Investments in lower back pain needed

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Elizabeth Newman
Elizabeth Newman

For a neurotic person who is convinced every bad headache indicates a brain tumor, I took a remarkably casual approach to ongoing nagging lower back pain that began last year.

I know this because once I finally saw an orthopedic specialist in January she said, “What do you mean you've had this problem since September?”

I shrugged and said, “It's low back pain. I figured it would go away.”

Spoiler alert: It did not go away.

After X-rays and a diagnosis (a hip labral tear and sacroiliac joint inflammation, possibly caused by some ill-advised heavy lifting), I began a month of physical therapy. I'm not 100%, but am much better than I was in January.

The experience has given me new sympathy to clinical workers and other adults with chronic low back pain. I suspect others, like me, figure it's either a part of life or something that will resolve normally.

That's why it was exciting to see the Patient-Centered Outcomes Research Institute announce this week it was authorizing $22 million to study ways to improve treatment of chronic low back pain, along with another $12.5 million for Patient-Powered Research Network demonstration projects. PCORI is an independent, non-profit organization whose mission is to “fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions.”

The back studies will compare clinical strategies that both do and don't include spinal fusion surgery, and is PCORI's ninth funding announcement. The board has awarded a total of $1.3 billion in awards since 2012 for patient-centered CER projects.

But as much as more research is needed, we all know that low back pain should be prevented before it becomes an issue, especially in long-term care facilities where worker's compensation and employee health are challenges. As most of us know, nursing is one of the worst professions for work-related injuries. In addition to mechanical lifts and transfers of a resident with another employee, managers need to provide guidance and education to those involved in anything that can cause back pain.

For example, building core strength is a major tenant of preventing back pain, as is avoiding twisting at the waist and bending at the knees.

Other ways you can help employees and prevent costly injuries:


  • Encourage wearing comfortable, low-heeled shoes. As Alice Bonner, Ph.D.,RN, Massachusetts' Secretary of Elder Affairs has said, “Real leaders wear sneakers.”
  • Assess office chairs - how old are they? Do they provide good lumbar support? Are your employees encouraged to periodically walk around the office? Do they have headsets in which they can do this?
  • Are there wellness programs or healthy options in the cafeteria that can allow employees to maintain a healthy weight? Are there walking clubs?
  • Are there employee programs that can help with smoking cessation?
  • Has your facility considered anti-fatigue mats at the nursing station?

As Emily Mongan wrote recently, one new study indicates that meditation can help with lower back pain as well.

Some of these tips require investigation, and it's easy to saw “there's no money.” But look at the cost benefit analysis around solutions that may save you from workers calling out sick. Given that spring is a time of renewal, it's a good time to take stock of what we're doing to preserve both our bodies, and those of our employees.

Elizabeth Newman is the Senior Editor at McKnight's. Follow her @TigerELN.


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.