After nearly a century of research and attempts by safety professionals to control low back pain, it is still the dominant workplace injury in industry. This fact has lead many, researchers and practitioners alike, to question hopes that back injuries can be prevented. Safety professionals must be careful about interpreting research and understand its limitations. Discernment must be used in differentiating good and bad research. This paper reviews what to look for in good research, why good research is difficult to conduct and therefore scarce and why it is slowly or never adopted by the safety community. How bad research can lead to myths and misconceptions and some of the best of the best research will be reviewed.
Depending on how you define it, anywhere from two-thirds to over three-quarters of the population suffers from low back pain sometime in their life (Deyo and Weinstein, 2001). Overexertion injuries (mostly back injuries) account for nearly 30% of the costs associated with serious1 workplace injuries (Liberty Mutual Workplace Safety Index). This is estimated to cost US businesses over $13 billion in 2002.
The focus of this paper is on PREVENTING low back pain at work. This is sometimes referred to as "primary" prevention. It is distinguished from efforts to reduce disability days. Getting employees to "heal" from back pain as fast as possible so they can return to work is an important aspect to risk control, but is not the primary focus of this paper. The key question that this paper seeks to address is, "Can research tell us anything for sure about how to prevent pack pain in the workplace?"
Most low back pain injuries in the workplace are associated with manual materials handling tasks, but a significant proportion (on the order of 16%) is also associated with slips and falls (Murphy and Courtney, 2000, p.362). This paper will not focus on prevention of low back pain due to falls.
A literature search on low back pain will reveal thousands (tens of thousands?) of articles, ranging from popular articles in popular magazines and books to scientific journals and texts. There are several challenges to this plethora of information. What is the truth among so many opinions? Which articles are worth reading? How can I be sure I'm finding all the "right" articles? How can you tell a sound finding from a spurious opinion? How can you tell good research from bad? Before I go into what I look for in good research articles, I need to comment on the value of "non-research."