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The aim of this study was to assess the relationship between the incidence and exacerbation of Low Back Pain (LBP) in young professional driversIn this controlled historical prospective study we included all male Israel Defense Forces (IDF) soldiers drafted between the years 1997–2006, followed them for 3 years and categorised them into three groups: administrative, light-duty vehicle drivers and heavy vehicle drivers. The incidence and recrudescence of LBP was calculated for soldiers with or without a medical history of LBP in either professional group accordingly.The incidence rates for LBP were 0.7%, 0.34% and 0.43% for the combined administrative and light vehicle driver groups, heavy vehicle driver and total driver groups, respectively (averagely 0.65%). The Relative Risk (RR) for severe LBP exacerbation for soldiers with a history of LBP without clinical findings was 1.4 (p<0.001) and for soldiers with a history of LBP with mild clinical/radiographic findings was 3.8 (p<0.01). Examination of RR exacerbation rates within different severity tiers yielded a similar trend amongst all professions.The crude incidence rate for LBP was found to be 0.65% - lower than literature reported rates, possibly attributable to our more stringent variable definition of severe LBP. The most prominent risk factors identified in our study include: a history of LBP and multiple complaints of LBP at recruitment. Driving profession in young age is not a risk for LBP.