Training showing the correct way to lift heavy objects does not prevent back injuries, according to a systematic review published on bmj.com today.
Back pain is a highly prevalent complaint and a cause of much suffering. In the UK employers have to ensure workers get proper training on how to handle loads correctly and this generally includes advising workers on specific lifting techniques. However this study, which reviewed all the evidence currently available, found no evidence that the advice has any effect.
The researchers looked at eleven studies: eight studies dealt with health workers who manually handled patients, the other three looked at baggage handlers and postal workers. All the participants in the studies worked in jobs where there was strain on the back and where there was the potential for alleviating any strain through an intervention such as training. None of the workers in the studies were actively seeking treatment for back pain.
The researchers found no difference in back pain in studies where one group received training and the other didn't. Training compared to minor advice (a video) showed no effect on back pain after a year.
Another trial showed no significant difference in back pain between one group who received training and another who were given back belts to wear. Training and physical exercise were compared in one trial and again no difference in back pain was found during a follow up less than a year later.
Finally a group receiving both training and an assistive device was compared to a group receiving training only and another control group which received nothing - there was no difference in back pain at follow up.
The researchers say either the advocated techniques do not actually reduce the risk of back injury, or workers do not significantly change their habits enough for it to make any difference.
They conclude that we need a better understanding of the relationship between exposure to stresses on the back at work and the subsequent development of back pain in order to develop new and innovative ways of preventing back pain because of lifting.
In an accompanying editorial Associate Professor Niels Wedderkopp says the current advice for people with back pain to stay active may not be appropriate for people whose work involves heavy lifting. He says: "A change of job and (prudently) staying active in daily life may be the best way for these patients to regain command of their back and their occupation."