Walking from the change rooms to the operating theatres, I go past a series of posters using drawings of animals in funny positions, extolling the virtues of manual handling techniques. Lifting with your knees, bending with your hips, twisting with your elbows, or whatever. And when I arrive in the operating rooms, I am regularly fascinated by the addition of yet another ingenious device to move a patient less than one metre from their bed to the operating table. Last week we used something that was basically a fully functioning hovercraft (here).
There are countless well-meaning guidelines (and rules) on how we should be moving objects (like this, and this) but do they help? I lift a lot of heavy things in awkward positions when I am working in the yard, but really only get back pain when I lie on my back for too long. I see Olympic weight lifters putting a fair bit of weight through their back without much back pain, and I know that the biggest predictors of back pain in the workplace are not physical factors (try this, this and this) but things like job satisfaction. What is the evidence that this advice, or these devices, actually work?
Fortunately, for this review I didn’t need to look very far. There is a Cochrane review (here, and BMJ version here) that reviewed all of the randomised controlled trials on the use of either assistive devices or handling advice in the workplace. Instead of coming to the usual Cochrane conclusion (“Inconclusive, more evidence is needed, etc.”) I was surprised to find that they said:
“There is moderate quality evidence that MMH [manual material handling] advice and training with or without assistive devices does not prevent back pain or back pain-related disability when compared to no intervention or alternative interventions. There is no evidence available from RCTs for the effectiveness of MMH advice and training or MMH assistive devices for treating back pain.”
So why do we stick with all this stuff? Because it sounds good, and there is an entire industry built around it.