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The high incidences of back pain among nurses are well documented. Dozens of books, studies and articles exist on the subject.
According to the U.S. Department of Labor Bureau of Labor Statistics, nurses and other medical attendants accounted for roughly 20 percent of all days away from work in 2006, mainly as a result of sprains and strains to the torso muscles.1
A study by the University of Alberta's Faculty of Rehabilitation Medicine found 65 percent of orthopedic nurses and 58 percent of ICU nurses develop debilitating low back pain at some point in their careers.2 "Nurses suffer from work-related low back pain more often than workers in other professions," stated the study's lead author.
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| Lisa Armstrong, RN, an operating room nurse at Tufts Medical Center, Boston, strengthens and adds flexibility to her lower back using a lumbar exercise machine with pelvic restraint. photo courtesy Back2Health: Spinal Fitness |
Due to the nature of the job, it seems most nurses have resigned themselves to living with some level of discomfort. Those who refuse to accept this malady as permanent often try various methods to reduce pain and increase quality of life. The majority of those methods offer varying degrees of relief, but none of them attack the problem from where it stems.
Incomplete Approaches
The inclusion of patient lifts within "zero-lift" hospital policies would be a great aid to nursing in general, and the issue of back pain in nurses specifically. However, this policy is currently used in few hospitals (roughly 5 percent as of 2007), and, very importantly, the use of these lifts will not aid those already injured.3 So while it would be a mistake to call the use of these lifts "ineffective," it is not a stretch to call them an "incomplete" solution.
Additionally, lower back problems do not only result from a sudden impact possible during a patient lift, but also from the repetitive nature of the job with regard to standing, bending, and holding certain positions during a shift, and the totality of such within a week, a month and a career. The typical ergonomic recommendations are quickly forgotten during a moment of crisis, and are hard to maintain during a long shift.
In attempts to relieve discomfort and improve functional ability (which includes vocational activities), nurses may choose from many methods.
If staying within the traditional medical establishment, a doctor's visit will frequently lead to physical therapy. However, this "therapy" usually consists of a series of stretches and/or easy exercise with ineffective tools. For reasons discussed below, most do not receive benefit equal to time committed.
For those moving outside of the traditional medical establishment, to "alternative" methods, various options exist. Chiropractic, acupuncture/acupressure, Pilates, yoga. all of these seem to have "some" merit depending on whom one speaks with (i.e., most people know someone who swears by one of these methods).
However, none deal with the problem at its core.
Core of the Problem
In the cases where both the traditional and alternative methods "help," it is mostly likely the result of the injured area returning to normal on its own.
Roughly 80 percent of lower back injuries heal naturally within the first 2-3 months following injury. Of the remaining 20 percent, something else is needed.4
Nurses, due to the chronic nature of lower back pathology across the board, would typically fall into this 20 percent.
The reason the lower back is so susceptible to injury, both in nursing and in the general population, is the muscles that support the lumbar spine are extremely weak. Were these muscles extremely strong, the likelihood of injury or general discomfort would be minimal.
However, sometimes the simplest solutions are the least likely to be arrived at, and this is the case with lower back problems.
The reason for this weakness is overuse. Every action the human body makes relies on the activation of the spinal muscles to maintain posture and efficiency of movement. Consider how often one adjusts one's positioning while sitting at a desk, or while standing for an extended period of time - the muscles of the lumbar spine are working non-stop.
And while this work is far from challenging, since the spinal muscles are typically comprised of predominately fast-twitch (and fast-to-fatigue) fibers, everyday activity results in overuse. In fact, spinal muscles begin to atrophy early, at around age 20.5
Regardless of diagnosis, the issue stems from weak lumbar musculature. The chance of disc slippage, rupture, degeneration, etc., would be limited if the support system for the spine were strong enough to withstand most of the strain placed upon it.
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