Journal of Safety Research

Journal of Safety Research

Volume 66, September 2018, Pages 39-59
Journal of Safety Research

Occupational interventions for the prevention of back pain: Overview of systematic reviews

https://doi.org/10.1016/j.jsr.2018.05.007Get rights and content
Under a Creative Commons license
open access

Highlights

  • Low back pain is prevalent worldwide.

  • Occupational factors may predispose workers to low back pain.

  • Various workplace interventions have been utilized to prevent the occurrence of low back pain.

  • Exercise interventions alone or in combination with educational interventions are effective in the prevention of LBP.

Abstract

Introduction

We conducted an overview of systematic reviews of interventions for the prevention of low back pain (LBP) that can be conducted in a workplace setting.

Methods

An electronic literature search was performed in Medline, EMBASE, and the Cochrane Library. Published peer-reviewed systematic reviews and meta-analyses, which described interventions for the primary or secondary prevention of LBP applicable to a workplace setting, were eligible for inclusion. The methodological quality of the included systematic reviews was assessed with the AMSTAR tool. The primary outcome of interest was the incidence of LBP; secondary outcomes were LBP-associated absenteeism, activity interference, and costs related to LBP.

Results

Twenty-eight eligible articles published between 1994 and 2016 were included in a qualitative synthesis following our screening of abstracts and full-text articles. The AMSTAR rating revealed 14 reviews of high, 10 of moderate, and 4 of low methodological quality. The identified interventions included workplace modifications (6 reviews, 10 studies, 6,751 subjects); shoe insoles (4 reviews, 6 studies, 2,356 subjects); and lumbar supports and other assistive devices (15 reviews, 18 studies, 60,678 subjects). Educational interventions investigated were back schools (10 reviews, 30 studies, 9,973 subjects); manual material handling techniques/advice (6 reviews, 24 studies, 10,505 subjects); and other forms of instruction including pamphlets, booklets, and other media (four reviews, 14 studies, 11,991 subjects). Exercise interventions, investigated in 12 reviews (35 studies, 19,330 subjects), showed moderate quality evidence of effectiveness for exercise interventions alone or in conjunction with educational interventions; no other type of intervention was consistently effective in the prevention of LBP or LBP-associated outcomes of interest.

Conclusions

Our overview provides evidence of effectiveness for exercise with or without educational interventions in the prevention of LBP.

Practical applications

Exercise interventions with or without educational interventions that can be applied in the workplace have the potential to prevent LBP.

Keywords

Back pain
Prevention
Workplace setting
Exercise
Education

Cited by (0)

Daniel Sowah (PhD, MSc) holds a PhD in Physiology with a specialization in Cell and Molecular Physiology from the University of Alberta. Daniel's research experience encompasses cardiovascular physiology and pharmacology, cellular and molecular signaling, molecular biology, and systematic reviews. Daniel currently works as a postdoctoral fellow at the Division of Preventive Medicine, Department of Medicine, University of Alberta.

Robert Boyko (BSc, MBA) graduated from the University of Alberta, with a Bachelor of Science degree in Computing Science and most recently completed an MBA at the University of Alberta. He has worked in the Department of Biochemistry (Protein Structure and Function Group) for over 25 years as a programmer-analyst. He recently joined the Division of Preventive Medicine, Department of Medicine, University of Alberta, as a Research Assistant.

David Antle (PhD, MSc, BSc) holds a PhD in Kinesiology from McGill University and a Master's of Science in Kinesiology from Memorial University, specializing in occupational biomechanics and ergonomics. David's research interests relate to prevention of work-related musculoskeletal disorders, identification of biological markers that relate to work-related injury, and review of knowledge translation and exchange systems to improve workplace injury prevention. David is an associate researcher with EWI Works International Inc. in Edmonton, Alberta, Canada, and has worked as a certified professional ergonomist in many industrial settings. Currently, David is enrolled in the Doctor of Medicine program at the University of Alberta.

Linda Miller (OTD, OT(c), MSc) is a certified Ergonomist and Occupational Therapist at EWI Works International Inc. for the past 25 years. She works extensively in injury prevention in the workplace. Industry experience ranges from mining to manufacturing environments focusing on ergonomic program development and education and training. She received her undergraduate degree in Occupational Therapy from the University of Alberta, Masters in Environmental Design from the University of Calgary and a Doctor of Occupational Therapy from Boston University. She is an Adjunct Professor in the Faculty of Rehabilitation Medicine at the University of Alberta. She is also a member of the Editorial Board of WORK: A Journal of Prevention, Assessment, and Rehabilitation.

Michael Zakhary (MD, MPH) graduated from the Faculty of Medicine, University of Alexandria, Egypt with distinction, and earned a Master's degree in Public Health from the High Institute of Public Health at the same University. He worked as a general practitioner and a Public Health specialist until he moved to Canada. He then joined the Public Health and Preventive Medicine residency program at the University of Alberta in 2015. Dr. Zakhary is currently in his second year of residency training, and is doing a Master's degree in Public Health focusing on Health Policy and Management at the School of Public Health, University of Alberta.

Sebastian Straube (BM BCh, MA (Oxon), DPhil) holds degrees in Medicine and Physiological Sciences from the University of Oxford (England) where he also did his DPhil (PhD). After clinical work and research at the Oxford Radcliffe Hospitals, Dr. Straube joined the Institute of Occupational, Social and Environmental Medicine at the University Medical Center Göttingen, Germany. Here he completed his Habilitation (German postdoctoral qualification) and his postgraduate medical training in the specialties of Occupational Medicine and Social Medicine. Dr. Straube was an Extraordinary Professor at the University of Göttingen until he took up his current post as Associate Professor in the Division of Preventive Medicine of the University of Alberta, Canada, in 2014. He was appointed as Division Director for Preventive Medicine in 2016. Dr. Straube's primary research interest is in evidence-based medicine (systematic reviews and meta-analyses).