Nurses and Back Pain

June 18th, 2012

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By , BSN, RN

For the past couple of months I have been meeting with a physical therapist twice a week to work on my core strength. This is because, like so many nurses out there, I have injured my back. See if this sounds familiar.

One Saturday morning I was drying my hair to go out and I thought, “huh, my back feels a little funny.” I finished my hair, thought I would lie down on the bed for a minute and Dang! I was immobile and in pain. Apparently, I now know, I was having a muscle spasm.

It passed, I felt kind of weak but went about my day as best I could. I did some stretching over the next few days, took a lot of ibuprofen and while I was mobile I was hurting. About five days later I gave in and called my doctor.

Now, my regular primary care doc wasn’t available but one of his partners was. When she came in the exam room I told her my story and she just sat there shaking her head. Finally, she says, eyes rolling, “I know your kind.” I’m thinking great, here it comes, you’re getting older, you’re overweight, you’re out of shape—then she says the last thing I expect. With a sigh and huff, she looks at me and says—wait for it—“NURSES!’

That’s right ladies and gentlemen, it is us, the nurse and the nurses aides—we are in the top 10 for back injuries, aches, and other problems.

The Statistics

According to the National Institute of Occupational Safety and Health (NIOSH), more than 24 percent of all work related injuries and illnesses involving missing days at work are due to back problems. In fact, healthcare workers have 4.5 times as many back overexertion injuries than any other type of worker. That’s right, more than mail personnel, more than sanitation workers, more than construction workers, and most of those healthcare people cited—nurses.

According to Premier, a performance improvement alliance of more than 2,600 U.S. hospitals and 84,000-plus other healthcare sites, national statistics show “six of the top 10 professions at greatest risk for back injury are: nurse's aides, licensed practical nurses, registered nurses, health aides, radiology technicians, and physical therapists. Greater than one third of back injuries among nurses are attributed to handling patients and the frequency with which they are required to manually move patients. From a worldwide perspective, back injuries to nurses have point prevalence of approximately 17 percent, an annual prevalence of 40-50 percent and a lifetime prevalence of 35-80 percent.”

These are just the reported incidents. And yes, you did read that right, it is a world-wide problem. I have read studies from Greece, China, and Denmark about nurses and back trouble, and that’s just to name a few.

About 80 percent of the back injuries are short in duration and nurses and everyone else return to normal functioning. For some the pain is long-term, and for a small percentage it lasts a lifetime. This is significant in its impact on the individual and their income and independence and significant to healthcare because an already overburdened system is losing care givers.

As our nursing workforce ages (average age 46.8 years) and we face a critical nursing shortage in this country (an expected 20% shortage by 2015 and 30% by 2020), preserving the health of our nursing staff and reducing back injuries in healthcare personnel is critical.

Causes of Back Injuries

There are a variety of causes at play when you talk about back injuries and nurses. Researchers tend to break those causes into two umbrella groups:

  • Organizational causes – While working there are wide number of factors affecting back injuries among healthcare personnel. As noted before, nurses are getting older—and there are fewer of us. The patient population is getting sicker, both the patients and the caregivers are heavier, and you can’t discount the general stressors of organizational changes such as adopting new policies and transitioning to a more electronic work place.
  • Individual causes – Back pain and other work-related musculoskeletal injuries may be caused by factors such as age, genetics, being overweight or out of shape, poor posture, poor body mechanics, pregnancy, tension, and personal stress. Then there are the traumatic events such as a slip or fall or a car accident. Or, there is cumulative trauma to the spine and related structures caused by a combination individual and organizational causes.

These injuries are due in large part to repeated manual patient handling activities, often involving heavy manual lifting associated with transferring, and repositioning patients. The problem of lifting patients is compounded by the increasing weight of patients due to the obesity epidemic in the U.S. and the rapidly increasing number of older people who require assistance with the activities of daily living.

Combine that with often working in awkward positions, moving equipment and supplies ourselves rather than waiting for help and not being in the greatest shape ourselves—it’s a back disaster waiting to happen.

Tomorrow we will take a closer look at cumulative trauma disorders and what, as organizations, we can do to lessen the likelihood of being injured. From policy and work practices to purchasing equipment and trainings to minimized manual lifting of patients.

In the meantime, I will tell you the middle of my story. The doctor told me the good news was I would get better; the bad news was it would be 8-12 weeks before that happened. She said I needed to find some light duty work when I was at the hospital (ok nurses stop laughing, just because we all know there really is no such thing) and go to physical therapy on a regular basis. Patients are my virtue; patience is not. It has been about eight weeks now and yes, I do feel better, but boy does my body let me know when I have done something wrong.

From early in nursing school, to every day in my nurse residency I heard it. I preach it at my coworkers and the young physicians and nurses around me and still here I stand here exhausted, my hand rubbing my lower back. At the risk of repeating myself, protect your back, it is the only one you have.

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