Whether from heaving, twisting, bending, or bad lifting postures, it’s well known that caring for the sick or elderly can lead to back pain, which often results in time off work or dropping out of caring professions altogether, says a new study. Danish research published in the online open access journal BMC Musculoskeletal Disorders suggests that the fear of getting back pain from care work is predictive of actually developing it.
Among health care workers, studies have found lower back pain (LBP) rates during a 12-month period of 45% to 63% compared with 40% to 50% in the general population. Rather than avoiding physical activity, medical guidelines based on LBP research recommend staying active and continuing normal daily life, including going to work.
Jette Nygaard Jensen and colleagues from the National Research Centre for the Working Environment, Copenhagen, Denmark, set out to investigate the association between physical work load and LBP, and whether fear-avoidance beliefs had a predictive effect on developing LBP. Fear-avoidance beliefs involve avoiding physical activities that are expected to cause pain, although ironically these beliefs are often associated with developing chronic pain.
Some 2,677 female health care workers were given questionnaires that measured fear-avoidance beliefs about work and fear-avoidance beliefs about physical activity. The researchers found that the picture differed among those who had already suffered from LBP versus those who had not.
For those who had a previous history of LBP, both workload and fear-avoidance beliefs played a part in new episodes of LBP. In general, a greater workload was associated with more LBP, and workload had a greater role to play than fear-avoidance beliefs.
For those without an LBP history, workload was not a significant factor in developing LBP during the study, but fear-avoidance beliefs were. For both groups, fear-avoidance beliefs could be used to predict LBP—this included fears that both work and physical activity would lead to pain. Specifically, both types of fear-avoidance belief were prospectively associated with a higher number of days with LBP (30 days or more).
"From a treatment perspective, focusing on changing fear-avoidance beliefs among those with more or less chronic LBP may be beneficial," said Jensen. "Health care professionals may benefit from additional education or information about how to cope with acute or chronic LBP. Particularly information about the potentially harmful effect of avoidance-behaviour could be useful."
The predictive effect of fear-avoidance beliefs on low back pain among newly qualified health care workers with and without previous low back pain: a prospective cohort study
Jette Nygaard Jensen, Karen Albertsen, Vilhelm Borg, and Kirsten Nabe-Nielsen
BMC Musculoskeletal Disorders (in press)
BMC Musculoskeletal Disorders is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis, and management of musculoskeletal and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology. BMC Musculoskeletal Disorders (ISSN 1471-2474) is indexed/tracked/covered by PubMed, MEDLINE, CAS, Scopus, EMBASE, Current Contents, Thomson Reuters (ISI), and Google Scholar.
BioMed Central is an STM (science, technology, and medicine) publisher. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Science+Business Media.
[Source: BioMed Central, via Eureka Alert]