The researchers found no difference in back pain in studies where one group received training and the other didn’t. Training compared to minor advice (a video) showed no effect on back pain after a year.

Another trial showed no significant difference in back pain between one group who received training and another who were given back belts to wear. Training and physical exercise were compared in one trial and again no difference in back pain was found during a follow up less than a year later.

Finally a group receiving both training and an assistive device was compared to a group receiving training only and another control group which received nothing – there was no difference in back pain at follow up.

The researchers say either the advocated techniques do not actually reduce the risk of back injury, or workers do not significantly change their habits enough for it to make any difference.

They conclude that we need a better understanding of the relationship between exposure to stresses on the back at work and the subsequent development of back pain in order to develop new and innovative ways of preventing back pain because of lifting.

In an accompanying editorial Associate Professor Niels Wedderkopp says the current advice for people with back pain to stay active may not be appropriate for people whose work involves heavy lifting. He says: “A change of job and (prudently) staying active in daily life may be the best way for these patients to regain command of their back and their occupation.”