Paramedics have physically demanding jobs. Lower back pain is an occupation-related health condition that may cause difficulty with, or inability to, lift. Existing literature on lower back pain in paramedics is scant; no qualitative study specifically of lower back pain experiences or treatment was found. This qualitative study aimed to explore paramedics’ experience of chronic lower back pain, with a focus on their expectations of musculoskeletal treatment.
Nine paramedics (seven men, two women) who had sought chiropractic, physiotherapy, or osteopathy treatment for one or more episodes of chronic lower back pain, while working as a paramedic, were recruited from the national ambulance service. A general inductive qualitative approach was used and semi-structured interview data were thematically analysed.
The core theme was ‘frustration’. For paramedics, frustration stemmed from the difficulties and delays finding a musculoskeletal practitioner who could ‘help’; the widespread experience of lower back pain among paramedics that apparently went unacknowledged; their inability to make alterations at work; their risk of re-injuring their back at any time; and concerns about their future and job insecurity because they might not be able to continue working as a paramedic in the future due to their lower back pain.
The experience of the nine New Zealand paramedics interviewed for this study was frustration due to difficulties and delays in finding the right provider of helpful treatment, and persistent uncertainty about their future. Participants wished that the industry had better and more explicit organisational processes for managing lower back pain at work, and supporting them to better back health and being fit for work.
Lavender SA, Conrad KM, Reichelt PA, Meyer FT, Johnson PW. Postural analysis of paramedics simulating frequently performed strenuous work tasks. Appl Ergon 2000;31:45-57. doi:10.1016/S0003-6870(99)00027-7.
Maguire BJ, Hunting KL, Guidotti TL, Smith GS. Occupational injuries among emergency medical services personnel. Prehosp Emerg Care 2005;9:405-11.
Aasa U, Barnekow-Bergkvist M, Angquist K, Brulin C. Relationship between work-related factors and disorders in the neck-shoulder and low-back region among female and male ambulance personnel. J Occup Health 2005;47:481-9. doi: org/10.1539/joh.47.481.
Grimes P. Ambulance paramedic low back injury and workplace rehabilitation. Research Gate Website. Available at: www.researchgate.net/publication/228688056_Case_Study_Ambulance_Paramedic_Low_Back_Injury_and_Workplace_Rehabilitation [Accessed 30 March 2013].
Tam G, Yeung S. Perceived effort and LBP in non-emergency ambulance workers: Implications for rehabilitation. J Occup Health 2006;16:231-40. doi 10.1007/s10926-006-9019-2.
Prairie J, Corbeil P. Paramedics on the job: dynamic trunk motion assessment at the workplace. Appl Ergon 2014;45:895-903. doi:10.1016/j.apergo.2013.11.006.
Sofianopoulos S, Williams B, Archer F. Paramedics and the effects of shift work on sleep: a literature review. J Emerg Med 2012;29:152-5. doi:10.1136/emj.2010.094342.
Arial M, Benoit D, Wild P. Exploring implicit preventive strategies in prehospital emergency workers: a novel approach for preventing back problems. Appl Ergon 2014;45:1003-9. doi:10.1016/j.apergo.2013.12.005
De Souza LH, Frank AO. Experiences of living with chronic back pain: the physical disabilities. Disabil Rehabil 2007;29:587-96. doi: 10.1080/09638280600925852.
Snelgrove S, Liossi C. Living with chronic LBP: a metasynthesis of qualitative research. Chronic Illn 2013;9:283-301. doi:10.1177/1742395313476901.
Froud R, Patterson S, Eldridge S, et al. A systematic review and meta-synthesis of the impact of LBP on people’s lives. BMC Musculoskelet Disord 2014;15:1471-85. doi: 10.1186/1471-2474-15-50.
Gatchel RJ, Polatin PB, Mayer TG. The dominant role of psychosocial risk factors in the development of chronic LBP disability. Spine 1995;20:2702-9.
Accident Compensation Corporation. New Zealand acute LBP guide. Available at: www.healthnavigator.org.nz/media/1006/nz-acute-low-back-pain-guide-acc.pdf [Accessed 10 May 2013].
New Zealand Chiropractic Board. Practitioners. Available at: www.chiropracticboard.org.nz/Practitioners [Accessed 10 March 2016].
Physiotherapy Board of New Zealand. History of physiotherapy. Available at: www.physioboard.org.nz/ [Accessed 2 February 2016].
Orrock PJ, Myers SP. Osteopathic intervention in chronic non-specific LBP: a systematic review. BMC Musculoskelet Disord 2013;14:1-7. doi: 10.1186/1471-2474-14-129.
St John New Zealand. St John: Here for life. Available at: www.stjohn.org.nz/What-we-do/ [Accessed 6 January 2016.
Broadbent E, Patrie K, Main J, Weinman J. The Brief Illness Perception Questionnaire. J Psychosom Res 2006;60:631-7. doi:10.1016/j.jpsychores.2005.10.020.
Steven A, Richard D, Donald P, Karen C, Robert K, Daniel S. The Quebec Task Force classification for spinal disorders and the severity, treatment, and outcomes of sciatica and lumbar spinal stenosis. Spine 1996;21:2885-92.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3:77-101. doi: 10.1191/1478088706qp063oa.
Braun V, Clarke V. Thematic analysis. In Cooper H, editor. Handbook of Research Methods in Psychology. Volume 2: Research Designs, pp. 57-71. Washington, DC: APA books, 2012.
Kirby ER, Broom AF, Adams J, Sibbritt DW, Refshauge KM. A qualitative study of influences on older women’s practitioner choices for back pain care. BMC Health Serv Re 2014;14:1-10. doi: 10.1186/1472-6963-14-131.
Sibbritt D, Lauche R, Sundberg T, et al. Severity of back pain may influence choice and order of practitioner consultations across conventional, allied and complementary health care: a cross-sectional study of 1851 mid-age Australian women. BMC Musculoskelet Disord 2016;17:393. doi: 10.1186/s12891-016-1251-0.
Main CJ, Foster N, Buchbinder R. How important are back pain beliefs and expectations for satisfactory recovery from back pain? Best Pract Res Clin Rheumatol 2010;24:205-17. doi:10.1016/j.berh.2009.12.012.
Brown M, Dean S, Hay-Smith J, Taylor W, Baxter D. Musculoskeletal pain and treatment choice: an exploration of illness perceptions and choices of conventional or complementary therapies. Disabil Rehabil 2010;32:1645-57. doi: 10.3109/09638281003649896.
MacNeela P, Doyle C, O'Gorman D, Ruane N, McGuire BE. Experiences of chronic LBP: a meta-ethnography of qualitative research. Health Psychol Rev 2015;9:63-82. doi: 10.1080/17437199.2013.840951.
Darlow B, Dowell A, Baxter D, Mathieson F, Perry M, Dean S. The enduring impact of what clinicians say to people with LBP. Ann Fam Med 2013;11:527-34. doi: 10.1370/afm.1518.
Schoenfisch AL, Myers DJ, Pompeii LA, Lipscomb HJ. Implementation and adoption of mechanical patient lift equipment in the hospital setting: the importance of organizational and cultural factors. Am J Ind Med 2011;54:946-54. doi: 10.1002/ajim.21001.
Coole C, Drummond A, Watson PJ, Radford K. What concerns workers with LBP? Findings of a qualitative study of patients referred for rehabilitation. J Occup Rehabil 2010;20:472-80. doi: 10.1007/s10926-010-9237-5.