Education to Prevent Low Back Injuries?

Up to 40% of all workers’ compensation payments are for low back pain. In an effort to reduce injury rate, improve recovery time, and reduce risk of recurrences, a variety of back schools have been developed and employed, albeit based upon inconclusive controlled clinical trials.

Daltroy et al studied 4000 U.S. postal workers. Prior to the study, about 2.4% of injuries and 35% of payments were related to low back pain. Workers (and supervisors) were instructed by physical therapists in principles of back safety, posture, exercise, and lifting techniques pertinent to their jobs.

The study lasted 5.5 years, during which time 2534 workers and 134 supervisors were trained. Low back injury occurred more frequently, though not statistically significantly, in the intervention group. There was no substantial difference in proportions of injuries that involved lost workdays, nor the median amount of time off between groups. The cost per back injury was three times as great in the intervention group vs. control.

Results of this trial indicate that, despite industry’s widespread enthusiasm and adoption of such programs, back schools are not effective intervention for prevention of industrial low back injury.

Daltroy LH, et al. N Engl J Med 1997; 337:322-328.