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. 2025 Jul 3.
doi: 10.1007/s00586-025-09048-9. Online ahead of print.

Association between eveningness and low back pain among public servants in Japan: a cross-sectional analysis of the Aichi Workers' Cohort Study

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Association between eveningness and low back pain among public servants in Japan: a cross-sectional analysis of the Aichi Workers' Cohort Study

Mika Matsunaga et al. Eur Spine J. .

Abstract

Purpose: Low back pain (LBP) is a common occupational health problem. Chronotype, an individual's preferred timing of activity and sleep, has been linked to pain perception. Previous studies have found a potential association between chronotype and LBP, although the findings were limited by small sample sizes and restricted population types. We investigated the association between evening chronotype (eveningness) and LBP in a cohort comprising public servants of various ages.

Methods: We conducted a cross-sectional analysis of 4728 full-time public servants in Japan. LBP was assessed using a self-reported question. Individuals' chronotypes were determined using the reduced Morningness-Eveningness Questionnaire. The association between chronotype and LBP was analyzed using the chi-squared test and multiple logistic regression models adjusted for age, sex, occupation, overtime work, use of the internet/email, body mass index, smoking status, exercise habits, sedentary behavior, sleep duration, sleep medication use, and depressive symptoms.

Results: In total, 30% of the subjects reported LBP. The most common chronotype was intermediate type (51%), followed by morningness (38%) and eveningness (11%). A significant association between eveningness and LBP was observed. After adjusting for potential confounders, individuals with eveningness had a higher prevalence of LBP than those with morningness (36.2% vs. 28.7%; odds ratio: 1.46; 95% confidence interval: 1.16-1.83).

Conclusion: Eveningness was statistically associated with LBP in a cohort of public servants. The present findings would strengthen the association's generalizability to more varied populations.

Keywords: Chronotype; Epidemiology; Eveningness; Japan; Low back pain; Public servants.

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Conflict of interest statement

Declarations. Competing interests: All the authors, except for Dr. Tsuyoshi Kitajima, declare no competing interests. T.K. has received speaker honoraria from Eisai, Mitsubishi Tanabe, Otsuka, Takeda, Eli Lilly, MSD, Meiji, Yoshitomi, Fukuda, Dainippon Sumitomo, Shionogi, Viatris, and Novo Nordisk, and research grants from Eisai, MSD, and Takeda. None of these companies had any role in this study.

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