Low back pain is a major cause of disability that affects the quality of life as well as work performance. The high prevalence of low back pain in intensive care unit nurses negatively affect the quality of care in nursing, since patients in the ICU needes nurses’s assistance every minute of their life.
In this study, the magnitude of low back pain was 76 % [95% CI: (71.6%-79.9%)]. This is in line with a studies conducted in Nigeria (73.5%) [4], Egypt (79%)[11] and Rwanda 78% [20]. This might be due to similar operational definition of low back pain, study design and setting.
However, the prevalence of low back pain in this study was lower than different studies conducted in china (80%) [6] and Taiwan (82%) [21]. The discrepancy might be due to differences in pain reporting culture, lifestyle and socio-demographic characteristics of study participants.
On the other hand, it was higher than a study conducted in Saudi Arabia (51.2%) [22], Malaysia (63.1%), Brazil (67%), Bahirdar, Ethiopia (64.07%) [9], Wollega (63.3%)[18] and Addis Ababa, Ethiopia (45.8%)[10]. The difference might be due to, previous studies include all nurses working in all units, which results in a difference in the assigned task in which they are responsible; where ICU nurses are assigned with critically ill patients needing close follow-up that increase the prevalence of low back pain in the current study..
In this study, females were 2.67 times more likely to develop low back pain than male. This finding is supported by studies conducted in Uganda [23], South Africa [24] and Nigeria [25]. This is due to physiologically low disk space in females that predispose to low back pain and hormonal effects (especially in postmenopausal women, estrogen level decreases and collagen wasting occurs, as a result females might experience low back pain more than males). The physical stress of child-rearing and perimenopausal abdominal weight gain may also contributes to the occurrence of low back pain in females [26].
In this study, ICU nurses who didn’t perform regular exercise were 2.16 times more likely to experience low back pain when compared with those nurses who perform regular exercise. This is in line with studies conducted at Adama hospital medical college staff and turkey Istanbul ICU nurses [17, 27]. The possible justification could be regular exercise improves physical fitness, which prevents easily fatigability of back muscles that reduces the incidence of low back pain[28]. The other possible reason is, those nurses who perform regular exercise can acquire normal body weight, which indirectly prevents low back pain by reducing their weight; since most studies suggested that overweight nurses are more at risk for low back pain when compared with nurses who have normal body weight[11].
In this study, those ICU nurses who had job stress were 3.66 times more likely to experience low back pain when compared with those who didn’t have job stress. This finding is supported by a study conducted at Addis Ababa, Ethiopia among nurses [10]. The possible justification could be when ICU nurses become stressed at work by different assigned tasks, they become physically fatigued and fatigue negatively influences pain receptors by increasing sensation, leading to low back pain.
In the current study, ICU nurses who didn’t have an assistive devices (wheelchair, lift, transfer beds, automated beds…) for patient handling were 2.3 times more likely to experience low back pain when compared with ICU nurses who had an assistive device. This finding is supported by cross-sectional studies conducted in Gaziantep Turkey [29] and Nigeria [28]. The possible justification could be, when ICU nurses use available assistive devices for patient handling activity they can easily perform their activity without fatigability and the workload on their body especially on their lower back decreased as a result the occurrence of low back pain will be reduced.
Lack of special training on intensive care was also the other factor that was significantly associated with the experience of low back pain among ICU nurses. The odds of experiencing LBP in this study were almost doubled in those ICU nurses who didn’t take training on intensive care when compared with those who have taken the training. This study was supported by a study conducted in Wollega [18]. It is also strengthened by an interventional study which was conducted in turkey, that showed health care staff who engaged in training on patient transferring and lifting perform six out of seven behaviors better than they did previously [30]. Even though the exact relationship between taking training and low back pain was not estabilished, training increases awareness of nurses towards preventive measures of low back pain in work place that leads to behavioral change and maintenance of workplace safety cultures [18].