Effect of a multidisciplinary program for the prevention of low back pain in hospital employees: a randomized controlled trial. A review and proposal for a core set of factors for prospective cohorts in low back pain: a consensus statement. Occupational, Personal and Psychosocial Resources for Preventing Persistent Low Back Pain Discographic, MRI and psychosocial determinants of low back pain disability and remission: a prospective study in subjects with benign persistent back pain. Assessment of psychosocial risk factors for the development of non-specific chronic disabling low back pain in Japanese workers—findings from the Japan Epidemiological Research of Occupation-related Back Pain (JOB) study A Prospective Study of Incidence and Risk Factors for the Onset and Persistence of Low Back Pain in Thai University Students The natural course of low back pain: a systematic critical literature review Identification of Modifiable Personal Factors That Predict New-onset Low Back Pain: A Prospective Study of Female Nursing Students A study of work stress, patient handling activities and the risk of low back pain among nurses in Hong Kong. Low back pain incident episodes: a community-based study. Potential Risk Factors of Persistent Low Back Pain Developing from Mild Low Back Pain in Urban Japanese Workers Dose-response relations between occupational exposures to physical and psychosocial factors and the risk of low back pain Improving the care for people with acute low-back pain by allied health professionals (the ALIGN trial): A cluster randomised trial protocol The Predictive Relationship of Physical Activity on the Incidence of Low Back Pain in an Occupational Cohort Non-specific low back pain in primary care in the Spanish National Health Service: a prospective study on clinical outcomes and determinants of management Biomechanical constraints remain major risk factors for low back pain. Results from a prospective cohort study in French male employees. Persistence and Change in Nonspecific Low Back Pain Among Adolescents: A 3-Year Prospective Study
BACKGROUND Hospital workers with physically dem and ing jobs are at risk for developing recurrent LBP . There is a lack of studies evaluating multidisciplinary prevention of  low back pain ( LBP ) in hospital workers . OBJECTIVE This r and omized controlled trial evaluates the effect of a multidisciplinary prevention program , focusing on a client-centred approach , on hospital workers at risk for developing LBP . METHODS Caregiving hospital workers were allocated to an experimental ( 12-week lasting multidisciplinary prevention program ) or control group ( no intervention ) . They were evaluated prior to the intervention and after a 6 months follow-up period . Primary outcome measures included incidence of LBP , work absenteeism and general health . Secondary outcomes included daily physical activity , job satisfaction and coping strategies . RESULTS A significant improvement was seen for passive coping after 6 months follow-up , but no significant differences were observed between groups in primary or other secondary outcome measures ( p > 0.05 ) . CONCLUSIONS A multidisciplinary prevention program fitting into a bio-psychosocial context may not have been intensive enough to promote a change in daily habitudes , and had no effect on work absenteeism , incidence of LBP or general health . Further research should determine whether prevention of LBP is possible in caregiving personnel Introduction The Multinational Musculoskeletal Inception Cohort Study ( MMICS ) Statement is a consensus statement aim ed at improving the quality of prospect i ve investigations into the transition from early stages of low back pain ( LBP ) to persistent problems . The statement aims to help improve the quality of such studies by recommending an agreed minimal list of measures for inclusion in baseline data collection . The MMICS Statement is primarily aim ed at research ers who want to investigate prognosis in LBP , and this will allow data from cohorts to be pooled and will facilitate comparisons between different health care systems . One approach to preventing acute new episodes of LBP ( up to 3 weeks from onset ) from developing into persistent disabling pain is to identify those individuals with LBP who are most likely to progress to chronic disability . Targeting interventions at those at highest risk could reduce the population burden of chronic LBP . A wide range of baseline parameters have been associated with poor outcome in inception cohort studies ( 1–6 ) . Few existing studies have been of sufficient size and method ologic rigor to produce conclusive findings . Even in method ologically robust studies , baseline factors only account for a small proportion of the variance in outcome ( 7 ) , typically around 30 % . Systematic review s of the literature could not pool data because studies used different measurements ( 1–3 ) . Despite some information on physical , psychosocial , and work-related risk factors , it has not been possible to adequately estimate the comparative impact of individual psychosocial and societal factors on the transition from acute to persistent disabling LBP . How to address this problem was one focus of the VI International Forum for Primary Care Research in Low Back Pain held in April 2003 . A steering group for the collaboration was appointed , and 8 national team leaders volunteered to recruit teams of national experts . Three additional team leaders were recruited by the steering group ( Australia , France , and Germany ) . Independent experts were invited to advise on the quality of the MMICS process . The MMICS steering group , located in the UK , met regularly and included expert research ers in clinical and outcome factors in back pain ( AB ) , work-related issues in back pain ( AKB ) , psychosocial aspects of back pain ( TP and RS ) , and general practice aspects of back pain ( MU ) . The MMICS Statement set out to include 1 ) a minimal but comprehensive number of predictor factors based on current evidence and theory ; 2 ) appropriate measurement instruments for agreed predictor factors based on their clinometric properties , availability , and practical characteristics ; and 3 ) a minimum set of followup measures , including recommendations about measurement and timing The aim of this prospect i ve cohort study was to identify modifiable protective factors of the progression of acute/subacute low back pain ( LBP ) to the persistent state at an early stage to reduce the socioeconomic burden of persistent LBP .  Patients attending a health practitioner for acute/subacute LBP were assessed at baseline addressing occupational , personal and psychosocial factors , and followed up over 12 weeks . Pearson correlations were calculated between these baseline factors and the presence of nonpersistent LBP at 12-week follow-up . For those factors found to be significant , multivariate logistic regression analyses were performed . The final 3-predictor model included job satisfaction , mental health and social support . The accuracy of the model was 72 % , with 81 % of nonpersistent and 60 % of persistent LBP patients correctly identified . Further research is necessary to confirm the role of different types of social support regarding their prognostic influence on the development of persistent LBP BACKGROUND CONTEXT A range of morphologic and psychosocial variables has been suggested as risk factors for serious low back pain ( LBP ) illness . Although the relative contributions of structural and psychosocial variables are intensely debated , the validity of differing hypotheses has proven difficult to test because the incidence of serious disabling LBP illness is low in healthy subjects . These factors dictate the requirement for large sample sizes , extensive structural imaging and extended longitudinal study . Previous studies included either small cohorts with intensive imaging testing or large population studies that do not establish a detailed morphologic baseline . PURPOSE To establish , using a strict patient sample design , the relative contribution of structural and psychosocial determinants of serious LBP illness among subjects with no previous LBP disability or clinical LBP illness . STUDY DESIGN / SETTING A prospect i ve , longitudinal study of subjects with high risk factors for serious LBP as determined by structural and psychosocial characteristics . PATIENT SAMPLE One hundred subjects with known mild persistent low back pain and a 2:1 ratio of chronic ( non-lumbar ) pain syndrome were recruited from a study population with a predisposition to disc degenerative disease , to undergo baseline examination , testing and 5-year follow-up . OUTCOME MEASURES Observations were made at 6-month intervals over 4 to 6 years ( mean , 5.3 ) for the after primary outcomes measures : episodes of serious back pain ( visual analogue scale [ VAS ] > or = 6 ) , episodes of occupational disability less than 1 week , episodes of occupational disability for 1 week , remission episodes of all back pain symptoms at least 6 months and medical visits primarily for LBP evaluation and treatment . METHODS Lumbar magnetic resonance imaging ( MRI ) , lumbar provocative discography ( in psychometrically normal subjects ) , physical examinations , medical and work histories and psychometric testing were performed at baseline . Imaging and psychometric testing were grade d by blinded examiners . A scripted interview was conducted every 6 months during follow-up by independent research assistants who also were blinded to patient baseline data . The interview covered interval medical , occupational and accident or injury histories . RESULTS Psychosocial variables strongly predicted both long- and short-term disability events , duration and health-care visits for LBP problems ( p<0.0001 - 0.004 ) . The likelihood of a sustained remission from the baseline persistent ( sub clinical ) LBP appeared to be linked to occupation factors ( leaving a heavy labor occupation ; p=0.0001 ) , neurophysiologic variables ( chronic nonlumbar pain ; p=0.0002 ) and psychometric profiles at baseline ( DRAM and FABQ-PA ; p=0.003 - 0.002 ) . Of the structural findings measured only moderate or severe Modic changes of the vertebral end plate were weakly associated with an adverse outcome . A positive provocative discogram at baseline did not predict any future adverse event . CONCLUSION The development of serious LBP disability in a cohort of subjects with both structural and psychosocial risk factors was strongly predicted by baseline psychosocial variables . Structural variables on both MRI and discography testing at baseline had only weak association with back pain episodes and no association with disability or future medical care To investigate the associations between psychosocial factors and the development of  chronic disabling low back pain ( LBP ) in Japanese workers . A 1 yr prospect i ve cohort of the Japan Epidemiological Research of Occupation-related Back Pain ( JOB ) study was used . The participants were office workers , nurses , sales/marketing personnel , and manufacturing engineers . Self-administered question naires were distributed twice : at baseline and 1 yr after baseline . The outcome of interest was the development of chronic disabling LBP during the 1 yr follow-up period . Incidence was calculated for the participants who experienced disabling LBP during the month prior to baseline . Logistic regression was used to assess risk factors for chronic disabling LBP . Of 5,310 participants responding at baseline ( response rate : 86.5 % ) , 3,811 completed the question naire at follow-up . Among 171 eligible participants who experienced disabling back pain during the month prior to baseline , 29 ( 17.0 % ) developed chronic disabling LBP during the follow-up period . Multivariate logistic regression analysis implied reward to work ( not feeling rewarded , OR : 3.62 , 95%CI : 1.17–11.19 ) , anxiety ( anxious , OR : 2.89 , 95%CI : 0.97–8.57 ) , and daily-life satisfaction ( not satisfied , ORs : 4.14 , 95%CI : 1.18–14.58 ) were significant . Psychosocial factors are key to the development of chronic disabling LBP in Japanese workers .  Psychosocial interventions may reduce the impact of LBP in the workplace This study aim ed to examine the 12-month incidence and risk factors for the onset and persistence of low back pain ( LBP ) in undergraduate students . A 1-year prospect i ve study was carried out among 684 healthy students in a large public university in Thail and . Data were collected using a self-administered question naire and a physical examination . Follow-up data were collected every 3 months . A total of 524 ( 77 % ) students were followed for 1 year . A total of 31 % reported a new onset of LBP , of whom 31 % reported persistent LBP . Having no low back support during computer work was a significant predictor for the onset and persistence of LBP . The onset of LBP was also associated with quadriceps muscle tightness . LBP is common among undergraduate students , and many of them may have persistent symptoms . Physical risk factor plays a significant role for the onset and persistence of LBP among the study population Background Most patients in the secondary care sector consulting for low back pain ( LBP ) seem to have a more or less constant course of pain during the ensuing year . Fewer patients with LBP in the primary care sector report continual pain over a one-year period . However , not much is known about the long-term course of LBP in the general population . A systematic critical literature review was undertaken in order to study the natural course of LBP over time in the general population . Methods A search of articles was performed in Pubmed , Cinahl and Psychinfo using the search terms ‘ epidemiology ’ ; ‘ low back pain ’ or ‘ back pain ’ ; ‘ prospect i ve study ’ or ‘ longitudinal study ’ ; ‘ follow-up ’ , ‘ natural course ’ , ‘ course ’ or ‘ natural history ’ ; ‘ general population ’ or ‘ working population ’ . Inclusion criteria were that one of the objectives was to study the course of (L)BP in the adult population , that the period of follow-up was at least 3 months , and that there were three points of observation or more . The review was undertaken by two independent review ers using three checklists relating to description of studies , quality and outcomes . The course of LBP was established in relation to those who , at baseline , were reported not to have LBP or to have LBP . Would this course be stable , fluctuating , worsening , or improving over time ? A synthesis of results in relation to common patterns was presented in a table and interpreted in a narrative form . Results Eight articles were included . Articles were different on time span , the number of surveys , and the definition of LBP . In six of the seven relevant studies , for those with no LBP at baseline , relatively substantial stable subgroups of people who continued to be LBP free were identified . In six of the seven relevant studies , definite stable subgroups of continued LBP were noted and improvement ( becoming pain free ) was never reported to be a common finding . Conclusion The status of LBP in individuals of the general population appears to be relatively stable over time , perhaps particularly so for those without LBP at baseline Objectives Prevention of occupational low back pain ( LBP ) in nurses is a research priority . Recent research suggests intervening before commencing nursing employment is ideal ; however , identification of modifiable risk factors is required . The objective of this study was to investigate modifiable personal characteristics that predicted new-onset LBP in nursing students . Methods This prospect i ve study was conducted on female nursing students ( n=117 ) without LBP at baseline to predict new-onset LBP ( an episode of significant LBP during the follow-up period ) . At the 12-month follow-up , participants with ( n=31 ) and without new-onset LBP ( n=76 ) were compared across baseline social or lifestyle , psychologic ( distress , back pain beliefs , coping strategies , and catastrophising ) , and physical ( spinal postures and spinal kinematics in functional tasks , leg and back muscle endurance , spinal repositioning error , and cardiovascular fitness ) characteristics . Results Participants response rate at follow-up was excellent ( 91 % ) . After controlling for earlier LBP , age , and BMI , regression analysis showed that modifiable social or lifestyle , psychologic and physical characteristics ( namely , smoking , increased physical activity , higher stress , reduced back muscle endurance , greater posterior pelvic rotation in slump sitting , and more accurate spinal repositioning in sitting ) were significant and independent predictors of new-onset LBP at follow-up . Inclusion of these factors in multivariate logistic regression analysis , with significant new-onset LBP as the outcome , result ed in a substantial model R2 of 0.45 . Discussion Modifiable personal characteristics across multiple domains are associated with new-onset LBP in female nursing students . These findings may have implication s for the development of prevention and management interventions for LBP in nurses RATIONALE Low back pain ( LBP ) remains a common and costly problem among the nursing profession . Several studies have indicated that LBP is attributed to mentally straining or dem and ing work , fatigue or exhaustion or general work satisfaction . AIMS This study aims to measure the magnitude of LBP among Hong Kong nurses and its association with the work-related psychological strain and patients h and ling activities . RESEARCH METHODS AND MEASURES : A cross-sectional study of Hong Kong hospital nurses was conducted . Three hundred and seventy-seven nurses were recruited from six district hospitals . They were registered nurses or enrolled nurses working full-time for at least 1 month in the current ward . One hundred and seventy-eight ( 47.2 % ) study subjects were r and omly selected from two district hospitals and 199 ( 52.8 % ) study nurses made up the convenience sample . Possible bias from psychological distress , socio-demographics and lifestyle factors was controlled for . Data were collected by face-to-face interviews . The data included work factors ( both psychological stress and patient h and ling activities related to work ) , demographics , psychological distress and lifestyle factors and the occurrence of LBP . RESULTS Of the 377 nurses interviewed , 153 ( 40.6 % ) reported having LBP within the last 12 months . With symptoms of LBP as the outcome , risks were increased where nurses self-reported that they only occasionally or never enjoyed their work [ adjusted odds ratio ( OR ) 2.07 ] , where frequent manual repositioning of patients on the bed was required ( adjusted OR 1.84 ) and where they were required to assist patients while walking ( adjusted OR 2.11 ) after adjustment for other potential confounders . CONCLUSION The results indicate that an association exists between work stress , manual lifting and LBP prevalence . The main route to prevention of LBP among nurses is likely to lie in improved ergonomics and psychological health in their work place . Good posture and correct transferring techniques in ward situations should be reinforced with h and s-on practice performed on nurses ' common types of clients BACKGROUND CONTEXT The available evidence regarding low back pain ( LBP ) incident episodes is not consistent . Such knowledge can add information for the potential contribution of preventive programs . PURPOSE a ) To evaluate annual incident episodes of LBP among the general population . b ) To evaluate the contribution of demographic , lifestyle , and back pain history to LBP incident episodes . STUDY DESIGN A community-based longitudinal study . PATIENT SAMPLE A r and omized sample of individuals , free of LBP at a previous cross-sectional survey . OUTCOME MEASURES Low back pain during the past year . METHODS Subjects were followed up after 1 year . Baseline data included back pain history , perception of general health , physical activity , smoking , work satisfaction , and demographic characteristics . RESULTS Annual incident episodes of LBP were 18.4 % . Those who experienced LBP during the past year had a lower baseline perception of general health and were less involved in sporting activities than those free of pain . Those without history of LBP were more likely to be free of back pain after 1 year . CONCLUSIONS The annual incident episodes of LBP are relatively high and relate indirectly to baseline perception of general health and to level of sporting activities . Those without history of LBP are more likely to be free of back pain after 1 year . These results raise the potential of LBP preventive programs for adult population Study Design Two-year , prospect i ve cohort data from the Japan epidemiological research of occupation-related back pain study in urban setting s were used for this analysis . Objective To examine the association between aggravated low back pain and psychosocial factors among Japanese workers with mild low back pain . Summary of Background Data Although psychosocial factors are strongly indicated as yellow flags of low back pain ( LBP ) leading to disability , the association between aggravated LBP and psychosocial factors has not been well assessed in Japanese workers . Methods At baseline , 5,310 participants responded to a self-administered question naire including questions about individual characteristics , ergonomic work dem and s , and work-related psychosocial factors ( response rate : 86.5 % ) , with 3,811 respondents completing the 1-year follow-up question naire . The target outcome was aggravation of mild LBP into persistent LBP during the follow-up period . Incidence was calculated for the participants with mild LBP during the past year at baseline . Logistic regression was used to explore risk factors associated with persistent LBP . Results Of 1,675 participants who had mild LBP during the preceding year , 43 ( 2.6 % ) developed persistent LBP during the follow-up year . Multivariate analyses adjusted for individual factors and an ergonomic factor found statistically significant or almost significant associations of the following psychosocial factors with persistent LBP : interpersonal stress at work [ adjusted odds ratio ( OR ) : 1.96 and 95 % confidence interval ( 95%CI ) : 1.00–3.82 ] , job satisfaction ( OR : 2.34 , 95%CI : 1.21–4.54 ) , depression ( OR : 1.92 , 95%CI : 1.00–3.69 ) , somatic symptoms ( OR : 2.78 , 95%CI : 1.44–5.40 ) , support from supervisors ( OR : 2.01 , 95%CI : 1.05–3.85 ) , previous sick-leave due to LBP ( OR : 1.94 , 95%CI : 0.98–3.86 ) and family history of LBP with disability ( OR : 1.98 , 95%CI : 1.04–3.78 ) . Conclusions Psychosocial factors are important risk factors for persistent LBP in urban Japanese workers . It may be necessary to take psychosocial factors into account , along with physical work dem and s , to reduce LBP related disability Aims : To assess dose-response relations between occupational exposures to physical and psychosocial factors and the risk of  low back pain .  Methods : A cohort of 523 subjects , working in nursing homes and homes for the elderly , was followed prospect ively for one year . Physical load for different occupations was assessed by quantitative observations at the workplace . Information on low back pain and other factors was gathered with question naires administered at baseline and at one year . Two outcome measures of low back pain incidence were used : any new episode of pain lasting for at least a few hours during follow up ( LBP ) ; and any new episode of disabling pain that interfered with daily activities during follow up ( LBP/D ) . Hierarchical regression analysis with a spline function was used to estimate dose-response relations . Results : The risk of LBP was not associated with physical factors , controlling for confounders ; but this outcome was inversely associated with age and weakly , though imprecisely , associated with two psychosocial factors — low decision authority and high work dem and s. In contrast , the risk of LBP/D was positively associated with age and not associated with the psychosocial factors . Trunk flexion over 45 degrees was monotonically associated with the risk of LBP/D ; the estimated relative risk was 3.18 ( 95 % CI 1.13 to 9.00 ) for 1 hour and 45 minutes of bending per week ( 90th centile ) , relative to 30 minutes per week . The hierarchical estimates of effect were more stable than were the maximum likelihood estimates . Conclusion : Occupational exposure to trunk flexion over 45 degrees appears to be a risk factor for low back pain with disability among persons employed in nursing homes and homes for the elderly in the Netherl and Background Variability between clinical practice guideline recommendations and actual clinical practice exists in many areas of health care . A 2004 systematic review examining the effectiveness of guideline implementation interventions concluded there was a lack of evidence to support decisions about effective interventions to promote the uptake of guidelines . Further , the review recommended the use of theory in the development of implementation interventions . A clinical practice guideline for the management of acute low-back pain has been developed in Australia ( 2003 ) . Acute low-back pain is a common condition , has a high burden , and there is some indication of an evidence - practice gap in the allied health setting . This provides an opportunity to develop and test a theory-based implementation intervention which , if effective , may provide benefits for patients with this condition . Aims This study aims to estimate the effectiveness of a theory-based intervention  to increase allied health practitioners ' ( physiotherapists and chiropractors in Victoria , Australia ) compliance with a clinical practice guideline for acute non-specific low back pain ( LBP ) , compared with providing practitioners with a printed copy of the guideline . Specifically , our primary objectives are to establish if the intervention is effective in reducing the percentage of acute non-specific LBP patients who are either referred for or receive an x-ray  , and improving mean level of disability for patients three months post-onset of acute LBP . Methods The design of the study is a cluster r and omised trial . Restricted r and omisation was used to r and omise 210 practice s ( clusters ) to an intervention or control group . Practitioners in the control group received a printed copy of the guideline . Practitioners in the intervention group received a theory-based intervention developed to address prospect ively identified barriers to practitioner compliance with the guideline . The intervention primarily consisted of an educational symposium .  Patients aged 18 years or older who visit a participating practitioner for acute non-specific LBP of less than three months duration over a two-week data collection period , three months post the intervention symposia , are eligible for inclusion . Sample size calculations are based on recruiting between 15 to 40 patients per practice . Outcome assessors will be blinded to group allocation . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12609001022257 ( date registered 25th November 2009 Objective : Quantify the relationship between physical activity and development of  incident low back pain ( LBP ) .  Methods : This nested prospect i ve cohort study utilized an objective measure of physical activity in 68 participants with 30 incident cases of LBP .  Physical activity was divided into tertiles and quartiles . Univariate and multivariate relative risks and hazard ratios were calculated . Results : Comparing highest to middle tertile of light activity demonstrated a statistically significant relative risk of 3.68 for developing incident LBP . Lowest and highest tertile of minutes of moderate/vigorous activity yielded statistically significant relative risks of 4.60 and 6.14 , respectively . Multivariate analyses demonstrated similar associations . Conclusions : Moderate amounts of physical activity were protective for the development of LBP  in this cohort , after adjustment for risk factors . This nonlinear relationship suggests higher levels of activity do not confer increased LBP prevention Background The Spanish National Health Service is a universal and free health care system . Non-specific low back pain ( LBP ) is a prevalent disorder , generating large health and social costs . The objectives of this study were to describe its management in primary care , to assess patient characteristics that influence physicians ' decisions , and to describe clinical outcome at 2 months . Methods A cross-sectional sample of 648 patients with non-specific low back pain was recruited by 75 physicians ( out of 361 – 20.8 % ) working in 40 primary care centers in 10 of the 17 administrative regions in Spain , covering 693,026 out of the 40,499,792 inhabitants . Patients were assessed on the day they were recruited , and prospect ively followed-up 14 and 60 days later . The principal patient characteristics that were analyzed were : sex , duration of the episode , history of LBP , working status , severity of LBP , leg pain and disability , and results of straight leg raising test . Descriptors of management were : performance of the straight leg raising test , ordering of diagnostic procedures , prescription of drug treatment , referral to physical therapy , rehabilitation or surgery , and granting of sick leave . Regression analysis was used to analyze the relationship between patients ' baseline characteristics and physicians ' management decisions . Only workers were included in the models on sick leave . Results Mean age ( SD ) of included patients was 46.5 ( 15.5 ) years , 367 ( 56.6 % ) were workers , and 338 ( 52.5 % ) were females . Median ( 25th–75th interquartile range ) duration of pain when entering the study was 4 ( 2–10 ) days and only 28 patients ( 4.3 % ) had chronic low back pain . Diagnostic studies included plain radiographs in 43.1 % of patients and CT or MRI scans in 18.8 % . Drug medication was prescribed to 91.7 % of patients , 19.1 % were sent to physical therapy or rehabilitation , and 9.6 % were referred to surgery . The main determinants of the clinical management were duration of the episode and , to a lesser extent , the intensity of the pain ( especially leg pain ) , a positive straight leg raising test , and degree of disability . The main determinant of sick leave was the degree of disability , followed by the characteristics of the labor contract and the intensity of leg pain ( but not low back pain ) . After at least 2 months of treatment , 37 % of patients were still in pain and approximately 10 % of patients had not improved or had worsened . Conclusion Although the use of X-Rays is high , determinants of physicians ' management of LBP in primary care made clinical sense and were consistent with patterns suggested by evidence -based recommendations . However , after 2 months of treatment more than one third of patients continued to have back pain and about 10 % had worsened BACKGROUND CONTEXT Low back pain ( LBP ) is a major public health problem , with a considerable impact on workers . PURPOSE To model the risk of LBP in the male general working population . STUDY DESIGN / SETTING Repeated cross-sectional surveys in a wide occupational setting . PATIENT SAMPLE A r and om sample of 2,161 men working in various occupations in a French region participated in a first survey in 2002 , and 1,313 of these ( 60.8 % ) participated in a second survey in 2007 . OUTCOME MEASURE The self-reported prevalence of LBP during the previous week in the second survey . METHODS Twenty-one biomechanical , organizational , psychosocial , and individual factors were assessed in the first survey . The association between these potential risk factors and the prevalence of later LBP ( in the second survey ) was studied , using multistep logistic regression models . RESULTS Three hundred ninety-four men reported LBP in the second survey ( prevalence 30.0 % ) . The final multivariate model highlighted four risk factors : frequent bending ( odds ratio [ OR ] , 1.45 , 95 % confidence interval [ CI ] , 1.07 - 1.97 for bending forward only ; and OR , 2.13 , 95 % CI , 1.52 - 3.00 for bending both forward and sideways ) , driving industrial vehicles ( OR , 1.35 ; 95 % CI , 1.00 - 1.81 ) , working more hours than officially planned ( OR , 1.38 ; 95 % CI , 1.05 - 1.81 ) , and reported low support from supervisors ( OR , 1.35 ; 95 % CI , 1.02 - 1.79 ) . CONCLUSIONS These results emphasize that biomechanical factors remain worth considering , even when psychosocial factors are taken into account , and provide a significant contribution to preventive strategies Study Design . This is a 3-year prospect i ve study of juvenile low back pain ( LBP ) . Objectives . To investigate persistence and change in LBP . Summary of Background Data . Earlier episodes of LBP are a strong risk factor for LBP in adults , while the persistence of LBP through adolescence is not known . Methods . The material comprised all pupils in eighth and ninth grade s ( N = 105 , mean age 14.7 years ) , living within two geographic areas in Eastern Norway in January 1997 . The analyses included 88 adolescents at baseline , and 85 at follow-up . The question naire , which identified LBP as pain or ache in the low back during the preceding year , was answered at baseline in the classroom and at follow-up by post . Results . LBP was reported by 58 % at baseline and by 39 % at follow-up , and LBP provoked by manual work by 40 % at baseline and 26 % at follow-up . Thirty-one percent reported LBP at both occasions . LBP more than 7 days was reported by 32 % at baseline , by 26 % at follow-up , and by 18 % at both occasions . Twenty-two percent of those reporting LBP at baseline rejected ever LBP at follow-up . Baseline reports of LBP predicted corresponding reports of LBP at follow-up : Odds ratio was 4.7 ( 95 % confidence interval 1.7–12.7 ) for LBP generally , 9.1 ( 3.0–27.2 ) for LBP more than 7 days , 9.2 ( 2.9–28.8 ) for LBP provoked by manual work , and 3.8 ( 1.3–11.3 ) for LBP provoked by sitting at school . Conclusion . The findings indicate a persistent , but changeable , trend in LBP from midadolescence until late adolescence . The consistency and the high rates of reports of LBP provoked by manual work and sitting imply needs for more research on the persistence of LBP , and on relevant interventions during school age
Overall studies showed that nursing activities conferred increased risk for , and were associated with back disorders regardless of nursing technique , personal characteristics , and non-work-related factors .
Patient h and ling appears to confer the highest risk , but other nursing duties are also associated with elevated risk , and confound dose – response assessment s related to patient h and ling alone .
A threshold of nursing activities below which the risk of back disorders is not elevated has not been established .
Abstract Background : Although non-specific low back pain ( LBP ) is known to be multifactorial , studies from across the globe have documented their higher prevalence in nurses .
This systematic review was conducted to ascertain whether this much-documented association constitutes a causal relationship , and whether there is a discernible threshold of exposures associated with this elevated risk .