Back Supports to Prevent Back Pain in Home Care Workers with Previous Low Back Pain

Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.

The summary below is from the full report titled "Lumbar Supports to Prevent Recurrent Low Back Pain among Home Care Workers. A Randomized Trial." It is in the 20 November 2007 issue of Annals of Internal Medicine (volume 147, pages 685-692). The authors are P.D.D.M. Roelofs, S.M.A. Bierma-Zeinstra, M.N.M. van Poppel, P. Jellema, S.P. Willemsen, M.W. van Tulder, W. van Mechelen, and B.W. Koes.

What is the problem and what is known about it so far?

Low back pain is a common problem that causes pain and inability to participate in usual activities. It is a common reason for people to be absent from work, especially among workers whose jobs involve physical labor. Treatment for low back pain aims to decrease pain and help patients resume their normal activities through exercise therapy, patient education, and pain-relieving drugs.

Patients also sometimes use "back belts" or "back supports" (lumbar supports) to prevent or treat back pain. These supports come in a variety of styles, but all involve a wide belt worn around the back and abdomen to support the muscles of the lower back. People whose work involves physical labor or lifting often use back supports. Unfortunately, good information about the benefit of back supports is scarce. The available studies suggest that back supports do not prevent a first episode of back pain, but they may help to prevent repeated episodes among workers with previous back pain.

Why did the researchers do this particular study?

To see whether adding back supports to a course on healthy work habits would help to decrease the number of low back pain episodes and days absent from work among home care workers who had previous low back pain.

Who was studied?

360 home care workers in the Netherlands who reported a history of low back pain. The workers' jobs involved housekeeping or help with personal care in people's homes.

How was the study done?

All of the workers participated in a short course on healthy work habits that included information on strategies to prevent back injury, such as good ways to lift heavy things. The researchers then assigned half of the patients to select and receive 1 of 4 types of back support. The workers who got back supports were advised to wear them on days when they had or thought they might get low back pain.

What did the researchers find?

Over 12 months, the workers with the back supports reported an average of 53 fewer days with low back pain than those reported by the other workers. However, days missed from work because of sickness were similar in both groups of workers.

What were the limitations of the study?

The researchers did not have good information on whether back pain was the reason for the sick days.

What are the implications of the study?

Adding back supports to a short course on healthy work habits may reduce low back pain days, but not the total number of sick days, among workers.