A biomedical factor i.e., Body mass index is one of the determinants of low back pain.

As a
female patient having 30 Kg/m2 BMI, is a potential risk factor for low back pain. According to
NHS inform BMI more then 30 Kg/m2 is described as obese.
The prevalence of low back pain was found to be significantly higher in patients with an
elevated BMI compared to those with normal or underweight BMI and demonstrated a
stepwise increase with each BMI category. Approximately 47.4% of patients with normal or
underweight BMI complained of low back pain compared with 72.8% of morbidly obese
patients (P < 0.0001). No association was seen between BMI and the frequency or severity of
low back pain episodes. Osteoarthritis of the back and depression were patient variables found
to be associated with all three measures (prevalence, severity, and frequency) of low back pain.
Charles, R et al. (2018)
Shiri, R et al. (2010) compared multiple cohort studies in a meta-analysis and noted that there is
a significant association between incidence of low back pain among overweight or obese
individuals.
On further exploration incidence of low back pain among adults between versus occupational
population. In order to determine that a cohort studies analysis was done among overweight or
obese adults between general vs occupational population, a pooled analysis among overweight
adult occupational population reports a odds ratio of greater than 1 (Shiri, R et al. 2010).
Similarly, Lake, J.K., Power, C. and Cole, T.J (2000) compared overweight adults among general
population analysed odds ratio of greater than 1. Hence, body mass index had a significant role
in determining the low back pain whether it is general or occupational population, both are
vulnerable to low back pain. After concluding previous literature, a 34- years-old female patient
of class one obesity need to be addressed in order to lower the odds of having low back pain by
reduction in body mass index.
High body mass index had hazardous effects so healthy activities and appropriate
dietary modification and lifestyle modifications are necessary to maintain normal body mass
index. Obesity is the major risk factor of developing low back pain as reported in a study
conducted by Narouze S et al which examined that lower body mass index alleviate body mass
index related functional physical impairment. The secondary prevention techniques help
patients to get into shape and be physically fit.
As a female is taking 10/day cigarettes. So she is a heavy smoker. a
This meta-analysis showed an association between smoking and low back pain. The association
was strongest for chronic low back pain and disabling low back pain. Former smokers were at a
lower prevalence of low back pain than current smokers. The association between smoking and
the incidence of low back pain was stronger in adolescents than in adults. Shiri, Karppinen,
Leino-Arjas, et al (2019)

Back pain prevalence rose with increasing levels of smoking, with a relative risk of 1.47
for persons reporting 50 or more pack-years of smoking. This association was strongest in
persons under the age of 45 years, however, for whom the corresponding relative risk was 2.33.
There were similar trends toward greater prevalence with Increasing body mass index, but
prevalence rose substantially only in the most obese 20% of subjects (1.7 times higher than the
lowest 20%). Deyo, et al (1989)