For many nursery and landscape workers, back pain does not send them home. It's something they work through, and ultimately, it’s so common that many workers view it as part of the job.

Scientists from the University of Florida (UF)-based Southeastern Coastal Center for Agricultural Health and Safety (SCCAHS), including faculty from UF’s College of Public Health and Health Professions (PHHP) and the Department of Family, Youth and Community Sciences (FYCS), are conducting a study to determine if self-management of pain and ergonomic modifications are effective for addressing back pain in the horticulture industry.

In the study’s first phase, stakeholders from the nursery and landscape industry, including supervisors, workers and insurance consultants, confirmed that many workers continue working despite pain.

“Not only is back pain debilitating for workers who rely on their bodies for income, reduced productivity, losing experienced workers and overall costs for injury have major consequences for companies,” said Kim Dunleavy, a clinical professor in the

Department of Physical Therapy in UF’s PHHP and lead researcher for this study. “Back pain can also lead to relying on pain medication, such as opioids and muscle relaxers, or over-the-counter medications, such as acetaminophen and anti-inflammatories, with negative health side-effects.”

Early interviews with horticulture workers and industry leaders highlighted the seasonal and weather-related variability in workloads, requiring practical solutions that serve both employees and employers.

Workers described spending long hours lifting heavy plants, carrying materials, digging, and working in bent or awkward positions, all of which can take a toll on the body over time. Many said the short-term benefits of working through pain can come at a longer-term cost, including injuries, worker burnout, lost productivity and challenges keeping talented employees.

Study participants said preventing back injuries would not require major changes in workplace practices, but they pointed to the need for tailored interventions for the horticulture industry. They acknowledged the need for greater awareness in the workplace about pain, and more guidance on injury prevention, an area where formal training is often limited, Dunleavy said.

Using the information collected in the first phase, the research team created short videos introducing the risks of medication, including opioids, alternative options to manage pain spikes and easy ways to modify work to reduce physical stress. During the study, English- and Spanish-speaking workers were shown the videos in their work settings and used the strategies presented.

“Participants in the study were grateful to their companies for making it possible for them to participate and commented on the importance of options to help them continue to work and to reduce their pain,” Dunleavy said.

Preliminary findings are encouraging with improvements in work task difficulty and pain, she said. The results highlight the importance of introducing the risks of pain medication, encouraging workers to use simple ways to manage pain and tailoring strategies to protect workers before pain becomes a more serious or long-term problem.

“Workers shared ways to adjust tasks with others rather than ignoring the pain, allowing them to ask for or offer help,” Dunleavy said.

One theme from the interviews was the role supervisors can play in preventing pain and responding to back pain. In an industry where much of the training happens on the job, Dunleavy said supervisors are often the first to notice when a worker is struggling and are a source of guidance on safe work practices. Workers, business owners and industry consultants all similarly pointed to crew leaders and supervisors as critical influencers of workplace culture and safety.

Dunleavy said creating a culture where workers feel comfortable speaking up and supervisors are equipped to reinforce safe work habits could help reduce injuries and keep experienced employees on the job longer. As one of the first studies investigating a combination of self-management for pain and risk-reduction methods at work, Dunleavey said the methods used in this study easily could be implemented in horticulture and other agricultural settings.

This research was funded by the National Institute of Occupational Safety and Health through SCCAHS. The research team partnered with the Florida Nursery, Growers and Landscape Association to co-create relevant interventions to be delivered in the workplace.