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Causes of Low Back Pain in the Workplace
Approximately 40 million people suffer from low back
pain in the United States. Second only to the common cold, it is a leading
cause of absenteeism at work. Low back pain results in a tremendous strain
on the economy
and represents one fourth of all Workman’s Compensation claims. About 3
out of 4 people will have an episode of severe low back pain at some time in
their life, the majority of these occurrences are work-related.
For about 85% of back pain sufferers the primary pain site
is located within the low back. Diseases affecting the spinal column which can
cause low back pain can include muscle strain, herniated discs, arthritis, tumors,
infections, and congenital abnormalities. These problems can be the result of
wear and tear, trauma, or unfavorable genetics.
The workplace can cause a variety of injuries to the low
back. Improper lifting techniques can account for a significant number of low
back muscle strains and disc herniations. This is related to the fact that when
a person lifts even 10 pounds from a fully flexed (bent over) to upright position,
a force approximately 10 times the weight lifted or 100 pounds is transmitted
to the lumbar disc. The added force results because the weight lifted is relatively
far away from the spine.
Another common cause of disc injury is when workers
lose their balance or footing while carrying heavy weights, forcing an
unexpected shift in the weight away from the spine. The unexpected redistribution
of weight results in the worker trying to compensate and regain control
of the object being carried. This often results in using smaller muscle
groups within the low back and upper extremities. These small muscle groups
are not suited for heavy lifting and can often be injured. Also, this shift
in balance frequently moves the object being carried away from the workers
center of gravity further transmitting weight to the lumbar spine.
Other work-related low back injuries could result
from more sedentary jobs, as well. Poor posture related to improper
computer monitor heights or poor chair ergonomics can contribute
to low back pain. Typically these injuries are more insidious in
nature and present with a more chronic pain or low back muscle fatigue
syndrome.
Fortunately, the majority of these injuries can
be avoided with appropriate injury prevention programs, including
education and modification of the workplace. Moreover, early identification
of problems through worksite evaluations can potentially avoid progressive,
debilitating, low back problems in the future.
The good news about low back pain of spinal origin
is that over 90% of these conditions will improve without surgery. The
vast majority of employees with spinal disease will improve with medication,
rest, physical therapy, and temporary activity alterations. For the less
fortunate 10%, surgery, in properly selected patients, can offer a high
degree of success in reducing or even curing low back pain.
Although the overall prognosis for work-related
low back pain is good, the best treatment will always be prevention.
The hallmarks of a good prevention program are strong education
and early intervention.
--Mark McLaughlin MD practices neurosurgery in Springfield, Holyoke, and Greenfield,
MA
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