Workplace

Belt to Prevent Back Pain at Work | Safety in the Workplace

Another back belt? Didn’t we already go through that scenario and find that they were almost worthless? Yes, we did, but those were lumbar belts, which function under a completely different concept than sacroiliac belts. Please continue reading.

The major study that promoted lumbar belts was done at a home improvement chain in which thousands of workers wore lumbar belts for an extended period of time.

Home Depot Stores [1]

Reduction of Acute Low Back Injuries by Use of Back Supports

However, Kraus, the lead author of the study, said that mandatory implementation of a back-support-use policy significantly reduces the incidence of acute low back injuries but he did not address the severity of the injuries nor the cost effectiveness of the belts.

Home Depot Stores [2]

Study provides new evidence of back belts’ effectiveness

This study was basically a review of the above study by Kraus, et al. They pointed out that a major new study at Home Depot stores showed a 34% reduction in low back injuries when using a back belt. However, that doesn’t tell the whole story. The key point to note is that while they reported a reduction in the number of injuries, the injuries were more severe and costs were significantly higher. Back belt manufacturers hailed this study as proof that back supports are effective personal protective equipment – a contention at odds with the position of NIOSH. None of the authors in the Kraus study were listed in this study and vice versa. This study was simply a biased review of the original study and was promoted to sell belts.

Tinker Air Force Base [3]

Effectiveness and cost-effectiveness of employer-issued back belts in areas of high risk for back injury

Here is the kicker. Data suggest that back belts appear to be minimally effective in preventing injury. However, overall costs of injury while wearing lumbar belts were substantially higher than if injured without belts ($373,250 with vs $235,980 without, per 1000 workers). So, although back belts led to a smaller number of injuries, the injuries of those with belts were more significant and led to greater expense. This study went ignored by the back belt manufacturers.

Journal of Physical Therapy [4]

Use of back belts in occupational settings

This study found that there is potential for increasing the degree of low back injury, and lost work days, with general application of back belts even after the worker stops using the belt.

NIOSH stated that the only benefit of a lumbar belt was that it helped maintain proper posture, and they did not recommend their use. Additionally, lumbar belts limit movement to a narrower range of motion, which may contribute to cumulative trauma injuries [5]. The additional muscular activity needed to overcome the restricted movement should put additional loading on the lumbar disc, potentially overcoming any benefit that may occur with increased internal pressure provided by the belt [6]. Yet, during the rest of the day, the lumbar belts would limit muscular activity and lead to non-use weakness and possible injury [7] [8].

After researching these and many other studies, the Cochrane Collaboration, stated that workers should not wear lumbar supports to prevent back injuries [9].

Unlike a lumbar belt or weight lifting belt which is worn high around the waist over the abdominal muscles, the Serola sacroiliac belt is worn low around the hips to support the ligaments of the SIJ. Correctly placed on the pelvis, the Serola Belt allows free movement throughout the full range of motion. Because of this key difference in placement and function, the Serola Belt does not cause muscle atrophy or weakness like a lumbar belt or weight lifting belt.  This is similar to the way a knee brace supports the ligaments of the knee without causing weakness of the leg muscles.  For this reason, the Serola Belt can be worn as much as needed, even 24/7, without causing muscle atrophy or weakness.

Bending, lifting, and twisting are known movements that can cause or aggravate sacroiliac joint injuries. These movements are essential functions in many workplaces. When the worker twists his or her spine, the ligaments within the spine and sacroiliac joints absorb the force at the end of the motion and help the body decelerate. Although the disc is involved, it is constructed to withstand twisting. On the other hand, the sacroiliac joint is much more vulnerable to the forces encountered in twisting, especially when bending and lifting are involved at the same time. The Serola Belt acts as an external ligament and helps support the SIJ ligaments against excess force, both after injury and as a preventive.

In fact, studies show that many people with low back pain felt relief and improved functionality when using a sacroiliac belt [10-18].

NEGATIVE EFFECTS OF SITTING.

As with any joint, the SIJ is more stable against forces that are perpendicular to its surfaces. The SIJ is almost vertical, so a horizontal force is most stabilizing. When standing, force comes up from the ground, through the legs, bending with the neck of the femur bone, into the pelvic socket (acetabulum) at an angle that is about 45 degrees to the SIJs surface. Then, the actions of the upper leg and pelvic muscles change the force stream to an almost horizontal plane, perpendicular to the SIJ, enhancing stability.  However, when sitting, the legs are removed from the situation and all the upper body weight goes on the ischia (sit bones). Now, the force stream changes to a vertical plane, and becomes destabilizing to the SIJ. Accordingly, sitting can be considered a repetitive motion that places consistent stress on the SIJ ligaments over the course of one’s lifetime. Eventually, micro tears may occur, which trigger an avoidance reaction that may be expressed as tightness and pain. For this reason, wearing the Serola Belt during sitting may help relieve stress on the SIJ ligaments and enhance comfort.

Our Common Goals: Reducing health care costs, increasing productivity, reducing absenteeism, and improving morale; these are the promises of the Serola Sacroiliac Belt.

References:
1. Kraus, J.F., et al., Reduction of Acute Low Back Injuries by Use of Back Supports. Int J Occup Environ Health, 1996. 2(4): p. 264-273.
2. McIntyre, D.R., K.M. Bolte, and M.H. Pope, Study provides new evidence of back belts’ effectiveness. Occup Health Saf, 1996. 65(12): p. 39-41.
3. Mitchell, L.V., et al., Effectiveness and cost-effectiveness of employer-issued back belts in areas of high risk for back injury. J Occup Med, 1994. 36(1): p. 90-4.
4. Minor, S.D., Use of back belts in occupational settings. Phys Ther, 1996. 76(4): p. 403-8.
5. Lavender, S.A., et al., Effect of lifting belts, foot movement, and lift asymmetry on trunk motions. Hum Factors, 1995. 37(4): p. 844-53.
6. Hodgson, E.A., Occupational back belt use: a literature review. AAOHN J, 1996. 44(9): p. 438-43.
7. Harman, E.A., et al., Effects of a belt on intra-abdominal pressure during weight lifting. Med Sci Sports Exerc, 1989. 21(2): p. 186-90.
8. Lander, J.E., R.L. Simonton, and J.K. Giacobbe, The effectiveness of weight-belts during the squat exercise. Med Sci Sports Exerc, 1990. 22(1): p. 117-26.
9. van Duijvenbode, I.C., et al., Lumbar supports for prevention and treatment of low back pain. Cochrane Database Syst Rev, 2008(2): p. CD001823.
10. Pel, J.J., et al., Biomechanical model study of pelvic belt influence on muscle and ligament forces. J Biomech, 2008.
11. Pool-Goudzwaard, A.L., et al., Insufficient lumbopelvic stability: a clinical, anatomical and biomechanical approach to ‘a-specific’ low back pain. Man Ther, 1998. 3(1): p. 12-20.
12. Prather, H., Sacroiliac joint pain: practical management. Clin J Sport Med, 2003. 13(4): p. 252-5.
13. Snijders, C.J., Transfer of Lumbosacral Load to Iliac Bones and Legs: Part 1 – Biomechanics of Self-Bracing of the Sacroiliac Joints and its Significance for Treatment and Exercise. Clinical Biomechanics, 1993a. 8: p. 285-294.
14. Snijders, C.J., Transfer of Lumbosacral Load to Iliac Bones and Legs: Part 2 – Loading of the Sacroiliac Joints when Lifting in a Stooped Position. Clinical Biomechanics, 1993b. 8: p. 295-301.
15. Snijders, C.J., et al., EMG recordings of abdominal and back muscles in various standing postures: validation of a biomechanical model on sacroiliac joint stability. Journal of Electromyography and Kinesiology, 1998. 8(4): p. 205-14.
16. Udo, H. and F. Yoshinaga, Effect of a pelvic belt on abdominal pressure by various weights and bending angles. Ind Health, 1997. 35(2): p. 229-34.
17. Vleeming, A., et al., An integrated therapy for peripartum pelvic instability: a study of the biomechanical effects of pelvic belts. American journal of obstetrics and gynecology, 1992. 166(4): p. 1243-7.
18. Walheim, G.G., Stabilization of the pelvis with the Hoffmann frame. An aid in diagnosing pelvic instability. Acta Orthop Scand, 1984. 55(3): p. 319-24.