FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

[BACK SUPPORT DEVICES DO NOT REDUCE WORKER INJURIES ]

Question: My employer requires us to wear back support belts to prevent back injury. Most of us think that these are only hot and uncomfortable and do little to prevent injury. Is there any proof that these things actually prevent back injury?

Answer: Back pain is a common problem that affects individuals as well as employers. About 80 percent of adults will miss some work because of back pain. The estimated cost for the lost work and associated health-care bills is $75 billion per year. Obviously, all employers would like to reduce their portion of this significant expense.

Individuals involved in any type of work can have a work-related back injury, but those who do tasks that require repeated bending and lifting, particularly of heavy items, are at significant risk. Airline baggage handlers, construction workers and many manufacturing and stocking jobs fall into the high-risk group. I'd guess that you do a job like this or your company wouldn't be requiring you to wear a back support.

Several years ago back supports with elastic sides and Velcro fasteners became widely available and inexpensive. Many companies with high rates of employee back injury hoped to simultaneously reduce the suffering of individuals and reduce their losses by requiring use of these devices. There were some early successes that subsequently enticed other companies to adopt a policy of mandatory use of these low-back support devices.

Now, however, we have several more years of careful scientific studies on this subject, and the picture is somewhat different. The more recent studies have revealed precisely what you and your co-workers have already figured out: low-back support devices do not reduce the risk of back injury. An interesting finding is that individuals who have previously had a back injury do have reduced risk of subsequent injury when they wear a back support.

I suspect that one of the reasons for these findings is that the devices are somewhat effective when worn properly, but that only those who have had a previous back injury are likely to have the motivation to wear them correctly. When worn properly, these devices are tight fitting. This makes them both hot and uncomfortable, just as you have said. This is probably why most workers that I see with these support devices, wear them as loosely as they can while still complying with the employer's rules. So, the bottom line is that they are not effective for these people.

Some companies utilize the services of a physical therapist or a physician to train employees to do their jobs in ways that minimize the risk of back injury. In addition, some companies actually modify the job to reduce the bending-lifting-twisting movements that typically are involved in back injury.

So, you are correct in saying that mandatory use of back supports does not reduce the risk of back injury. On the other hand, your employer obviously wants to reduce the rate of this type of injury. Your company may be receptive to employee efforts to look at other ways of reducing injuries on the job. Talk to you supervisor. If your company institutes training on the proper way to bend and lift or appropriately modifies the job so that less of this type of movement is necessary, you might be able to stop wearing those less-than-effective back supports.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.