Sagittal Alignment, Central Sensitization, and psychosocial Factors in Military Personnel with and without Chronic Non-Specific Low Back Pain: A Cross-Sectional Study

Objectives: The present study aimed to compare the sagittal alignment and range of motion of the spine in military personnel with chronic non-specific low back pain (CNLBP) and asymptomatic individuals and to determine the relationships between spinal parameters and central sensitization, pain, disability and psychosocial factors. Methods: This cross-sectional study enrolled ۱۰۴ male military personnel (۴۹ with CNLBP). The participants completed the spinal examination via the Spinal Mouse. Central sensitization (CSI), pain intensity (VAS), Lumbar pressure pain threshold (PPT), psychosocial factors (ÖMPSQ), and disability (ODI) were assessed. Results: Compared with controls, CNLBP participants showed smaller segmental angles during forward flexion for lumbar (MD = ۱۰.۹°, p < .۰۰۱), inclination (MD = ۲۰.۳°, p < .۰۰۱), and sacral/hip angles (MD = ۱۱.۴°, p < .۰۰۱). The spinal range of motion was reduced across all movement transitions in CNLBP with moderate to strong effect sizes. In addition to these biomechanical changes, CNLBP participants exhibited substantially lower PPT at the lumbar region (MD = –۲۳.۳۸, p < .۰۰۱) and higher CSI scores (MD = ۱۳.۳۹, p < .۰۰۱). Correlation analyses revealed significant negative correlations between the VAS score and the lumbar angle in the forward flexion and upright to flexion (r = -۰.۴۴ and -۰.۴۰, p < ۰.۰۰۱, respectively). The CSI correlated strongly with ÖMPSQ (r = ۰.۶۱, p < ۰.۰۰۱), and moderately with the ODI score (r = ۰.۴۹, p < ۰.۰۰۱), and showed correlations with the VAS and lumbar region PPT (r = ۰.۳۱, p < ۰.۰۵ and -۰.۳۸, p < ۰.۰۰۱, respectively). Discussion: CNLBP in military personnel is characterized by altered spinal biomechanics and neuro-psychosocial alterations. These findings suggest tailored interventions that address both mechanical impairments and neuro-psychosocial contributors.

کلیدواژه ها:

sagittal alignment ، low back pain ، psychosocial ، central sensitization