Pregledni rad
LOW BACK PAIN AT NEW WORKING AMBIENT IN ERA OF NEW ECONOMY: A SYSTEMATIC REVIEW ABOUT OCCUPATIONAL RISK FACTORS
NURKA PRANJIĆ
orcid.org/0000-0001-6145-1137
; Univerzitet u Tuzli, Medicinski fakultet, Katedra za medicinu rada, i Dom zdravlja u Tuzli, Univerzitetski nastavni odjel medicine, Tuzla, Bosna i Hercegovina
LJILJANA MALEŠ-BILIĆ
; Univerzitet Banja Luka, Medicinski fakultet, Katedra za medicinu rada i Zavod medicine rada i sporta Republike srpske, Banja Luka, Bosna i Hercegovina
Sažetak
Low back pain is the second most common symptom-related reason for physician visits and the fi rst reason of working disability. Low back pain is a ubiquitous complaint, with particularly high prevalence among people in their working years (67%). For many individuals, episodes of back pain are self-limited and resolve without specifi c therapy. For others, however, back pain is recurrent or chronic, causing signifi cant pain that interferes with employment and quality of life. Many occupations have been anecdotally linked to certain low back pain syndrome. However, the relationship between the work environment and the patient’s symptoms, though clearly perceived by the patient to be causative, may be less certain. The injury model of an occupational disorder proposes that specifi c work activities are the cause of the patient’s pain. The injury model for low back pain, implicating a causal connection with specifi c work activities, is complex and controversial. Determining whether a patient’s low back pain is a consequence of his or her occupational activity, and how best to treat symptoms to maximize functionality and potential for a return to full employment capacity, can be challenging. In this systematic review which included patients/employees with low back pain, the following databases were searched: Pub Med, Embase, Medline and Web of science. The role of occupational mechanical exposure e.g. lifting as a risk factors for low back surgery has been debated for several decades. Diagnostic uncertainty exists even for those with back symptoms and well-described fi ndings on scan, as these fi ndings are common even in subjects without back pain, and may be unrelated to the symptoms. As an example, herniated disks can be identifi ed in signifi cant numbers of CT or MRI low back studies in subjects with no back pain. In further analysis, lifestyle factors and occupational psychosocial exposures will be addressed. Many physicians, including those practicing in primary care settings where back pain is most often seen, lack training and confi dence in addressing workplace issues. Occupational factors that have a signifi cant infl uence on the development of low back pain disorders are not only mechanical and postural order but also organisational, social and psychological. Organisational changes and physical and psychological job demands should not be overestimated as causal factors. In the early phase of a work disability more emphasis should be laid however on appropriate information and medication and, in case of persistant impairment, active treatment (after 3 weeks or relapse). There is some evidence that catastrophizing as a stress coping strategy might lead to delayed recovery. Long- term work (sick) absence can be estimated through evaluation and observation of LBP risks and characteristics of the each individual case. An early return at workplace and to activities of daily life is urgent. To reduce LBS and its consequences, employers need to adopt a multifaced approach: concentrate on improving physical conditions as well as the psychosocial and environmental aspects of working environment. In cases at risk for chronifi cation and/or with obstacles to reintegration at work an interdisciplinary workoriented rehabilitation and occupational rehabilitation interventions (occupational reintegration) should be provided.
Ključne riječi
low back pain; occupational risk factors; organisational; psychosocial and psychological aspects of working ambient; early return at workplace; work oriented rehabilitation
Hrčak ID:
146939
URI
Datum izdavanja:
7.10.2015.
Posjeta: 3.601 *