logistic regression was used for analysis, with all models adjusted for age, sex, and socioeconomic status. In the sport PA domain, individuals inactive at one time point with neck pain showed an association with hypertension (OR = 2.96 [95%CI = 1.13; 7.78] p = 0.027), while an association between low back pain and high cholesterol was observed among persistently inactive individuals (OR = 3.70 [95%CI = 1.27; 10.75] p = 0.016). In the leisure-time PA and locomotion domain, persistently active individuals with neck pain showed an association with diabetes (OR = 8.46 [95%CI = 1.26; 56.73] p = 0.028), whereas individuals with low back pain who were persistently inactive were associated with high triglycerides (OR = 4.22 [95%CI = 1.21; 14.70] p = 0.028) and high LDL cholesterol (OR = 4.96 [95%CI = 1.82; 13.53] p = 0.001). In the occupational PA domain, individuals inactive at one time point with low back pain showed an association with high LDL cholesterol (OR = 3.09 [95%CI = 1.06; 8.98] p = 0.040). Persistent physical inactivity was more frequently associated with unfavorable cardiovascular risk factors among adults with low back pain, whereas associations among individuals with neck pain varied according to PA domain and level.