The leading priority of all healthcare workers is to provide appropriate services to protect, manage, and improve people’s health conditions. However, this statement often leads to the fact that nurses’ and doctors’ experience is neglected. In other words, not many experts admit that these healthcare professionals can suffer from specific health issues while providing patients with the required assistance. Low back pain is among such problems, and it is relatively frequent worldwide. According to Alnaami et al. (2019), the global prevalence of the issue is between 15% and 45%. Sufficient evidence also demonstrates that healthcare workers are subject to the problem. In particular, 35%-80% of nurses stipulate that they have experienced low back pain episodes at least once during their professional practice (Richardson et al., 2018). This statement denotes that there is robust scientific interest in focusing on the issue under consideration.
Since statistical data demonstrates that low back pain is prevalent among healthcare professionals, it is reasonable to look at how these individuals manage the given condition. The rationale behind this statement is that medical workers require specific management practices or interventions that will protect them from the problem. Thus, it is necessary to conduct a particular research project to identify the most effective approaches to avoid and control low back pain. This research should follow appropriate scientific procedures and focus on a particular population. It seems rational to consider how healthcare workers from New York City address the problem and what steps they take to manage the health condition under consideration. The following paragraphs will present the basics of the suggested project, including a problem statement, literature review, proposal, goal statement, and methodology.
Low back pain is a significant problem that adversely affects people’s health and overall well-being. This term stands for feelings of discomfort in the lower parts of the back, which makes individuals seek medical care (Tariq et al., 2022). When people suffer from the issue, it becomes more challenging for them to perform their work obligations and lead normal lives. This condition emerges when individuals are subject to regular physical load.
Sufficient evidence also explains why the problem should deserve attention. According to the Centers for Disease Control and Prevention (2022), people typically tend to ignore low back pain because they believe that it will resolve without interventions. However, this strategy is negative because the issue becomes a leading cause of disability, resulting in an $87-billion burden for the US healthcare industry annually (Tariq et al., 2022). In addition to that, Rezaei et al. (2021) indicate that contributing factors to the problem include the female gender, occupational factors, stress, age, and other conditions. That is why this condition is a significant problem in the healthcare industry.
The problem is widespread globally, but it is also necessary to consider its prevalence in the USA because several scholarly works present data in this format. According to Tariq et al. (2022), the prevalence of the condition among nurses in the USA can reach 90%. Richardson et al. (2018) support this statement and add that low back pain is widespread among licensed practical nurses, registered nurses, and nurse aides. Finally, other experts admit that “the estimated lifetime prevalence of lower back pain in health care personnel was 54.8%” (Rezaei et al., 2021, p. 102903). This high prevalence admits that it is reasonable to investigate the issue in a research project.
Comprehensive Literature Review
The literature review involved a comprehensive exploration of the relevant articles on the topic. A comprehensive literature review allows the research to accomplish various goals, including identification of gaps in current research, evaluation of scientific evidence strength, identification of significant issues in an area, bridging of knowledge gaps, generation of a research question, exploration of successful research methods, and identification of a conceptual or theoretical framework. The search for terminology related to low back pain among healthcare workers. The following keywords were the terms used for searching: back pain, lower back pain, back injuries, nurses, and healthcare workers. In the literature review, the databases were accessed through Google Scholar.
Low back pain is a significant and prevalent problem in the health care industry, it is not surprising that many scholars address the topic. The given literature review will summarize the evidence from scholarly peer-reviewed articles that were published within the last five years to ensure that the research project relies on credible and timely data. The section is divided into three sub-headings according to the number of sub-themes.
It has already been mentioned that many factors contribute to the spread of the problem. The article by Rezaei et al. (2021) provides a detailed overview of these phenomena. According to the scholars, the prevalence of the problems is connected to occupational factors, stress, gender, age, involvement in physical activity, and body-mass index (Rezaei et al., 2021). However, these authors also add that a body position at work is a leading prerequisite to the condition, meaning that whether a person manages to maintain a tall back can make a difference (Rezaei et al., 2021). That is why it is reasonable to consider other sources to investigate these risk factors.
Some authors can focus on the effect of a single issue. On the one hand, Vinstrup et al. (2020) admit that stress can play a leading role because the authors identified a connection between this psychosocial issue and low back pain. Parreira et al. (2018) also support this statement and add that constant stress increases the opportunity that low back pain will emerge. On the other hand, a cross-sectional study of more than 1,100 nurses revealed that being a female is associated with greater low back pain risks (Luan et al., 2018). However, it is challenging to mention that a single factor can contribute to the problem.
Other experts admit that a workplace routine fosters the spread of the problem among healthcare professionals, meaning that a combination of different factors leads to adverse outcomes. According to Andersen et al. (2019), a high number of patient transfers is a contributing issue because this practice results in excessive physical burden. In particular, the lack of assistive devices, including sliding sheets, walking aids, and intelligent beds, is associated with the problem (Andersen et al., 2019). These scholars also admit that poor collaboration in the workplace and insufficient support from colleagues lead to negative consequences (Andersen et al., 2019). Thus, it can be challenging to admit a single contributing factor.
The condition under analysis requires attention because it leads to multiple adverse outcomes. According to Chen et al. (2018), adverse effects can include disability, depression, and the movement of pain to other body parts (for example, limbs). This information demonstrates that a long endurance of this condition can harm various systems in the human body. It is not necessary to neglect the fact that the issue results in a significant financial burden (Hartvigsen et al., 2018). The experts also comment on versatile negative impacts and highlight the fact that recurrence is common (Hartvigsen et al., 2018). This statement denotes that once this pain disappears, there is an opportunity that this condition will return.
Other scholarly articles provide additional arguments to highlight the adverse consequences of low back pain. As Kazemi et al. (2019) admit, the condition under analysis leads to negative impacts on nurses’ individual, social, and occupational spheres. This finding reveals that various systems suffer from adverse processes caused by low back pain. Furthermore, Overstreet and Goodin (2018) stipulate that there is a significant connection between this type of pain and emotion deregulation. This statement denotes that people with this condition have difficulties controlling and managing their emotions (Overstreet & Goodin, 2018). That is why it is impossible to underestimate the negative effects of low back pain on people’s health.
Since the findings above represent multiple adverse consequences, it is reasonable to consider how this condition can be managed. Tariq et al. (2022) admit that sufficient attention should be drawn to the prevention of this issue. According to the scholars, there are different prevention levels that include changing lifestyle behaviors, risk assessment, training in manual handling, cognitive behavior therapy, and other steps (Tariq et al., 2022). Simultaneously, interventions include the provision of lifting equipment, workplace education, and a healthy diet (Tariq et al., 2022). It seems that a combination of organizational and individual interventions is needed.
Since there exist many management approaches, it is reasonable to compare their effectiveness. Traeger et al. (2019) admit that physical and psychological therapies should be prioritized over surgery, steroid injections, and pain medication. The data by the Centers for Disease Control and Prevention (2022) supports this suggestion and states that opioids are excessively prescribed even though their efficacy lacks supportive statements. Simultaneously, Foster et al. (2018) also admit that surgery, opioids, and imaging testing are overused in relation to low back pain. These experts insist that first-line treatments should be prioritized, including education, physical exercise, and psychological programs (Foster et al., 2018). It is worth admitting that these suggestions are more promising and cost-effective.
The literature review includes sources of original data, primary sources, and secondary sources. See table 1
Summary of Literature Searched by Categories
|Searched Categories||Scholarly Journals||Books||Total|
|Back Injuries |
Low back pain
Low back pain among health care workers
The identified information demonstrates that it is reasonable to conduct a research project that will focus on low back pain management among healthcare workers. Firstly, sufficient evidence reveals that these individuals are subject to the given condition, and many risk factors contribute to this state of affairs. Secondly, the literature findings have demonstrated that if this issue is left untreated, negative consequences can emerge. For example, they include depression, disability, a higher financial burden, and other adverse issues. That is why it is necessary to implement specific management practices to minimize and avoid negative impacts. However, the literature review has also indicated that improper interventions are currently overused, while more efficient and cost-effective steps are ignored. It seems adequate to conduct a research project that will confirm or deny the impact of specific interventions.
In addition to that, it is reasonable to comment on the rationale behind focusing on New York City. According to the official statistics, there are more than 733 thousand people employed in the medical sphere in the given state (New York State Department of Health, 2022). These individuals perform significant tasks and provide the city with the 8-million population with essential services. Consequently, if doctors and nurses are subject to various health conditions, their ability to assist others is limited or even canceled. That is why the given proposal aims to address this situation and generate positive outcomes. If the project identifies that a specific intervention or combination thereof significantly limits the prevalence of low back pain among healthcare professionals, this fact will contribute to the emergence of evidence-based practice. Thus, it is rational to start conducting the suggested research paper.
The given research project aims to achieve a specific goal. It is as follows: To determine to what extent the first-line treatments, including physical exercise, training, and psychological treatment, reduce the prevalence of low back pain cases among medical professionals in New York City. This statement denotes that it will be necessary to recruit nurses and other healthcare workers from a single or many settings, subject them to the intervention, and analyze its impact.
This project should be a prospective cohort study using a quantitative methodology.
The study showed that the problem of low back pain accompanies the majority of nurses in Asia, Africa, Oceania, and North America, which indicates the lack of management of the alleged problem. Although it is psychologically challenging to estimate the exact time of the onset of the first pains, many nurses say that the problem under discussion caught up with them after a year of full-fledged practice (Chen et al., 2018). Then these pains are discomfort caused by objective reasons and do not irritate (Hartvigsen et al., 2018). It is due to the transportation of patients, lifting weights, and long, irregular working hours.
Separately, experts identify the presence of 12-hour night shifts as a significant factor in the development of lower back pain. Low back pain is caused by stiffness and misalignment of the spinal discs, which can often be triggered by sleep deprivation (Rezaei et al., 2021). Moreover, the refusal of night rest and sleep is a predictor of the development of chronic stress, which is accompanied by musculoskeletal pain (New York State Department of Health, 2022). An unrested spinal region cannot be flexible and relaxed, and the muscles become stiff; the person feels spasms (Rezaei et al., 2018). Often health workers are unaware of this and turn their attention to the problem when it is too late. Excessive employment, workload, stress, and critical personal issues (family, financial difficulties, and others) do not allow health workers to identify the problem early (Luan et al., 2018). Most of them decide to ignore the pain and discomfort, believing that the situation is one of a kind. In the meantime, low back pain care is a considerable financial burden on individual families and the healthcare system.
Different studies show different percentages of nurses who complain of low back pain and have not yet found such symptoms in themselves. The median, based on research, is 54%, reflecting the borderline state of health workers facing this problem (Rezaei et al., 2021). Many health care workers try to protect themselves from back pain, but later taking care of themselves fades into the background. One of the most common implementations was wearing unique shoes that support the musculoskeletal system (Richardson et al., 2018). A study has shown that such shoes slow the progress of sciatica and lower back pain (Kazemi et al., 2019). It means that such an implementation has all the rights to disseminate and adopt experiences from different hospitals.
It is usually impossible to predict the exact occurrence of back pain. However, biological and some biosocial risk factors are obesity and overweight, lack of exercise, unbalanced diet, and daily routine. Most of the current research focuses on the fact that back pain has psychosocial factors at its foundation. Gender remains a controversial factor, as several studies suggest that women are more prone to sciatica and low back pain (Rezaei et al., 2021; Vinstrup et al., 2020). With age, the likelihood of severe injuries during work increases. Other studies calculate that low back pain affects men and women equally.
To avoid back pain, patients must activate the muscles responsible for postural control. It is why special (including orthopedic) shoes have become a widespread modern implementation (New York State Department of Health, 2022). Incorrect posture, formed by habit, usually at school, is a factor in low back pain (Parreira et al., 2018). Usually, health workers’ complaints relate to a similar degree of pain in the low back and the cervical region (about 40-45%) (Foster et al., 2018). All these areas of the vertebral part spasm with incorrect posture, and the bone substances stagnate. When combined with physical exertion (the power associated with lifting or moving heavy objects), such pain can develop into arthritis. Another option for creating the scenario is disk damage, which usually finds a health worker performing a particular physical task.
As for social factors, here research focuses on ergonomic subtleties. The lack of high-tech equipment in the hospital forces nurses to take responsibility for transporting patients, which must be carried out with special attention. At the same time, it seems that a large number of computers in the hospital will only make the working life of nurses more monotonous, worsening posture and pain in the cervical region. In addition, working with computers has its drawbacks, harming vision. Nor will it reduce worker stress, a critical factor in developing low back pain and other problems associated with burnout and chronic fatigue (Andersen et al., 2019). All this leads to losing healthcare personnel, even if they initially show excellent promise and burn with ambitions and dreams.
The critical factor and accompaniment of back pain is chronic stress combined with constant fatigue and overload. Typically, nurses are measured for stress levels using the Cohen Perceived Stress Scale (Vinstrup et al., 2020). The researchers are referring to the psychosocial stress associated with communication, complex patients, irregular working hours, and lack of sleep (Alnaami et al., 2019). It turned out that the perception of pain, including its ignoring and catastrophizing, is very dependent on the stress level. Frustration and a tendency to depression are recognized as influencing factors, and low back pain is different and unique. Back pain immobilizes the person, and without movement, it is usually difficult for a person to find something else to focus on other than the pain. Such pain slows down and makes people constantly think about it, which differs from the pain of ordinary bruised limbs. Chronic stress and fatigue contribute to high evening cortisol levels, a predictor of low back pain. At the intersection of psychology and physiology, a severe low back pain phenomenon is born, requiring a careful approach.
If stress is a factor in low back pain, then the pain itself does not reduce the amount of stress but only closes the circle. A frustrated and tired person begins to experience back pain during work. By enduring them and not having the time or desire to see a doctor, frustration and stress only intensify, leading to depression and complete exhaustion. People with chronic fatigue tend to pay more attention to their pain (Overstreet & Goodin, 2018). They have no resistance to this pain because the body is already exhausted. Depressive symptoms caused by other causes (personal troubles, problems with colleagues or superiors, general dissatisfaction with their results in treatment) contribute to the development of catastrophizing (Traeger et al., 2018). Pain becomes unbearable over time, and nurses resort not to primary but secondary and tertiary care, including diverse approaches.
There are different nursing approaches, replete with creative ways to help patients. These approaches include nursing plans for the care of patients with chronic pain (Paul-Savoie et al., 2018). Typically, such practices apply to severe patients with end-stage diseases. However, some of the details of this approach will be relevant in therapy for nurses living with back pain. It is especially appropriate for advanced cases that have been neglected for a long time and postponed the doctor’s visit.
Research has linked back pain to anxiety-based mental illness. Anxious people often experience doubts and weariness; for their body and muscles, states of stiffness and spasms are natural. The back is usually tense in such people; other muscles do not relax (Alnaami et al., 2018). Cognitive behavioral therapy seems to be the best way out of this situation for such patients (Tariq et al., 2022). Suffering from excessive demands and control at work, nurses in New York experience stress, but they try to deal with physiological manifestations. Thus, many patients resort to opioids, particularly long-acting opioids, as well as a large number of antibiotics. Programs are now being developed to reduce prescription doses of drugs for ailments such as back pain.
Nevertheless, the stereotypical view of medicine as a stronghold of pharmacology in the form of all kinds of pills remains in different patients and doctors. Patients are often the ones who want reliable and trusted treatment; stereotypically, drugs have formed high confidence in modern medicine (Tariq et al., 2022). Governments of various countries add different drugs every year to the OTC registry. For example, the Australian authorities included preparations containing codeine in such a registry (Traeger et al., 2019). Interventions should be multicomponent and have creative stress management techniques.
The literature review assumes conclusions are drawn only based on the latest published works. It does not rule out that unpublished papers may have had different results and changed the central ending. This systematic error is the first limitation of this article. The second limitation is to consider the problem of New York nurses based on literature that goes far into this city and state. Moreover, many sources focus on countries such as Nigeria, Australia, and Saudi Arabia. All this may raise doubts about how the results obtained can be applied to the problem of New York nurses. Initially, it was stated that the article focuses on them since their practice is full of stress and cases of low back pain; however, the report ignores the possible subtleties of their work itself. The authors of the article do not address the problem of the shoulder joint, while mentioning pain in the cervical region.
The third and most significant limitation is that the article does not specify the problems of nurses working in different departments and hospitals. The physical work of nurses in the parental department differs from that of nurses in dental clinics. In the same way, it can be argued that health workers in hospices, cosmetology departments, and support for terminal patients use their bodies in different ways. This article does not separate nurses but generalizes the medical community to focus on their stressful work and excessive workload, which is the same in all departments. The preliminary analysis of implementations and their insufficient initial review can be a slight limitation. More sources could showcase diverse and creative ways to manage low back pain. An actual implementation is specialized training not associated with strength exercises but with stretching muscles and joints. Such training could be fitness, yoga, or gymnastics, but these were not mentioned as the main implementations.
The problem of low back pain management is severe for the New York nursing community and the whole world. Increasing stress, the use of information technology, and, at the same time, poor equipment in several hospitals contribute to the overstrain of nurses. Long working days and excessive demands do not allow them to rest, leading to chronic fatigue. Chronic fatigue is always accompanied by stress, which directly impacts physiology. Stress does not cause pain but makes it very noticeable, literally unbearable. Nurses become temporarily irritable, and the circle of stress closes on the resulting state of lumbar pain. Thus, under pressure, anxiety, and depression, nurses do not relax the spinal muscles, and this contributes to early arthritis, which is preceded by low back pain.
The management of low back pain plays a vital role in staff retention in hospitals, as many nurses may leave their posts for objective reasons without finding support from colleagues or superiors. Being ordinary people with their personal problems, they often worry about this at work, which researchers should consider. Total control and excessive demands should be reduced by the authorities or explained to the nurses with arguments. Assistance to injured nurses should be comprehensive and not consist of prescribing large amounts of antibiotics and opioids. Prescribing drugs will only relieve the pain for a while but will not solve the central problem; hospital management thus mechanizes its subordinates by lulling symptoms. For low back pain and perceived stress, cognitive behavioral therapy is recommended. It can be combined with various exercises and outdoor activities. For severe cases of severe pain that becomes unbearable for nurses, colleagues can help them with specific nursing plans for chronic pain.
Alnaami, I., Awadalla, N. J., Alkhairy, M., Alburidy, S., Alqarni, A., Algarni, A., Alshehri, R., Amrah, B., Alasmari, M., & Mahfouz, A. A. (2019). Prevalence and factors associated with low back pain among health care workers in southwestern Saudi Arabia. BMC Musculoskeletal Disorders, 20(1), 1-7. Web.
Andersen, L. L., Vinstrup, J., Villadsen, E., Jay, K., & Jakobsen, M. D. (2019). Physical and psychosocial work environmental risk factors for back injury among healthcare workers: Prospective cohort study. International Journal of Environmental Research and Public Health, 16(22), 4528. Web.
Centers for Disease Control and Prevention. (2022). Acute low back pain. Web.
Chen, Y., Campbell, P., Strauss, V. Y., Foster, N. E., Jordan, K. P., & Dunn, K. M. (2018). Trajectories and predictors of the long-term course of low back pain: Cohort study with 5-year follow-up. Pain, 159(2), 252-260. Web.
Foster, N. E., Anema, J. R., Cherkin, D., Chou, R., Cohen, S. P., Gross, D. P., Ferreira, P. H., Fritz, J. M., Koes, B. W., Peul, W., Turner, J. A., Maher, C. G., Buchbinder, R., Hartvigsen, J., Cherkin, D., Foster, N. E., Maher, C. G., Underwood, M., van Tulder, M., … Woolf, A. (2018). Prevention and treatment of low back pain: Evidence, challenges, and promising directions. The Lancet, 391(10137), 2368-2383. Web.
Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., Hoy, D., Karppinen, J., Pransky, G., Sieper, J., Smeets, R. J., Underwood, M., & Lancet Low Back Pain Series Working Group (2018). What low back pain is and why we need to pay attention. The Lancet, 391(10137), 2356-2367.
Kazemi, S. S., Tavafian, S. S., Hidarnia, A., & Montazeri, A. (2019). Consequences and factors affecting work-related low back pain among nursing professionals: A qualitative study. Payesh (Health Monitor), 18(3), 291-303. Web.
Luan, H. D., Hai, N. T., Xanh, P. T., Giang, H. T., Van Thuc, P., Hong, N. M., & Khue, P. M. (2018). Musculoskeletal disorders: Prevalence and associated factors among district hospital nurses in Haiphong, Vietnam. BioMed Research International, 2018. Web.
New York State Department of Health. (2022). New York State Department of Health highlights healthcare workforce booster progress and announces additional efforts to bring boosters directly to healthcare workers. Web.
Overstreet, D., & Goodin, B. (2018). Emotion dysregulation and potential consequences in people with chronic low back pain. The Journal of Pain, 19(3), S37. Web.
Parreira, P., Maher, C. G., Steffens, D., Hancock, M. J., & Ferreira, M. L. (2018). Risk factors for low back pain and sciatica: An umbrella review. The Spine Journal, 18(9), 1715-1721. Web.
Paul-Savoie, E., Bourgault, P., Potvin, S., Gosselin, E., & Lafrenaye, S. (2018). The impact of pain invisibility on patient-centered care and empathetic attitude in chronic pain management. Pain Research and Management, 2018, 1–8. Web.
Rezaei, B., Mousavi, E., Heshmati, B., & Asadi, S. (2021). Low back pain and its related risk factors in health care providers at hospitals: A systematic review. Annals of Medicine and Surgery, 70, 102903. Web.
Richardson, A., McNoe, B., Derrett, S., & Harcombe, H. (2018). Interventions to prevent and reduce the impact of musculoskeletal injuries among nurses: A systematic review. International Journal of Nursing Studies, 82, 58-67. Web.
Tariq, R. A., George, J. S., Ampat, G., & Toney-Butler, T. J. (2022). Back safety. StatPearls Publishing.
Traeger, A. C., Buchbinder, R., Elshaug, A. G., Croft, P. R., & Maher, C. G. (2019). Care for low back pain: Can health systems deliver? Bulletin of the World Health Organization, 97(6), 423-433. Web.
Vinstrup, J., Jakobsen, M. D., & Andersen, L. L. (2020). Perceived stress and low-back pain among healthcare workers: A multi-center prospective cohort study. Frontiers in Public Health, 8, 297. Web.