March 8, 2016
Back to Basics: Your Job and Low Back Pain
Talk to anyone who has suffered severe low back pain, and they’ll tell you it’s downright disabling. Unlike the limitations of other body pain, like pain that limits neck movement, low back pain can leave its victims completely immobile. Unfortunately, the back is affected by so many factors that most jobs pose some sort of risk of injury. When it isn’t obvious that work is the cause of pain, people are unable to address the source and fix the problem. Worse yet, people work through the pain not realizing how much damage this can cause. Identifying the factors causing low back pain and addressing them as soon as possible is the best way to spare immense pain, cost, and lost work time.
The Bureau of Labor Statistics reports that most non-fatal work-related injuries are caused by overexertion and/or repetitive motion. Specifically, pushing, pulling, lifting, holding, carrying, and turning are all contributing factors to injury. Combining two or more of these actions increases risk. It is vital to understand that most injuries aren’t the result of one incident. Repeated stress and movement wears the body down over time, causing fatigue, weakness, instability, tissue damage, and the body’s compensation to all of these. This makes the body so vulnerable that something as simple as a sneeze may unexpectedly send the back into spasm. Let’s examine these movements:
- Pushing and Pulling – both of these movements initiate the natural tendency to bend forward or backward at the waist. Even proper posture during pushing and pulling recruits low back and abdominal muscles for stability to remain straight. Additionally, some pushing and pulling requires the worker to bend or rotate his spine, placing uneven or abrupt force on tissues.
- Lifting – it’s common knowledge that lifting with the legs can save the back. However, here again the back must stabilize to lift anything. Additionally, some tasks make it nearly impossible to avoid lifting with the back. Lifting heavy patients for bed transfers, for example, requires full body force to complete. It may feel unnatural or even disrupt the flow of work to move and lift with the legs. Some items lifted are high enough that bending the back is minimal and unnoticed. Workers may not realize they have poor body mechanics until pain sets in, at which point damage has already begun.
- Holding – dangers of holding aren’t just from holding an object, but holding the body. Some jobs require static postures for extended periods of time. When a muscle is shortened (bent or flexed) for a long period of time, it wants to stay that way. Returning to normal posture is painful because resting length of the muscle now stretches the muscle too far. To compensate, the muscle stays as short as it can. (Pay attention to people’s neck and shoulder postures. Often the neck is tilted or one shoulder is higher than the other. This is a common example of a muscle staying short.) The contracted muscle not only impedes the flow of nutrients and waste exchange in itself, but places additional stress on the muscles opposite of it. During the static posture, these opposing muscles are contracting to stabilize, but do so in a lengthened state. They, too, are unable to return to normal resting length after the activity, and become weak and unable to efficiently perform their primary movements. This cycle of asymmetry can tear or damage tissue and even pull bones out of place.
- Turning – as discussed in pushing and pulling, turning the body during any of the above activities places even greater stress on the body. Twisting the spine, especially twisting while lifting, is closely associated with slipped discs and sciatic pain. Muscles on either side of the spine need to work equally to keep it in place. Introducing more force on one side than the body can handle or without time to compensate can cause a lot of problems affecting both muscles and nerves.
Hopefully every job that entails these movements includes basic safety training and manual aids to minimize dangerous situations. No one should engage in handling an object in an unnecessary way – be it too heavy, placed at an improper height, manually transported too far, or moved too many times. There are many ways that worksites can ergonomically solve unnecessary overexertion and repetitive movement. Meanwhile, don’t ignore pain. Pain is a signal that something is wrong. Simply finding an unnatural position to work in that reduces the pain will exacerbate the problem. Rest, correct your posture or body mechanics, or recruit assistance from a manual aid or person.
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