iarjhcpIARJHCPIARJHCP2789-6048https://doi.org/10.47310/iarjhcp.2025.v05i02.001Public Understanding of Spine Health and Preventive Practices in the Mountainous Communities of Himachal PradeshBackground: Spine-related disorders—such as chronic back pain, postural imbalances, disc degeneration, and spinal injuries—are a rising public health concern globally and particularly in India. In mountainous regions like Himachal Pradesh, physically intensive lifestyles, occupational strain, poor ergonomics, and increasing sedentary behaviors contribute to heightened spinal risks. This study aimed to assess spine health awareness and preventive behaviors among adults in Himachal Pradesh and to identify socio-demographic factors influencing knowledge levels. Materials and Methods: A descriptive, cross-sectional study was conducted among 400 adults (≥18 years) from both urban and rural areas of Himachal Pradesh. A bilingual, pre-validated Google Form questionnaire assessed socio-demographics, spine health awareness (20 MCQs), and self-reported preventive practices. Each correct answer earned one point (maximum score: 20). Participants were categorized into four awareness levels: Very Good (17–20), Good (13–16), Fair (9–12), and Poor (0–8). Data were analyzed using Epi Info Version 7, with Chi-square tests evaluating associations between awareness scores and demographic variables (p<0.05 considered significant). Results: Of the 400 participants, 30.3% exhibited Very Good awareness, 34.8% Good, 23.3% Fair, and 11.8% Poor. High awareness was observed for topics such as spinal function (74.0%), posture-related risks (68.0%), physical activity (69.0%), and lifting techniques (72.3%). However, knowledge gaps persisted regarding sciatica (61.3%), ergonomic practices (64.0%), and appropriate stretching intervals (63.5%). Significant associations were found between awareness levels and age (p = 0.032), education (p<0.001), occupation (p = 0.039), and residence (p = 0.027). Urban, educated, and professionally employed participants had higher awareness. Gender differences were not statistically significant (p = 0.194). Conclusion: While spine health awareness in Himachal Pradesh is moderately high, critical knowledge deficits exist, especially among older adults, rural residents, and those with limited education. These findings underscore the urgent need for community-based, culturally tailored educational interventions focusing on preventive spine care.