BMJ  2008;336:398 (23 February), doi:10.1136/bmj.39464.656007.80 (published 31 January 2008)

Editorials

Preventing back pain

Advice to stay active may not be appropriate for people in manual jobs

The first 150 words of the full text of this article appear below.

Every month, back pain affects 18-45% of the adult Western population,¹ and the costs to society are between 200 (£150; $290) and 400 per capita per year.² People who do heavy physical work are particularly susceptible because back problems are likely to be exacerbated when the back is used in its full range of movements.

In the accompanying paper, Martimo and colleagues report a systematic review of the prevention of back pain in people whose jobs involve heavy lifting.³None of the randomised controlled trials or cohort studies included in the reviewfound a positive effect of advice or training in working techniques—with or without lifting equipment—for preventing back pain or consequent disability.

Although the results are disappointing, they are not surprising, because few pathological and anatomical labels(such as a tumour, fracture, inflammatory disease, or acute disc protrusion)can be used to explain the aetiology of back pain.⁴ After removing the relatively . . . [Full text of this article]

¹ Back Research Centre, Back Centre Funen, Funen Hospital, 5750 Ringe, Denmark, ² Institute of Sport Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, 5230 Odense M, Denmark

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