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Back Pain at work
DR. S.SENTHIL SAILESH MS ORTHO
Have you had low back pain?
Prevalence of Back pain
• 60% to 70%
– 76% of Computer professionals from India reported
musculoskeletal discomfort
• Prevalence increases and peaks between the
ages of 35 and 55 years
Back pain and other
Musculoskeletal disorders
at
work place
How is the back structured?
Cervical spine
Thoracic spine
Lumbar spine
Sacroiliac joint
Coccyx
Anatomy Of Spine
Vertebrae
• Individual bone of the spine
Intervertebral Disc
• Flat, round "cushions" that act
as shock absorbers between
each vertebra in our spine
Low back pain
• One of the most
common causes
of disability among
people of working age
• It’s been reported that
after headaches and
colds, back pain is the
3rd most common
reason for taking time
off work
Pain
Causes or risk factors in LBP
Causes of Back Pain
• Poor posture
• Weak muscles
• Improper footwear
• Lack of exercise
• Extra weight
• Improper lifting
• Our backs were not designed
to spend long periods of time
sitting at desks
• Spending 6 to 8 hours a day in
front of a computer can lead
to shoulder, arm, hand and
neck problems
Forward Head Posture
• Recognised by the
positioning of the ear
being forward of the
shoulder, rather than
sitting directly over it
Round Shoulders
• Rounded shoulders are
usually the result of
slouching. Prolonged
slouching can strain the
muscles between the
shoulder blades,
causing upper back
pain.
Rotated Hips
• Uneven Hips affects
the pelvic, lumbar and
thoracic areas of your
spine.
• Misalignments of the
lumbar spine can affect
the proper functioning
of the nerves, which
can lead to numbness,
tingling and associated
pain.
Effect On Quality of Life
Effect On Quality of Life
• Major physical, social, mental, and occupational
disruptions
• Loss of physical function
• Deterioration of general health and reconditioning
(loss of muscle tone and weight gain)
• Constant or episodic painor increase in the level of pain
Effect On Quality of Life
• Loss of social functioning
– Manifested as decreased participation in social and leisure
activities, family stress, or loss of group and community
relatedness
• Disruption of psychological functioning
– Manifested through insomnia, irritability, anxiety,
depression and somatic complaints
Identify Your risk
Check off the factors that apply to you
 I often carry heavy items
 I am more than 20% overweight
 I stand or sit in one position for 30 minutes or more
 I cradle a phone between my ear & shoulder
 I sleep on a mattress that is too hard or soft
 I wear high heeled shoes
 I perform tasks that require frequent bending
 I reach for items above my shoulders
 I carry or lift children
 I lift heavy objects off the floor
More boxes you have checked, the
greater your risk of back pain
DO NOT ignore signs and symptoms of Low
back pain
Truth about back pain
Posture tips
Proper posture gives spine the support it needs
• Avoid slouching or leaning forward
• Sit or stand upright with your shoulders over
your hips
Proper lifting techniques avoid pressure on
spine
• Before you begin a lift
– Evaluate the load
– Can you manage it?
– Get assistance if needed
– Rearrange the load if needed
– Use mechanical lift equipment if needed
Proper lifting techniques avoid pressure on
spine
• To lift correctly
– Get a firm footing and shoulder-width stance
– Bend your knees and hips instead of your waist
– Tighten your stomach muscles
– Use your legs
– Keep the load close to your body
– Keep your back upright
Practice healthy back habits
• Don’t sit for too long. Get up, stretch and
walk around from time to time
• In fact you should take a 1 – 2 minute break
every 30 minutes you spend sitting at a desk
or workstation
• Have back support to help you sit up straight
Practice healthy back habits
• Work at a comfortable height at your desk or
work bench
– Adjust your chair so that your feet are flat on the floor,
your thighs parallel to ground, with your knees forming a
90 degree angle.
– Your eyes should be in line with the top of your monitor
– Keyboard should be level with the height of your elbows
when your arms are hanging loose by your side
• Place often used objects within arm’s reach to
avoid twisting
Practice healthy back habits
• Avoid cradling the phone on your shoulder.
Use a speaker phone or headset
• Shift luggage weight from side to side to
balance the load
• Use good posture when standing
• Avoid awkward or unbalanced postures as
well a crossing your legs
• Use a mattress that supports your back
Strengthen and Stretch
Back Muscles
• Condition your back muscles to work as a
team. Start a regular exercise program
• Strengthen the muscles in the back, upper
legs, and stomach
• Increase your flexibility
• Maintain a healthy body weight
Exercises to Strengthen Your Back
• Wall slide - to strengthen upper leg muscles
– Stand with your back against a wall and feet slightly apart
about 1 foot out from the wall.
– Slowing sink into a sitting position.
– Hold for 5 seconds, then slide back
up the wall.
– Relax and repeat
Exercises to Strengthen Your Back
• Crunches – to strengthen stomach muscles
– Lie on your back with your knees bent and feet flat on the
floor
– Fold your arms across your chest
– Use your stomach muscles to lift your shoulders blades
and head a few inches off the floor
– Hold for 5 seconds and slowly lower back to the floor
– Relax and repeat
Exercises to Strengthen Your Back
• Elbow to Knee-to strengthen stomach muscles
– Lie on your back with your knees bent and feet flat on the
floor
– Place hands behind head to support your neck
– Press your lower back into the floor
– Using your stomach muscles to lift your left shoulder
toward your right knee
– Hold for 5 seconds and slowly lower back to the floor
– Relax and repeat on the other side
Exercises to Strengthen Your Back
• Trunk raise – to strengthen lower back
– Lie on your stomach with your hands at your sides
– Lift your upper body off the floor as high as you can
without lifting your arms
– Keep your spine and neck in line. Don’t tilt your head back
– Hold for 5 seconds, and slowly lower yourself back to the
floor
– Relax and repeat
Exercises to Strengthen Your Back
• Pelvic tilt
– Lie on your back with your knees bent and feet flat on the
floor
– Place your hands behind your head or at your sides
– Press your lower back into the floor
– Tighten your stomach and buttock muscles
– Tilt your pelvis up slightly and hold for 5 to 10 seconds
– Relax and repeat
Exercises to Strengthen Your Back
• Knee Drop
– Lie on your back with your knees bent and feet flat on the
floor
– Keeping your knees together, drop them to the left as far
as possible
– Keep both of your shoulders on the floor
– Hold for 5 seconds
– Relax and repeat on the other side
Exercises to Strengthen Your Back
• Knee to Chest
– Lie on your back with your knees bent and feet flat on the
floor
– Raise your right knee toward your chest and hold your
thigh behind the knee
– Slowly and gently pull your right knee to your chest
– Hold for 5 seconds, then lower leg to floor
– Relax and repeat on the other side
Exercises to Strengthen Your Back
• Hamstring stretch
– Lie on your back with your straight out in front of you and
your buttocks close to a doorway
– Raise your right leg and rest it against the doorway
– Keep your legs straight, but don’t lock your knees
– Hold for up to 20 seconds, then
lower leg to floor
– Relax and repeat on the other side
Exercises to Strengthen Your Back
• The Cat
– Kneel on all fours
– Distribute your weight evenly on your hands and knees,
flatten your back and hold your head in line with your
spine
– Tighten your stomach muscles
– Round your shoulders and gently pull in your buttocks
– Drop your head and neck forward so you are looking down
toward your knees
– Hold for 5 seconds
– Relax and repeat
Exercises to Strengthen Your Back
• Press up
– Lie on your stomach with your face down and your palms
flat on the floor
– Keeping your pelvis on the floor, lift yourself up onto your
elbows
– Raise your chest and allow your lower back to sag and
lengthen
– Look straight ahead. Don’t arch your neck by looking up
– Hold for 5 seconds and lower yourself back onto the floor
– Relax and repeat
Treating a Back Attack
• Signals
– Pain in the lower or upper back
– Pain down the side or back of the leg and/or into the foot
– Tingling or numbness in part of the leg
Treating a Back Attack
• Home Care
– Take it easy if you have mild pain
– Rest flat on your back if you have severe pain
– Apply cold packs and ice to reduce pain, swelling, and
muscle spasms
– Take over-the-counter pain medication
Treating a Back Attack
• After the swelling goes down
– Apply heat to soothe the pain
– Slowly return to your normal
activity level
• After your back heals
– Use good habits to prevent re-injury
– Rest, stretch, and strengthen your back
Treating a Back Attack
• Call your doctor if you have:
– A loss of bladder or bowel control
– Numbness in the groin or rectal area
– Numbness, pain, or extreme weakness in lower
extremities
– Significant pain for more than 1 week
– Symptoms that are getting worse
Managment of LBP
Non Pharmacological
Pharmacological
Myths for treatments!
X Bed rest
X Lumbar supports
X Electrical treatments e.g. Laser therapy,
interferential, therapeutic ultrasound
X Traction
X TENS machines – limited use in low back pain
Prevention is Up to You
• Use proper posture
• Use appropriate lifting techniques
• Practice healthy back habits
• Strengthen your back, leg and stomach
muscles
• Stretch your back, leg and
stomach muscles
Maintaining a healthy spine, can help you
maintain a healthier life

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Prevent back pain at work

  • 1. Back Pain at work DR. S.SENTHIL SAILESH MS ORTHO
  • 2. Have you had low back pain?
  • 3. Prevalence of Back pain • 60% to 70% – 76% of Computer professionals from India reported musculoskeletal discomfort • Prevalence increases and peaks between the ages of 35 and 55 years
  • 4. Back pain and other Musculoskeletal disorders at work place
  • 5. How is the back structured? Cervical spine Thoracic spine Lumbar spine Sacroiliac joint Coccyx
  • 6. Anatomy Of Spine Vertebrae • Individual bone of the spine Intervertebral Disc • Flat, round "cushions" that act as shock absorbers between each vertebra in our spine
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12. Low back pain • One of the most common causes of disability among people of working age • It’s been reported that after headaches and colds, back pain is the 3rd most common reason for taking time off work Pain
  • 13. Causes or risk factors in LBP
  • 14. Causes of Back Pain • Poor posture • Weak muscles • Improper footwear • Lack of exercise • Extra weight • Improper lifting
  • 15. • Our backs were not designed to spend long periods of time sitting at desks • Spending 6 to 8 hours a day in front of a computer can lead to shoulder, arm, hand and neck problems
  • 16. Forward Head Posture • Recognised by the positioning of the ear being forward of the shoulder, rather than sitting directly over it
  • 17. Round Shoulders • Rounded shoulders are usually the result of slouching. Prolonged slouching can strain the muscles between the shoulder blades, causing upper back pain.
  • 18. Rotated Hips • Uneven Hips affects the pelvic, lumbar and thoracic areas of your spine. • Misalignments of the lumbar spine can affect the proper functioning of the nerves, which can lead to numbness, tingling and associated pain.
  • 19. Effect On Quality of Life
  • 20. Effect On Quality of Life • Major physical, social, mental, and occupational disruptions • Loss of physical function • Deterioration of general health and reconditioning (loss of muscle tone and weight gain) • Constant or episodic painor increase in the level of pain
  • 21. Effect On Quality of Life • Loss of social functioning – Manifested as decreased participation in social and leisure activities, family stress, or loss of group and community relatedness • Disruption of psychological functioning – Manifested through insomnia, irritability, anxiety, depression and somatic complaints
  • 22. Identify Your risk Check off the factors that apply to you  I often carry heavy items  I am more than 20% overweight  I stand or sit in one position for 30 minutes or more  I cradle a phone between my ear & shoulder  I sleep on a mattress that is too hard or soft  I wear high heeled shoes  I perform tasks that require frequent bending  I reach for items above my shoulders  I carry or lift children  I lift heavy objects off the floor More boxes you have checked, the greater your risk of back pain
  • 23. DO NOT ignore signs and symptoms of Low back pain
  • 26. Proper posture gives spine the support it needs • Avoid slouching or leaning forward • Sit or stand upright with your shoulders over your hips
  • 27. Proper lifting techniques avoid pressure on spine • Before you begin a lift – Evaluate the load – Can you manage it? – Get assistance if needed – Rearrange the load if needed – Use mechanical lift equipment if needed
  • 28.
  • 29. Proper lifting techniques avoid pressure on spine • To lift correctly – Get a firm footing and shoulder-width stance – Bend your knees and hips instead of your waist – Tighten your stomach muscles – Use your legs – Keep the load close to your body – Keep your back upright
  • 30.
  • 31. Practice healthy back habits • Don’t sit for too long. Get up, stretch and walk around from time to time • In fact you should take a 1 – 2 minute break every 30 minutes you spend sitting at a desk or workstation • Have back support to help you sit up straight
  • 32.
  • 33. Practice healthy back habits • Work at a comfortable height at your desk or work bench – Adjust your chair so that your feet are flat on the floor, your thighs parallel to ground, with your knees forming a 90 degree angle. – Your eyes should be in line with the top of your monitor – Keyboard should be level with the height of your elbows when your arms are hanging loose by your side • Place often used objects within arm’s reach to avoid twisting
  • 34.
  • 35. Practice healthy back habits • Avoid cradling the phone on your shoulder. Use a speaker phone or headset • Shift luggage weight from side to side to balance the load • Use good posture when standing • Avoid awkward or unbalanced postures as well a crossing your legs • Use a mattress that supports your back
  • 36. Strengthen and Stretch Back Muscles • Condition your back muscles to work as a team. Start a regular exercise program • Strengthen the muscles in the back, upper legs, and stomach • Increase your flexibility • Maintain a healthy body weight
  • 37. Exercises to Strengthen Your Back • Wall slide - to strengthen upper leg muscles – Stand with your back against a wall and feet slightly apart about 1 foot out from the wall. – Slowing sink into a sitting position. – Hold for 5 seconds, then slide back up the wall. – Relax and repeat
  • 38. Exercises to Strengthen Your Back • Crunches – to strengthen stomach muscles – Lie on your back with your knees bent and feet flat on the floor – Fold your arms across your chest – Use your stomach muscles to lift your shoulders blades and head a few inches off the floor – Hold for 5 seconds and slowly lower back to the floor – Relax and repeat
  • 39. Exercises to Strengthen Your Back • Elbow to Knee-to strengthen stomach muscles – Lie on your back with your knees bent and feet flat on the floor – Place hands behind head to support your neck – Press your lower back into the floor – Using your stomach muscles to lift your left shoulder toward your right knee – Hold for 5 seconds and slowly lower back to the floor – Relax and repeat on the other side
  • 40. Exercises to Strengthen Your Back • Trunk raise – to strengthen lower back – Lie on your stomach with your hands at your sides – Lift your upper body off the floor as high as you can without lifting your arms – Keep your spine and neck in line. Don’t tilt your head back – Hold for 5 seconds, and slowly lower yourself back to the floor – Relax and repeat
  • 41. Exercises to Strengthen Your Back • Pelvic tilt – Lie on your back with your knees bent and feet flat on the floor – Place your hands behind your head or at your sides – Press your lower back into the floor – Tighten your stomach and buttock muscles – Tilt your pelvis up slightly and hold for 5 to 10 seconds – Relax and repeat
  • 42. Exercises to Strengthen Your Back • Knee Drop – Lie on your back with your knees bent and feet flat on the floor – Keeping your knees together, drop them to the left as far as possible – Keep both of your shoulders on the floor – Hold for 5 seconds – Relax and repeat on the other side
  • 43. Exercises to Strengthen Your Back • Knee to Chest – Lie on your back with your knees bent and feet flat on the floor – Raise your right knee toward your chest and hold your thigh behind the knee – Slowly and gently pull your right knee to your chest – Hold for 5 seconds, then lower leg to floor – Relax and repeat on the other side
  • 44. Exercises to Strengthen Your Back • Hamstring stretch – Lie on your back with your straight out in front of you and your buttocks close to a doorway – Raise your right leg and rest it against the doorway – Keep your legs straight, but don’t lock your knees – Hold for up to 20 seconds, then lower leg to floor – Relax and repeat on the other side
  • 45. Exercises to Strengthen Your Back • The Cat – Kneel on all fours – Distribute your weight evenly on your hands and knees, flatten your back and hold your head in line with your spine – Tighten your stomach muscles – Round your shoulders and gently pull in your buttocks – Drop your head and neck forward so you are looking down toward your knees – Hold for 5 seconds – Relax and repeat
  • 46. Exercises to Strengthen Your Back • Press up – Lie on your stomach with your face down and your palms flat on the floor – Keeping your pelvis on the floor, lift yourself up onto your elbows – Raise your chest and allow your lower back to sag and lengthen – Look straight ahead. Don’t arch your neck by looking up – Hold for 5 seconds and lower yourself back onto the floor – Relax and repeat
  • 47. Treating a Back Attack • Signals – Pain in the lower or upper back – Pain down the side or back of the leg and/or into the foot – Tingling or numbness in part of the leg
  • 48. Treating a Back Attack • Home Care – Take it easy if you have mild pain – Rest flat on your back if you have severe pain – Apply cold packs and ice to reduce pain, swelling, and muscle spasms – Take over-the-counter pain medication
  • 49. Treating a Back Attack • After the swelling goes down – Apply heat to soothe the pain – Slowly return to your normal activity level • After your back heals – Use good habits to prevent re-injury – Rest, stretch, and strengthen your back
  • 50. Treating a Back Attack • Call your doctor if you have: – A loss of bladder or bowel control – Numbness in the groin or rectal area – Numbness, pain, or extreme weakness in lower extremities – Significant pain for more than 1 week – Symptoms that are getting worse
  • 51. Managment of LBP Non Pharmacological Pharmacological
  • 52. Myths for treatments! X Bed rest X Lumbar supports X Electrical treatments e.g. Laser therapy, interferential, therapeutic ultrasound X Traction X TENS machines – limited use in low back pain
  • 53. Prevention is Up to You • Use proper posture • Use appropriate lifting techniques • Practice healthy back habits • Strengthen your back, leg and stomach muscles • Stretch your back, leg and stomach muscles
  • 54. Maintaining a healthy spine, can help you maintain a healthier life