PREVALENCE OF LOWER BACK PAIN (LBP)

Prevalence of Lower Back Pain (LBP) among London Ambulance Service

Table of Content

CHAPTER-I: INTRODUCTION4

Aims of the Study6

Background of the Research Problem7

Treatment and Management of Low Back Pain8

CHAPTER-II: LITERATURE REVIEW9

Demographics10

Patterns in Low Back Pain Prevalence10

Age, Gender and Physical Fitness as Risk Factors for Back Pain13

Causes and Symptoms16

Diagnosis21

Treatment Team24

Treatment24

Clinical Trials29

Prognosis30

Special Concerns30

Management of Low Back Pain31

Historical Perspective: Bed Rest31

Guidelines for the Management of Low Back Pain33

General Practitioners36

CHAPTER-III: METHODOLOGY39

Methodology of Occupational Health Intervention Studies41

Design and Questionnaires42

Questionnaire Design43

Fear Avoidance Beliefs Questionnaire45

The General Health Questionnaire49

Pilot of Questionnaire51

The Covering Letter52

Research Participants53

Procedure54

Ethical Approval55

CHAPTER-IV: RESULT, SURVEY AND ANALYSIS56

Response Rate56

Gender and Age Group56

Height, Weight and Body Mass Index56

Marital Status57

Exercise Frequency58

Type of Employment58

Length of Time in Present Job58

Low Back Pain Prevalence60

Lifetime Prevalence60

12-Month Prevalence (Total Number of Days of Low Back Pain)60

Number of “Spells” Of Low Back Pain in a Lifetime and In Previous 12 Months60

Point Prevalence61

Age and Prevalence61

Gender and Prevalence62

Psychosocial Factors And Cause Of Low Back Pain63

Psychological Distress (General Health Questionnaire)63

Fear Avoidance Beliefs (FABQ modified version)64

CHAPTER-V: CONCLUSIONS AND RECOMMENDATIONS66

Workforce Survey and Intervention Study Conclusions66

Summary of the Key Findings Drawn From This Research Study66

Recommendations: Workforce Survey68

Key Theory with Regards the Intervention Study69

Recommendations: Intervention Study71

LBP Self-Management Techniques as Part of Organizational Induction Training73

Statistical Analysis in Occupational Studies74

Ambulance Service Research75

References/Bibliography76

CHAPTER-I: INTRODUCTION

In order to begin a study on low back pain it is useful to be able to relate the experience to an actual person who has suffered from this condition. This person is a valued employee and his reaction to the pain suffered can be viewed as common to many people with low back pain. The following case example is such a person, constructed from a composite of London Ambulance Service (LAS) employees' experiences.

Paul had been employed by the LAS as a paramedic for 23 years. He loved his job and was a very popular and dedicated employee who had only ever taken sickness absence for the occasional cold. Paul first attended the Occupational Health Department (OHD) two months after he had first had to miss work because of illness. He was extremely depressed and could not contemplate returning to his job (Lynn, 2003). The following is an account of what had happened to Paul.

Whilst on duty, Paul and his colleague attended to a man who had fallen down some stairs and had fractured his leg. In order to get the man into the ambulance, Paul and his colleague had to lift him onto a stretcher. Paul bent down and, as he strained to come back up, he felt his back 'go'. Paul was sent home from work by his team leader and told to see his general practitioner (GP). The GP told Paul to stay at home and rest until he felt better and the pain had gone. Paul was at this point offered no advice on pain control by his GP.

Paul returned home and alternated between lying on his bed and on the sofa for the duration of one week. He did not take any pain killers because of his concerns about possible ...