University of Oulu

Modarress Julin, M., Saukkonen, J., Oura, P. et al. Association between device-measured physical activity and lumbar Modic changes. BMC Musculoskelet Disord 21, 630 (2020).

Association between device-measured physical activity and lumbar Modic changes

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Author: Julin, Marella Modarress1,2,3; Saukkonen, Jesperi1,2; Oura, Petteri1,2,4;
Organizations: 1Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, FI-90014, Oulu, Finland
2Center for Life Course Health Research, PO Box 5000, FI-90014, Oulu, Finland
3Clinic of Physiatry, Oulu University Hospital (OYS), PO Box 21, 90029, Oulu, Finland
4Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland
5Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland
6Department of Archaeology, Faculty of Humanities, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland
7Diagnostic Radiology, Oulu University Hospital (OYS), P.O. Box 10, FI-90029, Oulu, Finland
8Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation, PO Box 365, FI-90100, Oulu, Finland
9Finnish Institute of Occupational Health, Aapistie 1, FI-90220, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link:
Language: English
Published: Springer Nature, 2020
Publish Date: 2020-11-16


Background: Modic changes (MC) in the lumbar spine are considered one potential etiological factor behind low back pain (LBP). Multiple risk factors for MC have been suggested, including male gender, smoking and factors affecting hyperloading and mechanical stress such as high body mass index (BMI), strenuous physical work and high occupational and leisure-time physical activity (PA). So far, the effect of PA on the occurrence of MC has remained under debate due to contradictory findings. The purpose of this study was to investigate the possible association between device-measured moderate-to-vigorous PA (MVPA) (≥ 3.5 METs) and lumbar MC.

Methods: The study had 1374 participants from the Northern Finland Birth Cohort 1966. At the age of 46–48, PA was measured by a wrist-worn accelerometer, and lumbar magnetic resonance imaging (MRI) was carried out to determine MC. We analyzed the association between Type 1 (MC1) and Type 2 (MC2) MC and daily amount of MVPA (min/day) using sex-stratified logistic regression models before and after adjustment for BMI, socioeconomic status, smoking, and accelerometer wear time.

Results: Among men, increased amount of MVPA was positively associated with any MC (adjusted OR corresponding to every 60 min/day of MVPA 1.41; 95% confidence interval (CI) 1.01 to 1.95) and MC2 (OR 1.54; 95% CI 1.14 to 2.08), but not with MC1 (OR 1.06; 95% CI 0.80 to 1.39). Among women, we only found a positive association between MVPA and MC1 before adjustments (unadjusted OR 1.42; 95% CI 1.06 to 1.92).

Conclusions: Among men, increased amount of MVPA was associated with increased odds of any MC and particularly MC2. Among women, MVPA was not independently associated with MC.

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Series: BMC musculoskeletal disorders
ISSN: 1471-2474
ISSN-E: 1471-2474
ISSN-L: 1471-2474
Volume: 21
Article number: 630
DOI: 10.1186/s12891-020-03638-y
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3126 Surgery, anesthesiology, intensive care, radiology
Funding: The NFBC1966 received financial support from University of Oulu Grant no. 24000692, Oulu University Hospital Grant no. 24301140, and ERDF European Regional Development Fund Grant no. 539/2010 A31592. The study was financially supported by the Ministry of Education and Culture of Finland, grant numbers OKM/86/626/2014, OKM/43/626/2015 and OKM/17/626/2016, and Infotech Oulu, Finland.
Copyright information: © The Author(s). 2020. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.