Response to: Low back pain: doesn't work matter at all?

We wish to thank Kuijer et al. for their continued interest in our research and their response to our systematic review which we prepared in recognition of the role played by occupational health physicians in managing low back pain (LBP) and adjudicating claims for injured workers [1]. Our review identified, appraised, summarized and synthesized the scientific evidence available to support a causal relationship between occupational physical activities (e.g. bending, lifting) and LBP. The framework for our analysis included various Bradford Hill criteria for causation [2], which were applied to individual studies (e.g. association) and groups of studies (e.g. consistency) as appropriate. Within these criteria, we determined the level of scientific evidence available (e.g. moderate evidence of positive association) in order to assess the presence of causal relationships between specific occupational physical activities and LBP. While our analysis found evidence supporting some aspects of causation (e.g. association, dose–response) for some physical activities (e.g. bending, twisting) and LBP, its findings were mixed. Undoubtedly, the aetiology of LBP is multifactorial [3]. A corollary to this notion is that no single factor is likely to cause LBP. Since our reviews attempted to isolate the causal effects of occupational physical activities, our conclusions that many activities were likely not independently causal of LBP are consistent with a multifactorial hypothesis. It should come as no surprise that any study focused on the role of isolated factors, whether physical, psychosocial, occupational, genetic, or other, will likely conclude that the factor studied is not sufficient, when acting alone, to cause LBP in workers.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.