The epidemiology of work-related musculoskeletal injuries among chiropractors in the eThekwini municipality

Abstract

Background: Chiropractors are a unique group of health care professionals who are at risk for developing work-related musculoskeletal injuries. Diversity of daily practice imposes different physical demands on the chiropractor. The present study aims to determine the prevalence of work-related musculoskeletal injuries in chiropractors in eThekwini municipality and selected risk factors associated with work-related musculoskeletal injuries. There are very few studies available that look at the chiropractor holistically in terms of work-related musculoskeletal injuries. However, these existing studies suggest that chiropractors are at a greater risk for the development of work-related musculoskeletal injuries.

Method: The study design was a quantitative, cross-sectional, descriptive study utilising a self- administered questionnaire, developed specifically for this research, using an expert group and pilot study. The questionnaire contained sections on personal as well as practice demographics, with questions pertaining to the single most severe work-related musculoskeletal injury, as well as the second and third most severe work-related musculoskeletal injury. Risk factors for work- related musculoskeletal injury were tested by using chi square in the case of categorical variables. In the event of violation of the expected frequencies, the Fisher’s exact test was used to obtain the p-value. Logistical regression was used to obtain odds rations in the presence of more than one explanatory variable. A p-value of <0.05 was used to indicate statistical significance.

Results: Sixty-two chiropractors responded, giving a response rate of 64%. The life-time prevalence of work-related musculoskeletal injuries was 69%. A predominance of injuries to the upper extremity (50%) and lower back (28.3%) were recorded. The hand/wrist was the most common anatomical site of injury (31.5%) followed by the lower back.

Number of years in practice was considered a risk factor for injury as most injuries occurred within the first five years of practice (41.6%). The likelihood of injury decreases with an increase in the number of years in practice.

The majority of injuries affected the soft tissue, including ligament sprains (27.5%) and muscle strains (26.6%) and occurred while the practitioner was performing manipulation (38.2%) of the lumbosacral (80.77%) area with the patient in the side posture (61.53%).

Conclusion: The results concur with other studies on work-related musculoskeletal injuries in chiropractors and add insight into risk factors predisposing this population to injury. Chiropractors need to understand the risk factors for occupational injury to implement strategies to avoid risk of injury.