Introduction. Low back pain is an important public health problem affecting 70-85% of the population worldwide and is a common cause of work-related disability. At Edendale Hospital, the physiotherapy nursing case load related to the management of low back pain increased from 30% to 45% over the past 3 years. The risk factors for low back pain at Edendale Hospital remain unclear and it is not clear whether low back pain is more prevalent in certain wards. Knowing the risk factors contributing to the prevalence of low back pain at the Hospital will assist nursing and hospital managers to plan appropriate interventions to minimize the occurrence. Methods. An observational cross sectional study with an analytic component was implemented. Data was collected utilizing a self- administered questionnaire to determine the prevalence of low back pain amongst nurses at the Hospital. Bivariate analyses and logistic regressions were performed to determine the risk factors associated with low back pain. Results. The point prevalence of current low back pain was 59%, of chronic low back pain was 47% and occupational low back pain was 57%. Logistic regression revealed bending and working in orthopaedic, surgery, paediatrics, obstetrics and gynaecology is significantly associated with low back pain. Conclusion. Occupational factors are strongly associated with low back pain. Thus workplace interventions are required. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2010.

Dissertation submitted to the faculty of Health Sciences at the Durban University of Technology in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, 2007. / The objectives of this study were: To determine how the frequency of manual work contributes to low back pain in nurses in state versus private hospitals in the Durban area. To determine how the frequency of manual work contributes to low back pain in nurses in state versus private hospitals in the Durban area. Hospital nurses have a high prevalence of low back pain (LBP) (Smedley et al., 2003). It has been found that nursing personnel ranked fifth in occupations claiming worker compensation for low back injuries (Owen and Garg, 1994). A number of studies have also indicated a strong association between musculoskeletal disorders and work related factors (Maul, 2002). An epidemiological study by Smedley et al (1997) has suggested that repetitive lifting, frequent bending and twisting play a role in the development of LBP, and that heavy physical workload has played a major role in the development of LBP in nurses. LBP is therefore a serious problem in the nursing field with a relatively high prevalence worldwide. It causes increased absenteeism from work and could impact on patient care. This study was a survey, which was quantitative in nature. Data was collected by means of a questionnaire. The questionnaires were handed out in randomly selected hospitals in the Durban Metropolitan area. The names of all state and private hospitals in the Durban Metropolitan area were put into two boxes and three names were picked from each box. A letter requesting permission to carry out this research was sent out to each hospital and a positive response was received from one state hospital, R.K Khan Hospital and two private hospitals, Westville and Entabeni hospitals. Questionnaires were handed out to the nurses by the researcher, as requested by the hospitals, and collected at a later time by the researcher. Questionnaires were handed out at each ward in the hospitals to nurses who met the criteria for the study and agreed to participate in this study. Questionnaires were also handed out to nurses in the nurses lounge during lunch breaks. The questionnaire was developed as combination of; a pre-validated questionnaire made available by Yip (2001), questions on socio-demographic data, work history, patient handling activities and LBP. The compiled questionnaire was tested for face and construct validity through a focus group, and piloted before being used in the study. A total of 500 questionnaires were handed, 250 to state hospitals and 250 to private hospitals. Participants consisted of nurses (registered, enrolled and student) between the ages of 18 and 45 years, both male and female. Nurses from all hospital wards were allowed to participate in this study. A total of 124 questionnaires were received back, ( 50 from private hospitals and 74 from the state hospital), from the nurses in all the hospitals. Data was then collected from these questionnaires and was analysed using the statistical package SPSS version 13 (SPSS Inc. Chicago, Illinois, USA). A p value of <0.05 was considered as significant. The data collected from the questionnaires was analysed and the results obtained were as follows: The prevalence of work related LBP in this study was 59.7%. Of the 74 nurses with LBP, only 7 (9.5%) reported having LBP before working as a nurse. 35.1% of participants reported that they experienced pain on a daily basis while 62.2% described their LBP as moderate and 27% described their pain as severe. The median duration of LBP was 3.5hours per episode. Of all the participants in this study, 64,9% had needed bed rest due to their LBP with 43.2% having taken sick leave from work for LBP. Back pain in nurses has been found to be a major cause of days lost due to sickness (French et al., 1997). The majority of nurses (93.2%) reported lifting to be the cause of their LBP, standing and bending were also found to be important causes. Low Back injury was reported in 31.1% of participants with up to 51.4% receiving treatment for their injuries, the main choice of treatment was from a hospital or General practitioner. With regards to the frequency of manual work on LBP, there was found to be a slight tendency toward LBP with more frequent manual activity, however this was viii found to be non significant. In those respondents with LBP, the activity associated with the most intense LBP was carrying or lifting patients. Time spent; standing, holding up hands and bending were found to be higher in the group which reported LBP. Having 1-2 children was also associated with increased LBP. The prevalence of LBP was found to be higher in the state hospital (67.6%) than in the private hospitals (48%). The aim of this study was to determine the association between frequency and intensity of manual work on LBP in nurses. The results showed that frequently performed manual activities were associated with LBP but not significantly. In terms of intensity of manual work, carrying or lifting patients was found to be most associated with LBP, standing and bending were also significantly associated with LBP. This study also aimed to determine any difference in LBP between state and private hospitals and a significant difference in LBP prevalence was noted between state and private hospitals. The findings of this study suggest that LBP is a common problem among hospital nurses. The results of this study were also found to be within the same prevalence rates of international studies, which ranged from 35.9% in New Zealand to 66.8% in the Netherlands (Nelson et al., 2003). As was found in the literature (French et al., 1997 and Smedley et al., 1997), lifting was reported to be a major cause of LBP.

Dissertation submitted to the faculty of Health Sciences at the Durban University of Technology in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, 2007. / The objectives of this study were: To determine how the frequency of manual work contributes to low back pain in nurses in state versus private hospitals in the Durban area. To determine how the frequency of manual work contributes to low back pain in nurses in state versus private hospitals in the Durban area. Hospital nurses have a high prevalence of low back pain (LBP) (Smedley et al., 2003). It has been found that nursing personnel ranked fifth in occupations claiming worker compensation for low back injuries (Owen and Garg, 1994). A number of studies have also indicated a strong association between musculoskeletal disorders and work related factors (Maul, 2002). An epidemiological study by Smedley et al (1997) has suggested that repetitive lifting, frequent bending and twisting play a role in the development of LBP, and that heavy physical workload has played a major role in the development of LBP in nurses. LBP is therefore a serious problem in the nursing field with a relatively high prevalence worldwide. It causes increased absenteeism from work and could impact on patient care. This study was a survey, which was quantitative in nature. Data was collected by means of a questionnaire. The questionnaires were handed out in randomly selected hospitals in the Durban Metropolitan area. The names of all state and private hospitals in the Durban Metropolitan area were put into two boxes and three names were picked from each box. A letter requesting permission to carry out this research was sent out to each hospital and a positive response was received from one state hospital, R.K Khan Hospital and two private hospitals, Westville and Entabeni hospitals. Questionnaires were handed out to the nurses by the researcher, as requested by the hospitals, and collected at a later time by the researcher. Questionnaires were handed out at each ward in the hospitals to nurses who met the criteria for the study and agreed to participate in this study. Questionnaires were also handed out to nurses in the nurses lounge during lunch breaks. The questionnaire was developed as combination of; a pre-validated questionnaire made available by Yip (2001), questions on socio-demographic data, work history, patient handling activities and LBP. The compiled questionnaire was tested for face and construct validity through a focus group, and piloted before being used in the study. A total of 500 questionnaires were handed, 250 to state hospitals and 250 to private hospitals. Participants consisted of nurses (registered, enrolled and student) between the ages of 18 and 45 years, both male and female. Nurses from all hospital wards were allowed to participate in this study. A total of 124 questionnaires were received back, ( 50 from private hospitals and 74 from the state hospital), from the nurses in all the hospitals. Data was then collected from these questionnaires and was analysed using the statistical package SPSS version 13 (SPSS Inc. Chicago, Illinois, USA). A p value of <0.05 was considered as significant. The data collected from the questionnaires was analysed and the results obtained were as follows: The prevalence of work related LBP in this study was 59.7%. Of the 74 nurses with LBP, only 7 (9.5%) reported having LBP before working as a nurse. 35.1% of participants reported that they experienced pain on a daily basis while 62.2% described their LBP as moderate and 27% described their pain as severe. The median duration of LBP was 3.5hours per episode. Of all the participants in this study, 64,9% had needed bed rest due to their LBP with 43.2% having taken sick leave from work for LBP. Back pain in nurses has been found to be a major cause of days lost due to sickness (French et al., 1997). The majority of nurses (93.2%) reported lifting to be the cause of their LBP, standing and bending were also found to be important causes. Low Back injury was reported in 31.1% of participants with up to 51.4% receiving treatment for their injuries, the main choice of treatment was from a hospital or General practitioner. With regards to the frequency of manual work on LBP, there was found to be a slight tendency toward LBP with more frequent manual activity, however this was viii found to be non significant. In those respondents with LBP, the activity associated with the most intense LBP was carrying or lifting patients. Time spent; standing, holding up hands and bending were found to be higher in the group which reported LBP. Having 1-2 children was also associated with increased LBP. The prevalence of LBP was found to be higher in the state hospital (67.6%) than in the private hospitals (48%). The aim of this study was to determine the association between frequency and intensity of manual work on LBP in nurses. The results showed that frequently performed manual activities were associated with LBP but not significantly. In terms of intensity of manual work, carrying or lifting patients was found to be most associated with LBP, standing and bending were also significantly associated with LBP. This study also aimed to determine any difference in LBP between state and private hospitals and a significant difference in LBP prevalence was noted between state and private hospitals. The findings of this study suggest that LBP is a common problem among hospital nurses. The results of this study were also found to be within the same prevalence rates of international studies, which ranged from 35.9% in New Zealand to 66.8% in the Netherlands (Nelson et al., 2003). As was found in the literature (French et al., 1997 and Smedley et al., 1997), lifting was reported to be a major cause of LBP.

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban University of Technology, 2007. / To determine the prevalence and demographics of lumbo-sacral cases recorded at the D.U.T Chiropractic Day Clinic from 13th January 1995 to 30th November 2005. To identify the aetiology, common lumbo-sacral diagnoses, associated signs and symptoms, management and contra-indications to chiropractic treatment recorded on the initial consultation of patients with lumbo-sacral complaints. / M

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban University of Technology, 2007 xi, 61 leaves, Annexures A-E, 1-5 / Research is more than merely an academic exercise. It is a key ingredient in establishing chiropractic’s role in an evolving health care system (Dallas, 1997). Very little is known about the changes in the chiropractic patient population over time (Hartvigsen et al. 2003). Despite the widespread use of chiropractic, good descriptive data on chiropractors and their patients are limited (Coulter and Shekelle, 2005). Few studies have been reported which deal specifically with patients attending chiropractic teaching clinics (Nyiendo and Olsen, 1988). A teaching clinic is an outpatient clinic that provides health care for patients, as opposed to inpatients treated in a hospital. Teaching clinics are traditionally operated by educational institutes and provide free or low-cost services to patients (http://en.wikipedia.org/wiki/Teaching_clinic). In April 1994 the chiropractic day clinic was officially opened at the former Technikon Natal (now the Durban University of Technology). Thousands of patients have been treated at this clinic over this twelve year period. In 1994, Elga Renate Drews, conducted research aimed at identifying characteristics of chiropractic patients and their complaints at the chiropractic teaching clinic at Technikon Natal and private practices in South Africa. This survey was conducted from February 1994 to the end of April 1994. 162 Patients were involved in this study. A survey was completed which included the patient’s age, gender, occupation, presenting condition, duration of complaint, previous treatment, referral, severity, quality of pain and their disability. A comparison was made between patients seen in private practice and at the teaching clinic. It was found that generally both populations were very similar, with the exception of the patients’ age and occupation. No other research investigating patient characteristics has been undertaken at Durban University of Technology chiropractic day clinic after 1994. Furthermore, in the study conducted by Drews no mention was made of the type of treatment that was given to patients either in private practice or at the teaching clinic. Although the first successful chiropractic adjustment recorded was in the thoracic spine by Dr. D.D. Palmer, research since then has focused on the lumbar spine (Di Fabio, 1992). In reviewing literature relating to the thoracic spine, it is apparent that in comparison to the cervical and lumbar regions, the thoracic spine has been neglected (Edmonston and Singer, 1997). In South Africa there remains a paucity of information on the types of thoracic conditions chiropractors treat and the management protocols. The present research aimed to shed light on this aspect by collecting data from one of only two chiropractic teaching clinics in South Africa, namely the Durban University of Technology chiropractic day clinic. The purpose of this research was to investigate the age, gender, occupation (whether of a sedentary or non-sedentary nature), prevalence of pain, presenting complaints, common conditions treated and common management protocols of patients who presented with thoracic pain to the Durban University of Technology Chiropractic Day Clinic.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban University of Technology, 2007 xiii, 76, 13 leaves / To determine the prevalence and demographics of lumbo-sacral cases recorded at the D.U.T Chiropractic Day Clinic from 13th January 1995 to 30th November 2005. To identify the aetiology, common lumbo-sacral diagnoses, associated signs and symptoms, management and contra-indications to chiropractic treatment recorded on the initial consultation of patients with lumbo-sacral complaints.