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21 Jul 2007
Back pain is the number one cause of worker-compensation
complaints, second only to the common cold in causing lost workdays.
Consequently, employers and regulators have pushed training programs to
teach specific lifting methods, and some recommend or require the use of
assistive devices such as hoists for hospital workers. However, a new review
of the research on lifting advice and handling devices has found that they
do not prevent work-related back pain.
"According to the studies we have so far, it seems that this is not
effective," said lead author Kari-Pekka Martimo, of the Finnish Institute of
Occupational Health in Helsinki. He and his colleagues examined data from
more than 18,000 employees in 11 studies. Some studies looked at advice or
assistive devices alone and some looked at combining both, but the
combinations did not prove effective either.
The review appears in the latest issue of The Cochrane Library, a
publication of The Cochrane Collaboration, an international organization
that evaluates medical research. Systematic reviews draw evidence-based
conclusions about medical practice after considering both the content and
quality of existing medical trials on a topic.
The advice and devices did not prevent back pain or reduce disability claims
or sick leave.
According to Martimo, one explanation for the negative findings could be
that "safer" lifting techniques do not really exist so teaching particular
tactics would be unlikely to help. "Another possibility is that elevated
risk for back pain might not be related to lifting or moving heavy objects
themselves, but to other aspects of work," he said. High stress, for
example, might link jobs that require lifting to back pain, rather than the
lifting itself.
Alternatively, it could be that the teaching is the problem and that workers
do not actually adopt better habits. However, the studies looked at many
different training methods and did not find any to have a particular
advantage. "I don't think it's lack of adequate teaching methods," Martimo
said. One complication of considering that there is a "correct" lifting
technique that employees should adopt is that "when an employee has back
pain, there's a tendency to blame the victim because he didn't [use the
techniques or devices] correctly."
"This study confirms that much of what is happening at the workplace is
well-intentioned but probably pointless," said Christopher Maher, associate
professor of physiotherapy at the University of Sydney in Australia. "We had
a pretty good idea that this was the case but this study really does confirm
that we need to take a fresh look at the problem," said Maher, who was not
involved with the study.
"The frustrating thing is that government bodies and employers concentrate
on things that do not work, [such as] back belts, education, lifting
devices, workplace redesign and no-lift policies, and ignore the only known
effective intervention exercise," Maher added. "We also know that exercise
has health benefits beyond prevention of back pain, so you are getting two
health benefits (or more) for the price of one."
Martino concluded, "We need more studies and evidence on the chain of events
between certain jobs and an elevated risk of back pain. We do not know
enough about that chain yet."
Martimo KP, et al. Manual material handling advice and assistive devices for
preventing and treating back pain in workers (Review). Cochrane Database of
Systematic Reviews 2007, Issue 3.
The Cochrane Collaboration is an international nonprofit, independent
organization that produces and disseminates systematic reviews of health
care interventions and promotes the search for evidence in the form of
clinical trials and other studies of interventions. Visit
http://www.cochrane.org
for more information.
Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
http://www.hbns.org
Article URL: http://www.medicalnewstoday.com/articles/77367.php
Main News Category: Pain / Anesthetics
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