Screen-based sedentary behavior, physical activity, and the risk of chronic spinal pain: a cross-sectional and cohort study

BACKGROUND: Sedentary behavior (SB) is associated with chronic musculoskeletal pain, but limited evidence exists about its impact on chronic spinal pain (CSP).AIM: This study aims to explore the relationship between SB, physical activity, and the risk of CSP.DESIGN: Cross-sectional and cohort study design.SETTING: United Kingdom (UK).POPULATION: We included 481872 data collected between 2006 and 2010 for cross-sectional analysis and 45,096 data with the longest follow-up up to 2019 for longitudinal analysis of data from the UK.METHODS: Screen-based SB was defined as self-reported television (TV) viewing time, computer usage time, and total screen time. CSP was characterized as self-reported neck/shoulder or back pain for more than 3 months.RESULTS: Cross-sectional analyses suggested that screen-based SB is associated with a high risk of chronic neck/shoulder (OR [95%CI]=1.43 [1.31 to 1.57]) and back pain (OR [95%CI]=1.39 [1.28 to 1.52]). The longitudinal analysis showed that an increase of 1 h in daily screen-based SB was correlated with chronic back pain risk (RR [95% CI]=1.05 [1.03 to 1.07]). Replacing an equivalent amount of TV viewing time with 1 h of walking per day exhibited a connection with a lower potential for chronic neck/shoulder pain (4.82% reduction) and chronic back pain (5.26% reduction). Even replacing 10 min of TV viewing time with 10 min of physical activity demonstrated a similar trend.CONCLUSIONS: Daily screen-based SB is associated with CSP, but a causal relationship cannot be established. Replacing sedentary TV time with 10 minutes of physical activity per day shows potential benefits for CSP.CLINICAL REHABILITATION IMPACT: The public should be encouraged to reduce screen-based sedentary behavior and increase physical activity to mitigate the risk of chronic spinal pain.