Low Back Pain in the Nursing Field

Back disorders are one of the chief causes of disability within the working population. They can occur gradually or from one single event. Over time, repetitive activity can result in microtrauma to the tissues; the onset is so slow that the condition often is ignored until the damage becomes debilitating. Microtrauma is likely to have weakened the back when a single event causes a back disorder as well. Injury to the back includes muscles, ligaments, vertebrae, discs, and combinations thereof. Reading the OSHA Technical Manual on back disorders and injuries, one finds a list of about 15 work factors associated with back injury. Considering the economic burden as well as human suffering experienced in a back injury, as well as the most common, they can be the most devastating. One career field that consistently leads in back injury and also occupational injuries and illnesses is nursing.

Nursing aids, orderlies, and attendants are exposed to most of the 15 work factors associated with back injury. While many of their job tasks like making beds, handling carts, and a multitude of other duties do contribute to their risk, lifting and transferring patients is the most likely element of the job to cause injury. The leading cause for all work-related injury and illness is overexertion - a very likely result for anyone who is lifting and pushing hundreds of pounds at a time. Over half of nurses complain of low back pain, and many end up leaving the field, transferring units, and missing work because of it.

Studying the various effects of the spine and causes of back pain would include volumes of literature, but there are a few basics to note. It is suspected that the intervertebral disc is the primary source of most low back pain in nurses. Disc degeneration and cumulative trauma are common in those who lift and bend for a living. Inside the vertebral endplate, microfractures are sustained and the resulting scar tissue weakens the structure making the spine more vulnerable to injury. These microfractures could easily be sustained not only from lifting patients, but also from pushing them in wheelchairs and frequent bending and twisting of the spine all day every day.

Given the nature of the job and the need for nurses, extensive research on how to help minimize risk is ongoing. There is a great focus in nursing education on patient handling safety. Manual aids to help lift patients are also evolving and, in certain cases, required to be in place for the safety of the staff. Even manual aids to make other aspects of the job more ergonomically friendly will help keep the spine as healthy as possible. Nurses are in a unique position when it comes to following ergonomic guidelines. Many solutions involve frequent breaks and rotations in job tasks. Nurses need to be able to do whatever is needed when it is needed. The development of tools to relieve some of the stress of their jobs is very important. It helps not only the nurses, but everyone who has ever needed health care.