Systematic review: occupational physical activity and low back pain
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND: Although various occupational physical activities are suspected of contributing to low back pain (LBP), causal relationships have not been confirmed, complicating adjudication of work injuries, return to work instructions and preventive efforts.
AIMS: To summarize eight systematic review (SR) reports that examined evidence supporting causal relationships between bending/twisting, awkward postures, sitting, standing/walking, carrying, pushing/pulling, lifting and manual handling/assisting patients and LBP.
METHODS: A literature search was conducted to identify eligible studies. Methodological quality was assessed using a modified Newcastle-Ottawa Scale (NOS). Levels of evidence supporting factors for causation were examined using a Bradford Hill framework. Results were presented in eight SR reports, each focused on one or more related physical activities. This study summarizes findings from those reports and offers clinicians an overview.
RESULTS: Collectively, the eight SR reports included 99 studies. None found strong evidence supporting a causal relationship between any occupational physical activity considered and LBP. Conflicting evidence was found between LBP and bending, twisting, lifting or pushing/pulling, but only for statistical association, not causation. Strong evidence against a causal relationship was found between LBP and manual handling/assisting patients, awkward postures, carrying, sitting, standing or walking.
CONCLUSIONS: Although occupational physical activities are suspected of causing LBP, findings from the eight SR reports did not support this hypothesis. This may be related to insufficient or poor quality scientific literature, as well as the difficulty of establishing causation of LBP. These population-level findings do not preclude the possibility that individuals may attribute their LBP to specific occupational physical activities.
related content
- “Dose-response relationship between work-related cumulative postural exposure and low back pain: a systematic review,” Daniel Cury Ribeiro, Daniela Aldabe, J Haxby Abbott, Gisela Sole, and Stephan Milosavljevic, Ann Occup Hyg, 2012.
- “Causal assessment of occupational lifting and low back pain: results of a systematic review,” Eugene K Wai, Darren M Roffey, Paul Bishop, Brian K Kwon, and Simon Dagenais, Spine J, 2010.
- “Effect of training and lifting equipment for preventing back pain in lifting and handling: systematic review,” KP Martimo, J Verbeek, J Karppinen, AD Furlan, EP Takala, PP Kuijer, M Jauhiainen, and E Viikari-Juntura, British Medical Journal, 2008.
- “Epidemiologic evidence on manual materials handling as a risk factor for back disorders: a systematic review,” Judith I Kuiper, Alex, Burdorfb, and Jos Verbeek, International Journal of Industrial Ergonomics, 1999.
These two articles on PainScience.com cite Kwon 2011 as a source:
- PS Save Yourself from Low Back Pain! — Low back pain myths debunked and all your treatment options reviewed
- PS Don’t Worry About Lifting Technique — The importance of “lift with your legs, not your back” to prevent back pain has been exaggerated
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
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