Work-Related Low Back Pain Treatment: A Randomized Controlled Trial from Tehran, Iran, Comparing Multidisciplinary Educational Program versus Physiotherapy Education

STUDY DESIGN: Clinical trial. PURPOSE: To compare the multidisciplinary educational program versus physiotherapy education among Iranian nurses. OVERVIEW OF LITERATURE: Low back pain (LBP) can accompany significant occupational injuries in the nursing profession. There is no agreement on the most effective educational practice. METHODS: This study was conducted from August 17, 2014 to September 22, 2014 in Tehran, Iran. Eligible nurses with chronic mechanical LBP (n=136) were classified into an intervention group (n=66) or the control group (n=70). The intervention group received physiotherapy education for 120-minutes followed by a 120-minute health education session based on predictive constructs of social cognitive theory (SCT). The control group received the 120-minute physiotherapy education. Disability rate, pain severity and back pain prevention behavior were measured at initially and 3 months after intervention using visual analogue scale, Roland-Morris disability questionnaire and nursing low back pain preventive behaviors questionnaire. RESULTS: The two groups were the same in terms of all studied variables at the initiation of the study. At the 3-month follow up, predictive constructs of LBP preventive behaviors of participants in the intervention were improved (p<0.001). Significant decreases were evident at 3 months in pain severity (p=0.03) and disability (p=0.003). CONCLUSIONS: The designed multidisciplinary educational intervention could decrease chronic mechanical LBP in nurses.

Lumbalgia mecánica crónica en pacientes con vértebras limbus anterior: revisión de la literatura y presentación de tres casos clínicos / Chronic mechanical low back pain in patients with anterior limbus vertebra: a review of the literature and a study of three cases

La vertebra limbus es un hallazgo radiológico de prevalencia desconocida y significado incierto. Se trata de un defecto óseo que afecta al margen de los cuerpos vertebrados, con un fragmento desprendido de morfología triangular y bordes escleróticos. Se produce como consecuencia de una herniación intraósea del núcleo pulposo a través del anillo apofisario vertebral, antes de la fusión completa del cuerpo vertebral. En este artículo se describe tres casos clínicos de pacientes jóvenes (de 19, 20 y 22 años), reclusos en el Centro Penitenciario de Jóvenes (Barcelona, España), diagnosticados de lumbalgía mecánica crónica, y portadores de vértebras limbus lumbar. Nuestros hallazgos, y la revisión sistemática de la escasa literatura disponible, ponen en duda algunas convicciones actuales sobre la vértebra limbus.

The limbus vertebra is a radiological finding of unknown prevalence and uncertain significance. This is a bone defect which affects themargin of the vertebral bodies, with a triangular-shaped detached fragment and sclerotic margins. This occurs as a result of an intraosseus herniation of the nucleus pulposus through the vertebral apophyseal ring before the complete fusion of the vertebral body. In this paper we describe the clinical cases of three young patients(aged 19, 20 and 22), in mates of the Young Offenders Institute of Barcelona, Spain, who were diagnosed with chronic mechanical lowback pain and suffered from lumbar limbus vertebrae. Our findings, and the systematic review of the limited literature available, question some of the current beliefs about limbus vertebrae.