What do UK osteopaths view as the safest lifting posture, and how are these views influenced by their back beliefs?


      • Osteopaths believe that straight back lifting is safer for the back.
      • •Unhelpful and negative back pain beliefs are common amongst osteopaths.
      • •Osteopaths who believe straight back lifting is safer view the back as more vulnerable.
      • •Osteopaths should provide evidence-based information to patients such as ‘trust your back’ while staying active.



      Lower back pain is a leading cause of disability and a common condition seen by osteopaths. Evidence and advice for the safest lifting posture vary, as do healthcare practitioners' attitudes and beliefs towards back pain.


      The aim of this study was to understand osteopaths' beliefs about safe lifting postures in relation to their attitudes towards back pain, and to compare these findings with published data from physiotherapists and manual handling advisors.


      Cross-sectional study.


      Between October and November 2018 a cross-sectional electronic survey was used to invite a sample of UK osteopaths to select images that best represent their perception of safe lifting posture (straight or rounded back), and to complete the Back Pain Attitudes Questionnaire (Back-PAQ). Data was analysed to assess lifting posture selection and relationship to back pain attitudes.


      46 (85.2%) out of 54 osteopaths selected straight back posture as safest, these participants had significantly more negative attitudes to back pain injury (i.e. higher Back-PAQ scores), than the 8 osteopaths who selected a rounded back posture (p = 0.007). Data from 266 physiotherapists and 132 manual handling advisors revealed an overall agreement about straight back lifting posture, and differences in Back-PAQ attitude between the professions.


      Despite a lack of evidence and inconsistent recommendations, osteopaths in this study believed that straight back lifting posture is the safest. Practitioners' attitudes vary and are known to influence their patients' attitudes and recovery behaviour. Further research is recommended to identify reasons for different beliefs, and their impact on advice-giving and patient outcomes.


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