Workers' Predisposition to the Development of Low Back Pain: An Integrated Review of Biomechanical and Psychosocial Factors and Novel Preventive Approaches

Work-related low back pain (LBP) is multifactorial, reflecting interactions among biomechanical, ergonomic, individual, and psychosocial determinants.This SANRA-informed structured narrative review draws on 19 substantive publications and critically discusses occupational exposures, individual susceptibility, and integrated prevention strategies, with particular attention to passive back-support exoskeletons.Available evidence suggests reductions in lumbar extensor activity and other intermediate biomechanical outcomes during selected tasks, but effects are device- and task-dependent.The reviewed literature does not establish whether occupational exoskeletons prevent incident LBP, recurrence, disability, occupational injuries, or sickness absence over the long term.A 24-week field trial provides information on sustained surrogate effects among continuing users, without answering the question of long-term clinical prevention.Exoskeletons should therefore be considered, where appropriate, as adjuncts to established ergonomic, organizational, and exercise-based interventions rather than standalone preventive strategies.