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Causes for Low Back Pain Among Nurses

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Nurses are considered to be the most crucial component in the delivery of primary care within any public or private healthcare setting. Throughout this environment, regardless of the availability of several types of lifting equipment, the nurseā€™s role will generally include manually lifting or assisting in movement of patients as a major portion of regular healthcare activities, such as bed to chair transfer, toileting, or mobilizing.

However, the nurseā€™s constant participation in these type of tasks frequently leads to a considerable increase of back complications, back injury, or back pain in comparison with other occupational groups. In fact, nurses and other healthcare workers are considered to show the highest prevalence of lower back pain and back problems needing medical or hospital intervention among the high risk groups for occupational low back pain. Registered nurses rank seventh while nursing aides and orderlies are the highest ranked among all occupations for back injuries associated with work absences.

A study conducted in an acute care facility in Hong Kong to determine the occurrence of back pain in nurses reported that 80.9% of the participating individuals suffered from some form of back pain throughout their careers with one third of them experiencing back pain at least once a month. The study also concluded that the contributing factors for back injuries among those nurses were caused from lifting and transferring patients, where stooping was recognized at the most common factor contributing to back complications. Most diagnosed cases of back pain were reported on orthopedic wards, closely followed by elderly or geriatric nursing. According to the study, back pain as a result of standing for extended periods of time was not considered significant.

Another study conducted to determine the impact of back pain in nurses concluded that depression is associated with chronic low back pain and other symptoms which could exhibit as low morale and lower job performance among nurses. Additionally, the study also showed that two thirds of the nurse sample population suffered from back pain more than twice a year.

The physical size, build, and gender of the nurse were considered to be contributing factors to the occurrence of back complications in the study, especially where lifting assistance, either mechanical or by support staff, was not needed. Other determined factors that could possibly lead to an increased risk of developing back complications in nurses included, exposure to great amounts of physical loading on the back from lifting tasks, poor posture or abnormal twisting of the torso during mobilization tasks, improper lifting techniques, insufficient back pain prevention training or education, and physiological characteristics or psychosocial factors in nurses. The results of one cross sectional study while evaluating back complications in nurses demonstrated statistically that back pain was twice as high in female nurses (68%), than in male nurses.

Nursing qualifications are ultimately essential in healthcare settings where nursing assistants have shown a heightened risk of developing back pain as compared to registered nurses. Evidence indicates that experience or length of service in nursing may also be a contributing factor, with studies concluding that younger nurses are at greatest risk of developing low back pain. Although lumbar back pain in nurses is frequently diagnosed, it is not yet clear over what period a nurse may experience lower back complications. A study conducted in Western Australia sought to identify the relationship between age and occupational exposure on the prevalence of low back pain in both nursing students and graduates.

Ultimately, the study demonstrated that the increase in the occupational exposure from student to working nurse was the primary cause of the heightened chance for nurses developing low back complications.

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Nurses are considered to be the most crucial component in the delivery of primary care within any public or private healthcare setting. Throughout this environment, regardless of the availability of several types of lifting equipment, the nurseā€™s role will generally include manually lifting or assisting in movement of patients as a major portion of regular healthcare activities. As a result of the demanding tasks of the job, many nurses often experience low back pain and other symptoms. For more information, please feel free to ask Dr. Jimenez or contact us at (915) 850-0900.

By Dr. Alex Jimenez

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Dr. Alex Jimenez DC, MSACP, CIFM*, IFMCP*, ATN*, CCST
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