Four out of five adults experience significant low back pain sometime during their lifetime. It is considered one of the most costly health problems affecting industry and society. Back injuries are estimated to account for almost 20 percent of all injuries and illnesses in the workplace. Widely used strategies to prevent low back pain include fitness exercises, education on back mechanics and lifting techniques, and lumbar supports (typically, a lightweight, elastic belt worn around the lower back to provide additional support). However, the effectiveness of these measures is still unknown.

It is no wonder that researchers are trying to find effective ways to prevent recurrent low back pain, according to an article in the June 9, 1998, issue of The Journal of the American Medical Association (page 1789). Researchers in the Netherlands studying airline cargo workers confirmed that prevention education programs that attempt to reduce recurring low back pain often are not successful. The study showed no significant differences in back pain occurrence or in sick leave among those who received lifting instructions and lumbar supports to wear while lifting heavy objects at work, those who received lifting instructions only, those who received lumbar supports only, and those who received nothing.

Part of the reason for these results may be the challenge in getting participants to comply with wearing the lumbar supports (only 43 percent compliance in this study) or to use the proper lifting techniques at all times, note the researchers. The study did not evaluate the use of lumbar supports for treating pain.

Low back pain can be caused by a number of factors, including injuries and the effects of aging. Most cases of low back pain are not considered serious and should respond to simple treatment by your doctor. Consult your doctor for a specific diagnosis.

Preventing Low Back Pain:

• Exercise regularly to keep back muscles strong and flexible
• Use the correct lifting techniques (lift all objects close to your body and avoid twisting, bending forward, or reaching while lifting)
• Maintain proper body weight and avoid smoking
• Maintain proper posture when standing or sitting

When Should You See a Doctor?

• Your symptoms are severe and don’t go away after a few days
• The pain is keeping you from doing everyday activities
• You have problems controlling your bowel or bladder
• You feel numb in the groin or rectal area
• You have leg weakness or numbness

Proven Treatment Options:

• Medication
• For mild to moderate symptoms, over-the-counter painkillers, such as acetaminophen, aspirin, or ibuprofen, may be all that is needed. For more severe symptoms, your doctor may recommend prescription medication.
• Heat or cold applied to the back
• Within the first 48 hours of symptoms, you may want to use a cold pack (or a bag of ice) for five to 10 minutes at a time. For symptoms lasting longer than 48 hours, you may want to try a heating pad or a hot shower or bath to relieve symptoms.
• Spinal manipulation. This treatment should only be done by a professional and may be helpful for some people in the first month of symptoms.

When Do You Need Surgery?

Most low back pain often can be treated without surgery. The most common reason for surgery is to remove pressure from a slipped disk, which causes nerve and leg pain.

For More Information:

• American Academy of Orthopaedic Surgeons
  (800) 824-BONES
  http://www.aaos.org/SASE (business size) envelope to:

  Low Back Pain
  American Academy of Orthopaedic Surgeons
  P.O. Box 2058
  Des Plaines, IL 60017

• Agency for Health Care Policy and Research
  (800) 358-9295
  (888) 586-6340 (TTY)
  http://www.ahcpr.gov/
• National Institute of Occupational Health and Safety
  (800) 356-4674 or
  http://www.cdc.gov/niosh/homepage.html

Additional Sources: Occupational Safety and Health Administration, National Institute for Occupational Safety and Health, Agency for Health Care Policy and Research, American Academy of Orthopaedic Surgeons

Mi Young Hwang, Writer
Richard M. Glass, M.D., Editor
Jeff Molter, Director of Science News

(JAMA. 1998; 279:1846)

Published in JAMA: June 10, 1998

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