“It is time to focus on the psychosocial elements of life, on and off the job, that render too much of back pain so intolerable that it is memorable and even incapacitating," wrote Dr. Nortin M. Hadler and Timothy S. Carey in the Dec. 6 issue of the Journal of the American Medical Association. Hadler and Carey are professors of medicine at the UNC-CH School of Medicine.

Their editorial, written at the journal's request, reacts to a paper in the journal by a group led by Dr. James T. Wassell of the Centers for Disease Control and Prevention and National Institute for Occupational Safety and Health.

Wassell, Dr. Douglas Landsittel and colleagues studied 6,311 people whose work included lifting things at 160 Wal-Mart stores in 30 states and who completed both initial and follow-up interviews about low back pain and worker compensation claims. The study, which began with 9,377 workers, was the largest of its kind.

After adjusting for individual risk factors, "neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury claims or low back pain," Wassell wrote. Levels of physical exertion at work made no difference.

Tom Votel, president of Ergodyne, a back support manufacturer, called the study sloppy and questionable at best, and said it did not outweigh the 26 studies supporting the efficacy of back supports. Votel said NIOSH’s findings were compromised by the more than 3,000 workers who dropped out of the study, the survey’s limited choices for frequency of back belt use, and the short (six month) period of usage studied.