Diurnal variation in stature: Do those with chronic low-back pain differ from asymptomatic controls?



      Stature loss is a commonly used measure of spinal load. The aim of this study was to investigate the pattern of diurnal stature change in those with and without chronic low-back pain, over a 24-h period.


      Eight participants with chronic low-back pain (age 24.6 (SD 4.3) years, height 1.76 (SD 0.08) m, body mass 72.8 (SD 11.1) kg) and eight controls (age 21.8 (SD 2.0) years, height 1.75 (SD 0.10) m, body mass 71.8 (SD 11.6) kg) participated in this investigation. Twenty-four stature measurements were performed over a 24-h period.


      The trough to peak variation in stature of 17.9 mm (low-back pain group) and 17.6 mm (control group) did not differ between groups (P>0.05). Both groups experienced greatest stature change in the 1st hour after rising (31.3% [low-back pain] and 44.6% [control] of total stature change). At approximately 18:00 h the LBP group reached a plateau whilst the control group continued to lose stature. Between 14:00 and 18:00 h both groups demonstrated a previously unreported recovery of stature. A significant correlation was found between low-back discomfort and stature change in the low-back pain group only.


      No significant difference existed between groups in relation to total stature loss; however the low-back pain group appeared to reach their nadir earlier, possibly exposing other spinal structures to loading for a greater duration. This is supported by the relationship found between stature loss and discomfort. The reversal in stature loss in the afternoon may be of clinical significance and warrants further investigation.


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        • Adams M.A.
        • Dolan P.
        • Hutton W.C.
        Diurnal variations in the stresses on the lumbar spine.
        Spine. 1987; 12: 130-137
        • Adams M.A.
        • Dolan P.
        • Hutton W.C.
        • Porter R.W.
        Diurnal changes in spinal mechanics and their clinical significance.
        J. Bone Joint Surg. 1990; 72: 266-270
        • Adams M.A.
        • Hutton W.C.
        The effect of posture on the role of the apophyseal joints in resisting intervertebral compressive forces.
        J. Bone Joint Surg. 1980; 62: 358-362
        • Adams M.A.
        • Hutton W.C.
        The effect of posture on the fluid content of the lumbar intervertebral discs.
        Spine. 1983; 8: 665-671
        • Althoff I.
        • Brinckmann P.
        • Frobin W.
        • Sandover J.
        • Burton K.
        An improved method of stature measurement for quantitative determination of spinal loading.
        Spine. 1992; 17: 682-693
        • Beynon C.
        • Reilly T.
        Spinal shrinkage during a seated break and standing break during simulated nursing tasks.
        Appl. Ergon. 2001; 32: 617-622
        • Boos N.
        • Wallin A.
        • Gbedegbegnon T.
        • Aebi M.
        • Boesch C.
        Quantitative MR imaging of lumbar disks and vertebral bodies: influence of diurnal water content variations.
        Radiology. 1993; 188: 351-354
        • Botsford D.J.
        • Esses S.I.
        • Ogilvie-Harris D.J.
        In vivo diurnal variation in intervertebral disc volume and morphology.
        Spine. 1994; 19: 935-940
        • Corlett E.N.
        • Eklund J.A.E.
        • Reilly T.
        • Troup J.D.G.
        Assessment of workload from measurements of stature.
        Appl. Ergon. 1987; 18: 65-71
        • Dworkin S.F.
        • Von Korff M.
        • LeResche L.
        Multiple pains and psychiatric disturbance.
        Arch. Gen. Psychiatry. 1990; 47: 239-244
        • Garbutt G.
        • Boocock M.G.
        • Reilly T.
        • Troup J.D.G.
        Running speed and spinal shrinkage in runners with and without low back pain.
        Med. Sci. Sports Exerc. 1990; 22: 769-772
        • Healey E.L.
        • Fowler N.E.
        • Burden A.M.
        • McEwan I.M.
        Repeatability of stature measurements in individuals with and without chronic low-back pain.
        Ergonomics. 2005; 48: 1613-1622
        • Helander M.G.
        • Quance L.A.
        A. Effect of work — rest schedules on spinal shrinkage in the sedentary worker.
        Appl. Ergon. 1990; 21: 279-284
        • Hindle R.J.
        • Murray-Leslie C.
        Diurnal stature variation in ankylosing spondylitis.
        Clin. Biomech. 1987; 2: 152-157
        • Hirsch C.
        The reaction of intervertebral discs to compression forces.
        J. Bone Joint Surg. 1955; 37: 1188-1196
        • Jazwinska E.C.
        • Adam K.
        Diurnal change in stature: effects of sleep deprivation in young men and middle-aged men.
        Cell. Mol. Life Sci. 1985; 41: 1533-1535
        • Jensen M.P.
        • Turner J.A.
        • Romano J.M.
        What is the maximum number of levels needed in pain intensity measurement?.
        Pain. 1994; 58: 387-392
        • Kanlayanaphotporn R.
        • Trott P.
        • Williams M.
        • Fulton I.
        Effects of chronic low back pain, age and gender on vertical spinal creep.
        Ergonomics. 2003; 46: 561-573
        • Krishnan K.
        • Vij K.
        Diurnal variation of stature in three adults and one child.
        Anthrologist. 2007; 9: 113-117
        • Krag M.H.
        • Cohan M.C.
        • Haugh L.D.
        • Pope M.H.
        Body height change during upright and recumbent posture.
        Spine. 1990; 15: 202-207
        • Koeller W.
        • Funke F.
        • Hartmann F.
        Biomechanical behaviour of the human intervertebral discs subject to long lasting axial loading.
        Biorheology. 1984; 21: 675-686
        • Leatt P.
        • Reilly T.
        • Troup J.D.G.
        Spinal loading during circuit weight training and running.
        Br. J. Sports Med. 1986; 20: 119-124
        • Mannion A.F.
        • Muntener M.
        • Taimela S.
        • Dvorak J.
        A randomized clinical trial of three active therapies for chronic low back pain.
        Spine. 1999; 24: 2435-2448
        • McMillan D.W.
        • Garbutt G.
        • Adams M.A.
        Effect of sustained loading on the water content of intervertebral discs: implications for disc metabolism.
        Ann. Rheum. Dis. 1996; 55: 880-887
        • Nachemson A.L.
        • Schultz A.B.
        • Berkson
        Mechanical properties of human lumber spine motion segments: influences of age, sex, disc level and degeneration.
        Spine. 1979; 4: 1-8
        • Nickla D.L.
        • Rada J.A.
        • Wallman J.
        Isolated chick sclera shows circadian rhythm in proteoglycan synthesis perhaps associated with the rhythm in ocular elongation.
        J. Comp. Physiol. A Sens. Neural Behav. Physiol. 1999; 185: 81-90
        • Panjabi M.M.
        Clinical spinal instability and low back pain.
        J. Electromyogr. Kinesiol. 2003; 13: 371-379
        • Price D.D.
        • McGrath P.A.
        • Rafii A.
        • Buckingham B.
        The validation of visual analogue scales as ratio scale measures for chronic and experimental pain.
        Pain. 1983; 17: 45-56
        • Reilly T.
        • Tyrrell A.
        • Troup J.D.G.
        Circadian variation in human stature.
        Chronobiol. Int. 1984; 1: 303-307
        • Reilly T.
        • Boocock M.G.
        • Garbutt G.
        • Troup J.D.G.
        Shrinkage in total body length: its measurement and application.
        Humanbiologica Budapestinensis. 1988; 18: 183-191
        • Roberts N.
        • Hogg D.
        • Whitehouse G.H.
        • Dangerfield P.
        Quantitative analysis of diurnal variation in volume and water content of lumbar intervertebral discs.
        Clin. Anat. 1988; 11: 1-8
        • Rodacki C.L.N.
        • Fowler N.E.
        • Rodacki A.L.F.
        • Birch K.
        Technical note: repeatability of measurement in determining stature in sitting and standing postures.
        Ergonomics. 2001; 44: 1076-1085
        • Rodacki C.
        • Fowler N.E.
        • Rodacki A.L.F.
        • Birch K.
        Stature loss and recovery in pregnant women with and without low back pain.
        Arch. Phys. Med. Rehabil. 2003; 84: 507-512
        • Roland M.
        • Morris R.
        A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain.
        Spine. 1983; 8: 141-144
        • Tyrrell A.R.
        • Reilly T.
        • Troup J.D.G.
        Circadian variation in stature and the effects of spinal loading.
        Spine. 1985; 10: 161-164
        • van Dieen J.H.
        • Toussaint H.M.
        Spinal shrinkage as a parameter of functional load.
        Spine. 1993; 18: 1504-1514
        • Videman T.
        • Battie M.C.
        • Gibbons L.E.
        • Maraville K.
        • Manninen H.
        • Kaprio J.
        Associations between back pain history and lumbar MRI findings.
        Spine. 2003; 28: 582-588
        • Wilby J.
        • Linge K.
        • Reilly T.
        • Troup J.D.G.
        Spinal shrinkage in females: circadian variation and the effects of circuit weight-training.
        Ergonomics. 1987; 30: 47-54