Take Home Messages:

Workplace education on back safety, conducted by a physiotherapist, does not reduce the risk of back injuries or their complications. 

Why the research matters: 

Low back injuries are very common. 30 to 40 percent of workers’ compensation payments are made to those suffering from low back injuries. The large financial burden caused by low back injuries and the lack of effective treatment means that preventing these injuries from occurring is incredibly important. 

Employee education programs that teach safe lifting and handling have become commonplace, however the effectiveness of such programs has received little evaluation.

What the research involved:

This study, conducted in the USA over a 5.5 year period, evaluated an educational program designed to prevent low back injury in 4000 postal workers. Participants were divided into 34 groups. The 34 groups were sorted into 17 pairs of groups, with each pair containing workers who performed similar workplace activities. One group from each pair completed the education program, while the other group acted as a control. 2534 postal workers and 134 supervisors participated in the educational training program.

The program was taught by experienced physical therapists, and included the principles of back safety, correct lifting and handling, posture, exercises, and pain management. The education program involved two training sessions (three hours of training), followed by three to four reinforcement sessions over the succeeding few years. 

For injured workers, the time taken between injury and returning to work was calculated. Injured subjects (from both the intervention and the control groups) were randomly allocated a second time to receive either training or no training after their return to work.

Summary of research findings:

Over the 5.5 year duration of the study, 360 workers reported low back injuries. The average time off from work following low back injury was 14 days. After their return to work, 75 workers suffered from a second low back injury.

After comparing the group of workers that completed to education program to those that did not, the study found :

• Those who received the education program did not have a lower rate of low back injury;
• Participation in the education program did not reduce the costs related to injury;
• Those who participate in the education program did not take less time off work due to injury than those who received no education;
• Participation in the education program did not reduce the rate of other musculoskeletal injuries; and
• Participation in the education program did not reduce the rate of repeated injury after return to work.

Original research:

A controlled trial of an educational program to prevent low back injuries.

Daltroy LH, Iversen MD, Larson MG, Lew R, Wright E, Ryan J, Zwerling C, Fossel AH, Liang MH.

N Engl J Med. 1997 Jul 31;337(5):322-8.

Link to PubMed abstract