[KMI TDMC] – Back Pain Among Working Adult

Back pain is a frequent complaint among working adults, impacting not only individual well-being but also workplace productivity. It is not a one-size-fits-all challenge; it manifests in diverse forms and durations, influencing individuals regardless of gender.

Surveys among manual handling employees reveal alarming statistics, with a significant percentage experiencing back pain episodes that necessitate medical attention or time away from work.

This article explores the prevalence of back pain and its contributing risk factors in the workplace. Followed by various prevention and management strategies. We cover primary prevention strategies implemented within the workplace, secondary prevention measures focused on individual management, and even tertiary prevention methods aimed at facilitating a fast and successful return to work after experiencing back pain.

Additionally, we have recommended specific exercises that you can incorporate into your workday to keep your back feeling its best.

Prevalence Of Back Pain

1. Acute episodes of back pain and primary chronic back pain (lasting longer than six months) are prevalent in adults of working age, regardless of gender
2. According to surveys of manual material handling employees, the prevalence of back pain over one year is as follows: 25% for back pain lasting seven days or longer, 14% for back pain necessitating medical attention, and 10% for back pain needing time away from work
3. Following an acute episode of back pain, the majority of individuals recover to normal function within a few weeks of seeking healthcare. Recurrent episodes of back pain following an initial episode usually happen, with estimates of up to two-thirds occurring within 12 months following recovery from back pain
4. In general, for people with chronic back pain, multidisciplinary biopsychosocial rehabilitation interventions are regarded as the most efficacious methods for preventing long-term work disability and enhancing function

Workplace Risk Factors for Back Pain

Various types of physically demanding work can increase your risk of developing back pain, hence back pain can be encountered in various sectors and professions. Some of the work-related physical risk factors include prolonged periods of sitting or standing postures, lifting heavy objects, performing tasks such as vacuuming and tiling during each shift, repeatedly bending or leaning forward, working in incorrect positions, operating manual instruments, exceeding physical capacity, and working with full body vibration. Lack of regular exercise, inadequate rest, and continuous work despite injuries is a well-established risk factor for LBP among industrial laborers. A review investigated the workplace risk factors for low back pain. According to this review, heavy physical labor, static work postures, frequent bending and twisting, lifting, pushing, and pulling, repetitive work, vibration, and psychological, and psychosocial factors were found to be related to increased risk of low back pain

Back Pain Prevention

Due to the lack of understanding regarding the risk factors and etiology of back pain injuries, prevention can be challenging. Occupational back pain can be addressed through three distinct levels of prevention, all of which have proven to be effective.

Primary Prevention

The most popular strategy used by businesses is usually primary prevention of back pain at work. Adjustments made in the workplace to lower the frequency of new episodes of occupational back pain could avert a great deal of back pain cases. In this instance, educating staff members on causes, risk factors, management, and prevention would help them become low risk for back pain.

It has been demonstrated that teaching material handlers “proper” lifting practices can effectively reduce back pain related to their jobs. Another is to design the workspace to lower the physical requirements of the occupation. For example, hospitals use mechanical hoists to lessen the burden of nurses lifting patients.

To establish suggested weight limitations for workers, the National Institute of Occupational Safety and Health (NIOSH) created a lifting equation in 1981 and updated it in 1991. In 1993, the National Institute for Occupational Safety and Health (NIOSH) published the Revised NIOSH Lifting Equation (RNLE) for evaluating the physical demands of two-handed manual lifting tasks.

There is currently no widely recognized technique for estimating a worker’s safe lifting capacity. NIOSH recommends a maximum lifting weight of 23 kg when the object is close to the body. The use of physical examinations and replacement strength tests as screening techniques for back diseases is debatable; radiological screening has not significantly improved the predictive usefulness of screening for back pain in the future.

Furthermore, randomized clinical research has demonstrated that abdominal belts showed low evidence to prevent back discomfort. The effectiveness of back schools, which are educational programs providing information on back care, posture, body mechanics, back exercises, and strategies for preventing chronic back pain, has not been definitively established. Decreasing the physical requirements of the workplace through interventions has worked well. Discussions regarding the efficacy of preventive measures like workplace redesigns, which might be costly, should, nevertheless, consider a variety of things. One excellent illustration is the “ergonomics” of office design, which fits tasks to employees’ talents. These include the hand to input devices (mouse and keyboard), the torso to the chair, the feet to the floor, and the eyes to the source (monitor). The adjustments made in the workplace with the

intention of preventing back pain will not have the desired effect if workers are not involved and management is not committed to the change. It is challenging to pinpoint precisely what needs to change, and it is unclear how to assess the results.

Strong scientific data supports the cost-effectiveness of primary preventative measures against occupational back pain[17]. Further research on workplace interventions is yet required. Studies have proposed that they need to look more closely at the roles played by organizational and psychosocial elements in particular.

Secondary Prevention

International recommendations for the treatment of backache are well-documented and supported by science in the medical literature. Since the goal of these recommendations is to standardize clinical practice among physicians, their implementation presents a challenge.

It is becoming more and more obvious that managing back pain optimally will speed up a worker’s recovery and cut down on time off from work. Adhering to the following guidelines, which are measured against global norms, is crucial

The important features of back pain, both acute and subacute (<3 months):

• Encourage against bed rest, or if necessary, restrict to no more than two days.
• Continue to move (exercise).
• No radiographic investigations unless there is caution, which includes cauda equina syndrome, major trauma, age <20 or >50, and spinal infection.

For back discomfort that has persisted for longer than three months:

• Consult physiotherapy (for evaluation and exercises).
• Look for psychological issues, sometimes known as “yellow flags,” by using a published questionnaire or seeing a psychiatric professional.

According to studies, exercise helps with back pain symptoms, allowing for an earlier return to work and a reduction in sick days.

Tertiary Prevention

The employee with back discomfort may engage in flexible modified work. This can be challenging for small businesses. Back pain-related disability is a complex issue that challenges established notions of health and illness, as well as social and medical decision-making frameworks. It is crucial to recognize the limitations and valid merits of rehabilitation programs when it comes to the treatment of chronic back pain.

It’s important to highlight that achieving this level of prevention presents challenges unless the patient is motivated to engage in a rehabilitation program and interdisciplinary management addressing the psychosocial aspects of occupational back pain.

Recommended Exercise at Workplace

Studies indicate that exercising at work reduces stress and boosts creativity, vitality, and productivity. When workers include a midday workout, their mood is enhanced and the overall work atmosphere improves.

If working out throughout the workplace is still not practicable, even little activities can have a significant impact on preserving health. Just getting moving is the important objective!

The Extension of Michigan State University suggested that a person can do the following exercises at work.

• Leg lifts when examining emails during sitting.
• Whether to stand or move during a conference call.
• Place your filing cabinet across the room so that you have to get up to get things.
• Use the bathroom located furthest from your workstation.
• Ten push-ups each hour.
• During your lunch break, take a stroll around the building.
• Use the stairs rather than the lift.

Do you want to play around at your desk? Consider using gym ball in place of your boring, everyday chair. You won’t even realize you’re moving all day long thanks to its coziness. Another excellent core exercise is to balance your seat on an exercise ball!

Other tips to include physical activity at the workplace

• Utilizing a height-adjustable desk enables you to consistently engage in work while standing. However, even in the absence of appropriate equipment, one can enhance the activeness of the workday by, for instance, moving or walking around during phone calls or meetings[30].
• To prevent excessive sitting, it is advisable to plan and incorporate frequent intervals of physical exercise. The lunch break can be used well to engage in strolls, and physical activities, or participate in brief athletic sessions.
• The daily journey to work can frequently be planned using a more dynamic approach. Consider opting for cycling or walking instead of using a car. When using public transportation, it is recommended to get off one or two stops before your intended destination. If it is really necessary for you to drive a car, you could consider parking at a greater distance and covering the remaining distance on foot.
• Numerous corporations provide sporting activities for their staff members, for instance, arrange a break activity plan or an after-work run with coworkers. Collectively, the motivation is significantly amplified.

Occupational Rehabilitation

In cases where back pain hinders an individual’s ability to return to regular work for an extended period, multidisciplinary rehabilitation programs have demonstrated a moderate level of efficacy in restoring social, and physical function and facilitating work resumption for individuals with acute or chronic back pain.

In cases where back pain hinders an individual’s ability to return to regular work for an extended period, multidisciplinary rehabilitation programs have demonstrated a moderate level of efficacy in restoring social, and physical function and facilitating work resumption for individuals with acute or chronic back pain.

Conclusion

Back pain, while prevalent, doesn’t have to hold you back. By understanding the risks along with the preventative measures, and actively managing any discomfort you experience, you can empower yourself to maintain a healthy back and enjoy a fulfilling work life.

Remember, open communication with your employer and healthcare provider is crucial for creating a supportive environment and accessing appropriate resources. Implement the tips and strategies outlined in this post, and prioritize your back’s well-being – a healthy back is a productive back!

Proofread by:

MOHD KHAIRUL AZHAR BIN ARIFFIN

Senior Executive Physiotherapist

KMI Taman Desa Medical Centre