Occupational management of low back pain secondary to prolapsed intervertebral disc in a Malaysian healthcare worker: a case report emphasizing ergonomic intervention and risk reduction strategies.

Abstract

Low back pain (LBP) is a commonly encountered medical disorder in Malaysia's primary care setting, though establishing a direct connection between LBP and the workplace environment in adults is challenging. This case presents a clinic nurse who developed LBP due to a prolapsed intervertebral disc and her clinical management from an Occupational Health Doctor perspective. Her occupational management involved a walk-through survey at an urban hospital, which identified bone marrow aspiration as her most physically demanding task. Detailed assessment revealed that during this procedure, the nurse maintained awkward postures and performed repetitive movements while standing for extended periods. A Rapid Entire Body Assessment score of 4 suggested a medium risk, meriting further investigation. To accommodate her condition, the nurse was placed on light duty, with job modifications recommended to limit standing to no more than four hours and to avoid lifting objects exceeding five kilograms. Although the criteria for an occupational disease are not met, it is classified as a work-aggravated condition, given that her LBP was likely worsened by her daily work activities. In conclusion, effective management of occupational LBP requires thorough risk assessments. Modifying tasks and supervisor intervention are essential when job duties could exacerbate pre-existing LBP.