Evaluation and management of occupational low back disorders.
This clinical practice review of occupational low back disorders describes work-related risk factors, occupational history, physical evaluation, clinical tests, diagnosis, care, and prevention. It is part of a quality assurance (QA) and quality improvement (QI) effort to establish exemplary occupational practice standards. It emphasizes the involvement of occupational medicine physicians in exposure assessment, care of injured workers, and disease prevention. Important occupational risk factors such as lifting, awkward body posture and vibration, in addition to psychosocial, socio-economic and other factors are summarized. The focus is on mechanical back disorders. Return-to-work, rehabilitation and prevention strategies are discussed as part of integrated disability management involving the injured worker, the primary care provider, employers and other relevant parties.
Johanning
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Eastern New York Occupational and Environmental Health Center, Mount Sinai School of Medicine, Department of Community Medicine, Albany, NY, USA. johanni2@crisny.org
D019033:Delivery of Health Care, Integrated; D004185:Disability Evaluation; D006801:Humans; D017770:Lifting; D017116:Low Back Pain / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy; D009784:Occupational Diseases / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy; D016273:Occupational Exposure; D009787:Occupational Medicine; D010348:Patient Care Team; D010808:Physical Examination; D011187:Posture; D011785:Quality Assurance, Health Care; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D017749:Total Quality Management; D014732:Vibration / Q000009:adverse effects