AUTHOR=Guan Xiaoqing , Zhang Ding , Zhang Fengyi , Zong Yuan , Wang Hang , Shen Zhubin , Yin Fei 

TITLE=Causal association of physical activity with low back pain, intervertebral disc degeneration and sciatica: a two-sample mendelian randomization analysis study

JOURNAL=Frontiers in Cell and Developmental Biology

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/cell-and-developmental-biology/articles/10.3389/fcell.2023.1260001

DOI=10.3389/fcell.2023.1260001

ISSN=2296-634X

ABSTRACT=<p><bold>Objective:</bold> Previous studies are insufficient to confirm a causal association between physical activity (PA) and low back pain (LBP), intervertebral disc degeneration (IDD), and sciatica. The present study used a two-sample Mendelian randomization (MR) analysis method to demonstrate whether or not there was a causal connection.</p><p><bold>Methods:</bold> First, four PA phenotypes were selected [accelerometer-based PA (average acceleration), accelerometer-based PA (acceleration fraction &gt;425 mg), self-reported moderate-to-vigorous PA, and self-reported vigorous PA], setting thresholds for single nucleotide polymorphisms (SNPs) significantly concerned with PA <italic>p</italic> &lt; 5 × 10<sup>−8</sup>, linkage disequilibrium (LD) <italic>r</italic><sup>2</sup> &lt; 0.01, genetic distance &gt;5,000 kb, and F-value &gt;10. SNPs associated with the outcome and confounding factors were then excluded using the PhenoScanncer database. Finally, after coordinating the genetic instruments from genome-wide association studies (GWAS) effect alleles for exposure and outcomes, multiplicative random effects inverse variance weighting (IVW), MR-Egger, weighted median method (WMM), and weighted mode method were used to assess exposure-outcome causality and perform sensitivity analysis on the estimated results.</p><p><bold>Results:</bold> The current study’s IVW findings revealed proof of a causal connection between PA and LBP. While there was a positive causal tie between accelerometer-based PA (acceleration fraction &gt;425 mg) and LBP [OR: 1.818, 95% CI:1.129–2.926, <italic>p</italic> = 0.012], there was a negative causal link between accelerometer-based PA (average acceleration) and LBP [OR: 0.945, 95% CI: 0.909–0.984, <italic>p</italic> = 0.005]. However causal relationship between PA and IDD or sciatica was not found.</p><p><bold>Conclusion:</bold> Increasing average PA but needing to avoid high-intensity PA may be an effective means of preventing low back pain. Although PA is not directly causally related to disc degeneration and sciatica, it can act through indirect pathways.</p>