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back-pain

Complaints of chronic back pain are common in the veterinary professions but there are various ways to manage and prevent it. Kerryn Ramsey investigates

Dr Stephanie Wright, an Edinburgh-born veterinarian, knows all about the discomfort of long-term back injury from working in her profession. After spending 15 years with unrelenting pain, she finally had a major operation. Now running Murwillumbah Vet Clinic, a small-animal practice in far north-eastern NSW, Dr Wright admits this was the best thing she’s ever done.

Looking back, she admits she did “far too much heavy physical lifting, particularly with cattle”, while working in mixed practices in the north of England in the ’90s. “I was a bit young and silly back then but as a female, I was reluctant to ask for help from farmers. I was trying to prove myself in a very male environment.”

Her back injury occurred as a result of performing multiple caesarian sections on cows. After time off and some regular exercise, the pain eventually subsided. Dr Wright moved to Australia in 1993 and worked comfortably for mixed-animal practices but her back pain returned in 2000 when working on the NSW north coast.

One day, she was helping a vet X-ray a horse. She recalls: “I was holding the foot and all of a sudden, the stallion decided to lean against me and drop all his weight onto me. That was when I felt my back give out.” She soon discovered she had a slipped disc.

Back pain is a common complaint for veterinarians and vet nurses in both large- and small-animal practices. According to Dr Mark Craig, who practises musculoskeletal medicine at his Back Doctor practices in Brisbane and on the Gold Coast, it is essential to get the right diagnosis after an injury. “That way, you’ll then get the right treatment. Three of the most common causes are disc injury, facet joint arthropathy and sacroiliac joint dysfunction.”

Undoubtedly, there are risks when working in the veterinary profession, but back pain is extremely common across the entire population. According to an article in the Medical Journal of Australia, 80 per cent of Australians will be affected during their lives. “People who are sedentary and spend a long time standing—say, in an operating theatre—often suffer from discogenic back pain,” says Dr Craig. “Likewise, professions with a lot of sitting still, whether from long drives or in front of a computer, also suffer.

“The discs don’t have any blood supply; they get oxygen and nutrition from the surrounding tissue fluid. Movement causes compression and release, and that gets the fluid in and out of the discs. So you need activity to keep the discs healthy.”

“Living with chronic pain is hard … when it was really bad, I couldn’t even get dressed.”—Dr Stephanie Wright, Murwillumbah Vet Clinic

In many cases, he says, the best treatment for back pain is core stability training, such as Pilates and yoga. However, surgery may be the only option in a small minority of cases.

After Dr Wright’s disc injury in 2001, she spent a few years trying to recover by doing regular McKenzie exercises (a mix of physical therapy and exercise), using non-steroidal anti-inflammatories and seeing a GP, physiotherapist and acupuncturist.

Although she could only work comfortably three days a week, Dr Wright decided to join with a business partner to open the Murwillumbah Vet Clinic. “With a new business, I didn’t want to turn work down, even though I was in quite a lot of pain. Living with chronic pain is hard. I had to minimise my lifting but when I was really bad, I couldn’t even get dressed.” After giving birth to her second child in 2008, her back deteriorated further and, after taking advice from specialists, Dr Wright had major surgery—a fusion of L5-S1 and a disc replacement of L4. Although she was nervous due to major risks, there was an immediate improvement. “If I had known how good it would be, I would have had the surgery years ago,” she says.

While Dr Wright’s chronic back pain was severe, sufferers usually recover after doing core-strengthening exercise, such as Pilates, yoga and the McKenzie method. The Veterinary Industry Guide to Workplace Safety was endorsed by the Australian Veterinary Association and Veterinary Nurses Council of Australia (VNCA). Overall, if a staff member has back pain, they should seek appropriate medical treatment and advice—not only for the initial injury and pain but also to manage their back health going forward.

According to VNCA national president Jacque Pollitt, prevention is better than cure. “We really need to ensure that we don’t accept or encourage a ‘tough as nails’ attitude that’s detrimental to your back in the short and long term,” she says.

A common issue for veterinary staff is dealing with animals in cages and kennels. “Ideally, if patients can move out of a low cage by themselves, this minimises the risk to the veterinary nurse—but this is not always possible,” says Pollitt. “The safe lifting posture should always be used, remembering to bend at the knees and watch your head. It’s always important to assess the condition of the patient, taking care with sedated or recovering animals to avoid unexpected situations.”

At veterinary practices and clinics, providing quality ergonomic equipment such as scissor-lift trolleys and stretchers can help alleviate lower back pain. “Clinics should promote safe working practices and aim to have kennel rooms with cages that are easily accessible,” advises Pollitt. “You also need to know how to lift properly. Our rule is that any animal over 10 kilos requires two people to lift it. We have a table in the consulting room and a table in the prep area that can move up and down.”

Dr Mark Craig notes that optimal ergonomics—such as saddle stools, office chairs and sit-to-stand desks—all help improve posture. He also notes that a hydraulic operating platform needs to be well positioned for veterinarians. “The cost of a suitable operating platform would be much less than the cost of medical care due to injury from sub-optimal ergonomics,” he says. “It’s a false economy not to do it.”

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