Low-back pain in a 4hr case...

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Specializes in Med Surg, ER, OR.

I had my first experience with an open heart procedure today! I never knew what to anticipate other than what I read last night in my text prior to going in and seeing it. As a nursing student, we often don't get too many experiences at the local hospital with these kinds of cases, but boy-oh-boy was it fascinating! I am so jealous of all you cardiac surgery nurses out there who see this stuff day-in and day-out.

So...after the 4 hrs we spent in the OR, I realized my lower back was cramping and aching horribly. How do you nurses deal with the lower back strain? I never feel this way after being on the floors for 12hrs, so why so much pain for such a smaller amt of time? Maybe its just my inexperience, shoes, or standing in one spot for the entire time...who knows.

Thanks for any info you guys can provide.

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I had my first experience with an open heart procedure today! I never knew what to anticipate other than what I read last night in my text prior to going in and seeing it. As a nursing student, we often don't get too many experiences at the local hospital with these kinds of cases, but boy-oh-boy was it fascinating! I am so jealous of all you cardiac surgery nurses out there who see this stuff day-in and day-out.

So...after the 4 hrs we spent in the OR, I realized my lower back was cramping and aching horribly. How do you nurses deal with the lower back strain? I never feel this way after being on the floors for 12hrs, so why so much pain for such a smaller amt of time? Maybe its just my inexperience, shoes, or standing in one spot for the entire time...who knows.

Thanks for any info you guys can provide.

Its probably a combination of shoes, height and reaching wrong. Shoes - get good shoes with good arch support. I wear Danskoe's in the OR. They are expensive but worth it. The arch is great and they tilt you slightly forward which saves your back.

Table height. If the table is too low then see if they can raise it. Or if you are on too many steps so you are bent over when assisting or passing instruments then you need to get rid of some. The more common cause is that the table is too high. You are stretching and reaching when you don't have to. In this case you need some steps. If you have a big work area build a little platform to move around on.

As far is reaching. You want to square up to the table and reach from there. Try not to extend and twist as this is a good way to screw up your back.

Finally try some isometric exercises during the case to keep loose. Keep in mind that there are much longer cases. Four hours is just the tip of the ice berg.

David Carpenter, PA-C

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Specializes in CST in general surgery, LDRs, & podiatry.
i had my first experience with an open heart procedure today! i never knew what to anticipate other than what i read last night in my text prior to going in and seeing it. as a nursing student, we often don't get too many experiences at the local hospital with these kinds of cases, but boy-oh-boy was it fascinating! i am so jealous of all you cardiac surgery nurses out there who see this stuff day-in and day-out.

so...after the 4 hrs we spent in the or, i realized my lower back was cramping and aching horribly. how do you nurses deal with the lower back strain? i never feel this way after being on the floors for 12hrs, so why so much pain for such a smaller amt of time? maybe its just my inexperience, shoes, or standing in one spot for the entire time...who knows.

thanks for any info you guys can provide.

as the self-appointed "queen of the bad back society" i can surely empathyze! i have had two spinal surgeries myself since i started working in the or, for inherited spinal stenosis and spondylolisthesis. the first one a laminectomy and foramenotomy to release impinged nerves after suffering with bilateral sciatica down to my toes and including some degree of foot-drop; and the second one five years later was a spinal fusion with hardware because the original laminectomy was so wide it left me unstable, and with more nerve impingement with more bony overgrowth.

there are some things i have found that help a lot - whether you're an observer in the room, or actually at the field. first, the good shoes that were recommended in the first answer to yours are paramount - there's nothing worse than cheap, bad shoes to make your feet and back hurt and ruin your day. plan to replace them about every 6 months or so, more often if you are on your feet full time in the same shoes every day. if you can, get two pair of the same very good shoes and alternate them so you don't wear either of them out quickly and completely before replacing them. make sure they are absolutely heaven to walk in before you even buy them. don't plan on "breaking in" any shoe that is not totally comfortable from the get-go.

another thing is your hosiery. good support hosiery is a real help when it comes to spending hours on your feet, no matter how old you are. you may need to try a few different kinds to find the ones that work for you - your legs and feet and your back will thank you at the end of your day every time! i avoided varicose veins for 25 years by wearing them daily - working or not. a hint - if it says "light support" put it back on the rack - that's not the kind i mean. get at least medium if not firm support - they may be a pain to put on at first, but you get used to that, and by the time you've spent a few days on your feet constantly, you'll begin to appreciate them.

third - change your position frequently. don't get too overtired or cramped up in one spot if you can help it. i have found that putting one foot up for a while on a stool, or even the base of the or bed if i can get that close and i'm scrubbed in, is a big help, and changes the contour of your spine enough to relieve the stiffness.

if you are not scrubbed in, try bending slowly forward for a few seconds and letting your arms dangle, then stand back up slowly. or back up against a wall, and purposely flatten your spine against it while bending your knees - all the way down your back, especially including your lumbar spine. it's like trying to sit down but there's no chair there to sit on. this gives it a stretch and relieves some of the cramping you might begin to feel if you stand in one spot too long. hold it for about 20 seconds or so, and then slowly "unroll" your spine back into normal position. if you get to sit, then sit but don't slump. if you have to stand the whole time, just don't stand stock still in one spot for four hours - you won't be able to move once the case is over with! do not lock your knees, and don't try and stiffen up. bend your arms at the elbow, and then stretch your arms back like you are trying to touch your elbows together briefly. never bend and twist at the same time - ever. that's the worst thing you can do to your spine and it is not very forgiving after a while!

good luck on your future observations in the or - it's a really special place to be!

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Specializes in Med Surg, ER, OR.

thanks to the both of you for such great advice.

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Specializes in Cardiac.

When I was a student, I also had this low back pain when observing in the OR.

For me, it was because I was shivering all the time D/T the cold.

I don't have that kind of pain any other time except when it's that cold somewhere. Sometimes I do conscious sedation in an OR, and that pain comes back.

Of course, being a native of Az, I've very sensitive to the cold...

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Specializes in CST in general surgery, LDRs, & podiatry.
when i was a student, i also had this low back pain when observing in the or.

for me, it was because i was shivering all the time d/t the cold.

i don't have that kind of pain any other time except when it's that cold somewhere. sometimes i do conscious sedation in an or, and that pain comes back.

of course, being a native of az, i've very sensitive to the cold...

without mentioning brand names, for fear of supporting one over another - those self-heating wraps that go around your lower back - or even the stick-on kind - will help with the shivers two ways. one is that it provides a source of warmth, in general, and two, to your lower back where the muscles tend to tense up first, specifically. they can be a lifesaver for long cases in cold rooms when you can't find or can't wear a jacket for whatever reason.

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Specializes in Cardiac.
without mentioning brand names, for fear of supporting one over another - those self-heating wraps that go around your lower back - or even the stick-on kind - will help with the shivers two ways. one is that it provides a source of warmth, in general, and two, to your lower back where the muscles tend to tense up first, specifically. they can be a lifesaver for long cases in cold rooms when you can't find or can't wear a jacket for whatever reason.

omg, i never even thought of that! how clever!

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I have been a scrub for 8 years and I had an anterior lumbar fusion 4 years ago. I can tell you that the Dansko shoes have been a true life saver for me. I can be scrubbed in for hours up to 8hrs recently and my back and feet held up quite well. Was very tired and sore but know where near the pain level from when I wore tennis shoes in O.R. Plus the Dansko's $100/pair are a tax writeoff. Every little bit helps

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Specializes in ER,MED_SURG,REHAB,HOME HEALTH, OR,.

have u tried putting one foot on stool for a while then switching after a time just relaxing one of my legs and feet for just a lil bit seems to help me and yes the shoes

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