What are the back beliefs of NHS employees, and does manual handling training influence them

Background: Work absence due to back pain is best predicted by beliefs and attitudes. Lots of money is spent on training in the NHS trying to prevent back pain; this study explores the effect of that training on back pain beliefs. Methods: 151 NHS employees were surveyed using the Back Pain Attitudes Questionnaire before and after manual handling training. Results: NHS employees had mixed beliefs. Before training, staff had positive beliefs about activity participation (8.25, SD 1.78), neutral beliefs about psychological influences (6.11, SD 2.51) and prognosis (6.34, SD 2.18), negative beliefs about relationship with injury (5.26, SD 2.09) and strongly negative beliefs about vulnerability of the back (2.81, SD 1.45). Training had a small negative effect (–1.57, SD 4.06 p < 0.001) primarily through exacerbating beliefs regarding the vulnerability of the back (–0.45, SD 1.24, p < 0.001) and the relationship between pain and injury (–0.80, SD 1.83 p < 0.001). Conclusion: NHS employees hold many outdated views on back pain. The immediate effects of manual handling training based on the traditional paradigm of ‘protect your back’ appeared to make respondents slightly more cautious about using the spine; viewing it as easy to injure, that pain and damage may be linked, and slightly less optimistic about recovery.