<b>Association Between Daily Commute and Low Back Pain Among Students Using Local Transportation</b>

Background: Low back pain (LBP) is increasingly prevalent among young adults, with prolonged sitting and environmental exposures emerging as important contributors. University students in urban settings often experience extended daily commutes, yet evidence linking commute characteristics with LBP in this population remains limited. Objective: To examine the association between daily commuting patterns and low back pain among university students using local transportation. Methods: A cross-sectional study was conducted among 195 students at the University of Lahore who used bus-based local transport. Pain intensity was assessed using the Numeric Pain Rating Scale and functional disability using the Oswestry Disability Index. Daily commute duration and weekly commuting days were recorded. Associations were analyzed using chi-square tests and odds ratios with 95% confidence intervals. Results: The mean age was 20.51 ± 2.19 years, and 66.2% of participants reported LBP in the previous 12 months. Commute duration was significantly associated with LBP (χ² = 19.295, p < 0.001). Compared with students commuting 1–2 hours daily, the odds of LBP were higher for 2–3 hours (OR 4.02; 95% CI 1.94–8.33) and 3–4 hours (OR 10.08; 95% CI 1.25–81.33). No significant association was found between LBP and the number of commuting days per week. LBP was strongly associated with higher functional disability (p < 0.001). Conclusion: Prolonged daily commute duration is a significant risk factor for low back pain and related disability among university students. Interventions targeting commute duration and ergonomic conditions may help reduce the early burden of LBP in young adults.