Brace Yourself for Pain Relief : Health: The backbone’s connected to a controversy over the use of support belts. Are they the best defense against back strain?
After years of moving heavy equipment and lifting bedridden patients, operating room nurse Doreen Nadler woke up one morning and found she couldn’t move.
Her back, she says, simply “went out.”
Nadler’s doctor found a bulging disk in her lower back and prescribed bed rest. Fortunately, the strategy worked and Nadler returned to work about two months later. Now, however, she rarely does anything at Century City Hospital without lacing a white abdominal back support belt over her uniform.
“I don’t use it all the time at work, but I’m trying to get into the habit of wearing it more,” says Nadler, whose doctor prescribed the belt. “It makes me feel more supported. And it feels very comfortable.”
Belts similar to those that help competitive weightlifters heave their massive loads can now be seen cinching the waists of luggage handlers, furniture movers, nurses, landscapers, even supermarket clerks--practically anyone who does a lot of heavy lifting. The belts help stabilize the spine while lifting.
Back support belts are rapidly becoming the “hard hat of the ‘90s,” say many observers.
“A lot of the original research on back support belts was done in the sporting goods industry,” says Ted Yewer, vice president of Valeo Inc., a back support belt company in Waukesha, Wis. “But about two years ago, industry discovered the product and its benefits.”
Some occupational health experts worry about the devices’ growing popularity. There is little scientific research about their effectiveness in the workplace. No studies have been done specifically to show which workers might benefit most from such belts and just how they should be used. Some experts say the belts might be unnecessary if more attention were paid to workplace safety and proper lifting techniques.
It’s clear, however, that some new approaches are needed to reduce back injuries, which far exceed any other occupational injury, representing 22% of all injuries.
And, as Nadler or anyone who has had a back injury can attest, these mishaps are debilitating and costly. Back injuries account for 31% of workplace compensation costs, according to the U.S. Department of Labor, again far ahead of any other injury.
“It was awful,” says Nadler of her injury. “I had no idea it was so painful.”
Adds Yewer: “If you rupture a disk lifting something, that’s it. You’ll be visiting the doctor, taking medication and limiting what you can do for the rest of your life.”
*
Insurance companies, labor unions and the Occupational Safety and Health Administration are pressuring companies to reduce back injuries. And back support belts, which cost from $20 to $50, may help do so.
Dr. Ian Armstrong, a neurosurgeon with the West Coast Spine Institute in Los Angeles, says back support belts, by themselves, are only a partial solution: “They have to be coupled with the proper use of the belt and proper lifting. You also have to look at changing the work environment to make it more safe.”
Back injuries occur for many reasons, including improper lifting techniques, an unsafe work environment and the worker’s physical condition, says Mike Peltier, safety director of the National Safety Council. Because there is no single cause of back injuries, the agency refuses to issue a blanket recommendation for the use of back support belts.
“There are a lot of forces acting upon employers to find a quick solution.” Peltier says. “But a lot of times there isn’t a quick solution. Some people think you can just put a person in a back belt and it’s the end of your problems. But I strongly disagree.”
Peltier says he often advises companies to use back support belts for short-term use until “you can redesign the work station to reduce injuries.”
When you lift a heavy object, you contract the abdominal muscles and the muscles at your sides and your waist shrinks. This creates pressure within the abdomen that pushes against the curve in the lower spine, holding the spine more rigid. This allows you to overcome the stress of the lift, Yewer says.
Back support belts--which are made of a rigid, lightweight nylon and are usually worn over clothing--assist in this process by compressing the abdomen and increasing the pressure within.
But, says Dr. Michael Sinel, director of physical medicine and rehabilitation at the West Coast Spine Institute, “we’re not sure how much the belts prevent injuries.”
Surveys often show a lower rate of injuries once a company puts belts in use. But, he says, “we don’t know if it was the belt itself or whether people were just more conscious of how to lift properly.”
Armstrong thinks the benefits may be mainly psychological: “One of the major roles of a back belt is it acts as a reminder so you can use proper posture and biomechanics when lifting.”
Another criticism of back belts is that, when worn frequently, they can weaken back muscles, actually increasing the risk of injury when the belt isn’t worn. Workers should be instructed to tighten the belt for lifts and loosen it between lifts, experts say. Some belts have suspenders so the belt can be worn loosely between lifts.
*
Wearing a back belt may also lead some people to believe they can lift more weight--a dangerous misconception.
“It gives them a false sense of security,” Armstrong says.
Because of these concerns, back support belts should not be used without instruction on their use and lifting, and “should never be given out in lieu of a back injury prevention program,” Sinel says. “That would be an injustice to the worker.”
Some employees don’t like back braces, as they can be uncomfortable, hot and scratchy. Peltier has some advice for such people: Learn to lift properly and get in shape.
“Employees should put their energy into effective exercise programs,” he says. “Being overweight and sedentary is the real problem.”
Nadler agrees that the best way to prevent back problems is through proper lifting techniques and staying in shape.
“I think back supports are great, but I think exercise is really the most important thing,” she says. “If I slack off on exercise, I feel it in my back.”
