Prevention strategies for occupational low back pain.

Among the strategies to prevent occupational LBP, only job design/redesign and exercise programs appear to have a protective effect; however, the studies pertaining to exercise remain contradictory, and controlled trials evaluating ergonomics interventions are lacking. Risk factor modification is beneficial from a general health perspective, but studies are contradictory with respect to its role in prevention of LBP. There is no conclusive evidence to support the use of structured education programs in the workplace, and the cost of these programs is not justified. There is no support for the use of orthotics or worker selection methods based on the available data, and these methods should not be employed in the workplace. Despite efforts from the medical community and industry, there is little evidence that there has been a substantial impact on the prevalence of LBP and disability. Further work is needed in both occupational and nonoccupational settings to determine effective prevention strategies for LBP in the future.