Back Pain in Nursing Student

roser13, ASN, RN · Mar 9, 2015

You asked for honesty: If I were you, knowing what I now know, I would find a new outlet for my ambition. Most nurses who eventually incur back injuries/pain likely started off their careers pain-free. Even then, their bodies were stressed to the point of injury & pain. If a few hours of shopping currently cause you back pain, imagine those few hours on your feet, with tremendous stress added in.

Yes, it's possible (as some will no doubt point out) to have a desk job as a nurse. However, those jobs, for the most part, require some years of experience and usually are in great demand. Even nursing school clinicals will be a tremendous challenge.

I am not looking to deny your lifelong dream, but only to help you view your career choices in a realistic manner.

dishes, BSN, RN · Mar 9, 2015

Back and musculoskeletal injuries are common occupational hazards in nursing and it is a realistic to think that working as a nurse will worsen your back pain. Consider looking at allied health care occupations and keep an open mind, you will find there are alternatives to nursing and that it is possible to have job satisfaction and minimal back pain.

scottaprn · Mar 9, 2015

We can't give medical advice but PLEASE talk to a knowledgable spine surgeon about your back and learn body mechanics from a physical therapist.

There are very good reasons biomechanically that your back hurts when you lay on your stomach and why it is made worse when inverting your feet (which externally rotates your hips) etc. You need to be taught why.

Having a spondylolosthesis by itself does not preclude a full and active life but you need individualized treatment more than generalized advice from a message board.

meganec17 · Mar 10, 2015

roser13: You're right, I did ask for honestly. I did not particularly like your answer, only because I know you're right. I'm unsure of what I am going to do right now. Thank you.

dishes: That was definitely not the answer I was hoping for, yet I was expecting it. I have something thinking to do. Thank you.

scottaprn: Hi, I am currently under the care of an orthopedist, and I have physical therapy twice a week. I totally understand that I need a more individualized treatment rather than general advice, but I was just looking for some experiences or thoughts. Thanks for taking the time to answer :)

meganec17 · Mar 10, 2015

bump.

nurseprnRN, BSN, RN · Mar 10, 2015

I'd suggest a consult with a good back physiatrist, a physician with expertise in rehabilitation. The problem with ortho (and neuro) surgeons is that they like to operate; that's not their fault, they're called "surgeons" for a reason. And the more honest ones will, if pressed, tell you that surgery for back problems is only indicated for structural/safety reasons, including active damage to nerves, but not primarily for back pain. Most back surgery will not make back pain go away, it will only stabilize an unstable condition. Back Pain, Neck Pain, Lower Back Pain, and Spinal Disorders by Spine Experts | SpineUniverse is a reputable site for professionals and patients for more information.

Physiatrists come from many backgrounds-- neuro, ortho, psych, internal med, for example. There are many specialties-- pediatric, sports medicine, elders, SCI, stroke, burns, to name but a few. A good back specialist will help you get to a place where, perhaps, your pain doesn't get better but your function and tolerance will. A good back rehab program is usually staffed by physiatry, physical therapy, pain management, psychology, and nurse case management, and they are the most egalitarian and collegial groups I know. Everyone has an equal say in treatment plans, and they do far, far better treatment and patient teaching than you'll find anywhere. They will be honest and tell you they may not be able to make your pain go away, but they can make you able to live with it, emphasis on the "LIVE!"

You want someone that will focus on function, not meds or injections, and not surgery unless for safety reasons. You can get references from the nurse case managers in worker's comp in your area-- call the local insurance carriers for leads on how to reach a few of them, and ask for their advice. They know better than anyone who's good in the area. Or you can PM me and I can see who's in my extensive electronic rollodex. :)

Best of luck for whatever you decide.

Anna Flaxis, BSN, RN · Mar 10, 2015

More and more facilities are going "lift free", but back injuries among nursing staff remain a huge problem, and I would imagine more so if you already have existing back problems. Another angle to this is that I work in a small hospital, and so staff are few. If I need help moving a patient, it would be extremely frustrating to have the only other staff member available unable to assist because they have a back problem.

nurseprnRN, BSN, RN · Mar 10, 2015

If I need help moving a patient, it would be extremely frustrating to have the only other staff member available unable to assist because they have a back problem.

Also, remember that in many nursing positions the requirement to be able to lift (and catch a falling patient if necessary) is a bona fide job requirement. They can't ask you about physical limitations during interviews, but it is perfectly legal (and appropriate for everyone) to make an offer of employment conditional on passing a physical exam or functional capacity eval.

mmc51264, BSN, MSN, RN · Mar 10, 2015

I go to yoga, I know it sounds corny, but I have a lot of issues and I refuse to let them start sticking needles in my back. I have had joints injected, so I don't have a problem with that in general, but I have seen the progression and it is never good. I saw an oestopath who was great but he moved out of town, I see a chiropractor and the yoga strengthens bilaterally (PT is great, but usually focused on one site). Since I have been going to yoga and deep tissue massage, my sciatica, numbness in my leg and back pain have diminished, No narcotics or NSAIDS. I do have my own TENS unit, I am not giving advice, I am sharing what alternative methods have worked for me.

Good luck and I hope you get relief.

scottaprn · Mar 11, 2015

If your therapist and doctor haven't taught you to avoid lumbar extension (which lying on your stomach creates) and hip external rotation it may be wise to seek additional information.

hopefully your doctor has ordered the correct xray series to assess for instability. And just as importantly has seen enough of them to interpret them correctly (reliability of measurement is a huge issue with this series even among radiologist which is a strong reason for seeing a spine surgeon who looks at them all day long).

The criteria for surgery on this problem is well established and it is very rare to actually operate on one. If you look at Sinaki study from all the way back in 1989 you will see that with proper rehab you have about a 16 percent chance of rating your back pain moderate or severe at a three year follow up and about a 75 percent chance of working fully.

Libby1987 · Mar 11, 2015

Nursing is not the end all be all. You can do wonderful things for people say as a SLP.

Hands down and across the board, our SLP's are happy cheery people, I don't exactly know why but I think their workload and stress is different than nursing. Yet they're svery educated and make differences in people's lives. And not a lot of holiday, on call or nights.