SlideShare a Scribd company logo
Does	
  a	
  heavy	
  job	
  wear	
  out	
  your	
  
back?	
  
Dr	
  Angus	
  Forbes	
  
Occupa9onal	
  Physician	
  
Lumbar	
  spine	
  
•  Studies	
  limited	
  by	
  the	
  nature	
  of	
  back	
  pain	
  and	
  
diagnosis	
  
•  Life9me	
  prevalence	
  up	
  to	
  80%	
  
•  Ac9vity	
  limi9ng	
  pain	
  has	
  a	
  1	
  year	
  recurrence	
  
of	
  24-­‐80%	
  
Lumbar	
  spine	
  
•  Lumbar	
  disc	
  degenera9on	
  is	
  almost	
  universal	
  
•  Proposed	
  (but	
  not	
  validated)	
  as	
  a	
  cause	
  of	
  
back	
  pain	
  
•  Degenera9on	
  largely	
  based	
  on	
  gene9cs(1)	
  
BaLe,	
  videman.The	
  twins	
  spine	
  study.	
  
2009	
  
Lumbar	
  spine	
  
•  Pathology	
  and	
  disability	
  do	
  not	
  appear	
  to	
  be	
  
related	
  
– Degenera9ve	
  changes	
  occur	
  later	
  in	
  women,	
  but	
  
cohort	
  studies	
  do	
  not	
  demonstrate	
  a	
  difference	
  in	
  
back	
  pain	
  
Lumbar	
  spine	
  
•  Work	
  percep9on	
  and	
  psychosocial	
  factors	
  are	
  
predic9ve	
  of	
  acute	
  low	
  back	
  pain(1)	
  
(1)	
  Bigos	
  et	
  al	
  
Lumbar	
  spine	
  
•  Heavy	
  physical	
  work	
  
– A	
  number	
  of	
  studies	
  report	
  no	
  sta9s9cally	
  
significant	
  rela9onship	
  with	
  back	
  pain.	
  
– Some	
  studies	
  show	
  a	
  weak	
  link	
  
– Sta9s9cally	
  significant	
  links	
  in	
  high	
  manual	
  
handling	
  of	
  materials	
  in	
  scaffolders,	
  and	
  liUing	
  and	
  
standing	
  in	
  smokers.	
  
Lumbar	
  spine	
  
•  Physical	
  load	
  not	
  associated	
  with	
  occurrence	
  
of	
  back	
  pain,	
  but	
  was	
  a	
  risk	
  factor	
  for	
  sickness	
  
absence(1)	
  
(1)	
  Burdorf,	
  Jansen	
  2006	
  
Lumbar	
  spine	
  
•  SiLng	
  
– Strong	
  evidence	
  this	
  is	
  not	
  associated	
  with	
  back	
  
pain	
  
– Belief	
  that	
  siLng	
  increases	
  disc	
  pressure	
  is	
  not	
  
founded	
  in	
  evidence(1)	
  
(1)	
  Claus,	
  Hides	
  2006	
  
Lumbar	
  spine	
  
•  AGE	
  
– Strong	
  evidence	
  no	
  associa9on	
  with	
  back	
  pain	
  
•  Obesity	
  
– Conflic9ng	
  evidence	
  
•  History	
  of	
  back	
  pain	
  
(1)	
  Claus,	
  Hides	
  2006	
  
Lumbar	
  spine	
  
•  Psychosocial	
  
– Weak	
  associa9on	
  with	
  job	
  sa9sfac9on	
  
•  Support	
  
– Strong	
  evidence	
  that	
  a	
  lack	
  of	
  social	
  and	
  
supervisory	
  support	
  is	
  a	
  risk	
  factor	
  for	
  absence	
  
with	
  low	
  back	
  pain.	
  
(1)	
  Claus,	
  Hides	
  2006	
  
Cervical	
  Spine	
  
•  Life9me	
  incidence	
  of	
  neck	
  pain:	
  14	
  –	
  71%	
  
•  1	
  year	
  prevalence:	
  16	
  –	
  75%	
  
•  “Heritability”	
  73%(1)	
  
1. 	
  Macgregor	
  1999,	
  204	
  
Cervical	
  spine	
  
•  Heavy	
  work	
  
•  Prospec9ve	
  studies	
  
Cervical	
  spine	
  
– “insufficient	
  evidence(1)”	
  
– LiUing	
  >50kg/hr	
  above	
  shoulder	
  height	
  weakly	
  
associated	
  with	
  neck	
  and/or	
  shoulder	
  pain	
  
– Pushing	
  and	
  pulling	
  not	
  associated	
  
(1)	
  AMA	
  guide	
  to	
  disease	
  and	
  injury	
  
causa9on	
  2014	
  	
  
Cervical	
  spine	
  
•  Insufficient	
  evidence(1)	
  for:	
  
– Neck	
  posture	
  
– Prolonged	
  work	
  in	
  sedentary	
  posi9on	
  
– Repe99ve	
  and	
  precision	
  work	
  
(1)	
  AMA	
  guide	
  to	
  disease	
  and	
  injury	
  
causa9on	
  2014	
  	
  
Cervical	
  spine	
  
•  Age	
  
–  Significant	
  increase	
  in	
  neck	
  pain	
  with	
  increasing	
  age	
  (>50	
  
years)	
  
•  Gender	
  
–  Strong	
  data	
  for	
  increase	
  in	
  women	
  >	
  men	
  
•  BMI,	
  smoking	
  
–  Uncertain	
  
•  Past	
  neck	
  pain	
  
–  significant	
  
Whole	
  body	
  vibra9on	
  	
  
•  No	
  iden9fied	
  associa9on	
  or	
  causal	
  rela9onship	
  
between	
  WBV	
  and	
  imaging	
  findings	
  
•  No	
  iden9fied	
  discrete	
  condi9on	
  
•  No	
  known	
  dose	
  response	
  
•  Withdrawl	
  from	
  WBV	
  has	
  not	
  been	
  shown	
  to	
  
stop	
  symptoms,	
  or	
  alter	
  aging	
  degenera9on	
  
END	
  
	
  

More Related Content

What's hot

What else could it be?
What else could it be?What else could it be?
What else could it be?
SpinePlus
 
Facet dislocation management
Facet dislocation managementFacet dislocation management
Facet dislocation management
SpinePlus
 
Approach to Low Back Pain
Approach to Low Back PainApproach to Low Back Pain
Approach to Low Back Pain
RK Dahal
 
Neck pain case presentation - Cervical spondylosis
Neck pain case presentation - Cervical spondylosisNeck pain case presentation - Cervical spondylosis
Neck pain case presentation - Cervical spondylosis
Dr Pamudith Karunaratne
 
Causation and decision making
Causation and decision makingCausation and decision making
Causation and decision making
SpinePlus
 
The role of surgery in common lumbar conditions
The role of surgery in common lumbar conditionsThe role of surgery in common lumbar conditions
The role of surgery in common lumbar conditions
SpinePlus
 
Appropriate imaging for low back pain
Appropriate imaging for low back painAppropriate imaging for low back pain
Appropriate imaging for low back pain
SpinePlus
 
Approach to low back pain
Approach to low back painApproach to low back pain
Approach to low back pain
Sushil Sharma
 
Low back pain by Dr.bagasi
Low back pain by Dr.bagasi   Low back pain by Dr.bagasi
Low back pain by Dr.bagasi
Abdulaziz Bagasi
 
Should I order an injection or let the specialist do it? – Part 2
Should I order an injection or let the specialist do it? – Part 2Should I order an injection or let the specialist do it? – Part 2
Should I order an injection or let the specialist do it? – Part 2
SpinePlus
 
Surgery for degenerative stenosis and deformity
Surgery for degenerative stenosis and deformitySurgery for degenerative stenosis and deformity
Surgery for degenerative stenosis and deformity
SpinePlus
 
Low back pain or Backache
Low back pain or Backache Low back pain or Backache
Low back pain or Backache
BhaskarBorgohain4
 
Acute back pain Presentation
Acute back pain PresentationAcute back pain Presentation
Acute back pain Presentationmeducationdotnet
 
Acute back pain
Acute back painAcute back pain
Acute back pain
jehh87
 
approach a patient with low back pain
approach a patient with low back painapproach a patient with low back pain
approach a patient with low back painalyaqdhan
 
Common conditions of the lumbar spine
Common conditions of the lumbar spineCommon conditions of the lumbar spine
Common conditions of the lumbar spine
SpinePlus
 
Myelopathy management
Myelopathy managementMyelopathy management
Myelopathy management
SpinePlus
 
Surgery for back pain
Surgery for back painSurgery for back pain
Surgery for back pain
SpinePlus
 
Low BACK PAIN
Low BACK PAINLow BACK PAIN
Low BACK PAIN
drsp46
 

What's hot (20)

What else could it be?
What else could it be?What else could it be?
What else could it be?
 
Facet dislocation management
Facet dislocation managementFacet dislocation management
Facet dislocation management
 
Approach to Low Back Pain
Approach to Low Back PainApproach to Low Back Pain
Approach to Low Back Pain
 
Neck pain case presentation - Cervical spondylosis
Neck pain case presentation - Cervical spondylosisNeck pain case presentation - Cervical spondylosis
Neck pain case presentation - Cervical spondylosis
 
Causation and decision making
Causation and decision makingCausation and decision making
Causation and decision making
 
The role of surgery in common lumbar conditions
The role of surgery in common lumbar conditionsThe role of surgery in common lumbar conditions
The role of surgery in common lumbar conditions
 
Appropriate imaging for low back pain
Appropriate imaging for low back painAppropriate imaging for low back pain
Appropriate imaging for low back pain
 
Approach to low back pain
Approach to low back painApproach to low back pain
Approach to low back pain
 
Low back pain by Dr.bagasi
Low back pain by Dr.bagasi   Low back pain by Dr.bagasi
Low back pain by Dr.bagasi
 
Low back pain
Low back painLow back pain
Low back pain
 
Should I order an injection or let the specialist do it? – Part 2
Should I order an injection or let the specialist do it? – Part 2Should I order an injection or let the specialist do it? – Part 2
Should I order an injection or let the specialist do it? – Part 2
 
Surgery for degenerative stenosis and deformity
Surgery for degenerative stenosis and deformitySurgery for degenerative stenosis and deformity
Surgery for degenerative stenosis and deformity
 
Low back pain or Backache
Low back pain or Backache Low back pain or Backache
Low back pain or Backache
 
Acute back pain Presentation
Acute back pain PresentationAcute back pain Presentation
Acute back pain Presentation
 
Acute back pain
Acute back painAcute back pain
Acute back pain
 
approach a patient with low back pain
approach a patient with low back painapproach a patient with low back pain
approach a patient with low back pain
 
Common conditions of the lumbar spine
Common conditions of the lumbar spineCommon conditions of the lumbar spine
Common conditions of the lumbar spine
 
Myelopathy management
Myelopathy managementMyelopathy management
Myelopathy management
 
Surgery for back pain
Surgery for back painSurgery for back pain
Surgery for back pain
 
Low BACK PAIN
Low BACK PAINLow BACK PAIN
Low BACK PAIN
 

Viewers also liked

Surgery for low back pain
Surgery for low back painSurgery for low back pain
Surgery for low back pain
SpinePlus
 
Should I order an injection or let the specialist do it? – Part 1
Should I order an injection or let the specialist do it? – Part 1Should I order an injection or let the specialist do it? – Part 1
Should I order an injection or let the specialist do it? – Part 1
SpinePlus
 
Alternative therapies for low back pain
Alternative therapies for low back painAlternative therapies for low back pain
Alternative therapies for low back pain
SpinePlus
 
WorkCover Certificates
WorkCover CertificatesWorkCover Certificates
WorkCover Certificates
SpinePlus
 
How to avoid missing something serious in the spine
How to avoid missing something serious in the spineHow to avoid missing something serious in the spine
How to avoid missing something serious in the spine
SpinePlus
 
What to do if the spine x-ray shows a ---? – Part 2
What to do if the spine x-ray shows a ---? – Part 2What to do if the spine x-ray shows a ---? – Part 2
What to do if the spine x-ray shows a ---? – Part 2
SpinePlus
 
Progressive rehabilitation for low back pain
Progressive rehabilitation for low back painProgressive rehabilitation for low back pain
Progressive rehabilitation for low back pain
SpinePlus
 
What to do if the spine x-ray shows a ---? – Part 1
What to do if the spine x-ray shows a ---? – Part 1What to do if the spine x-ray shows a ---? – Part 1
What to do if the spine x-ray shows a ---? – Part 1
SpinePlus
 
Medications for low back pain
Medications for low back painMedications for low back pain
Medications for low back pain
SpinePlus
 
Non-operative treatment for common back conditions
Non-operative treatment for common back conditions Non-operative treatment for common back conditions
Non-operative treatment for common back conditions
SpinePlus
 
Surgery for common lumbar conditions
Surgery for common lumbar conditionsSurgery for common lumbar conditions
Surgery for common lumbar conditions
SpinePlus
 
Pain management
Pain managementPain management
Pain management
SpinePlus
 
Licina low back pain
Licina low back painLicina low back pain
Licina low back pain
SpinePlus
 
Licina lumbar disc herniation
Licina lumbar disc herniationLicina lumbar disc herniation
Licina lumbar disc herniation
SpinePlus
 
How we think about back pain?
How we think about back pain?How we think about back pain?
How we think about back pain?
SpinePlus
 
Where do I fit in?
Where do I fit in?Where do I fit in?
Where do I fit in?
SpinePlus
 
This unbearable pain
This unbearable painThis unbearable pain
This unbearable pain
SpinePlus
 
Where do I fit in?
Where do I fit in?Where do I fit in?
Where do I fit in?
SpinePlus
 
Surgery for low back pain
Surgery for low back painSurgery for low back pain
Surgery for low back pain
SpinePlus
 
Core Stability Programme
Core Stability ProgrammeCore Stability Programme
Core Stability Programme
SpinePlus
 

Viewers also liked (20)

Surgery for low back pain
Surgery for low back painSurgery for low back pain
Surgery for low back pain
 
Should I order an injection or let the specialist do it? – Part 1
Should I order an injection or let the specialist do it? – Part 1Should I order an injection or let the specialist do it? – Part 1
Should I order an injection or let the specialist do it? – Part 1
 
Alternative therapies for low back pain
Alternative therapies for low back painAlternative therapies for low back pain
Alternative therapies for low back pain
 
WorkCover Certificates
WorkCover CertificatesWorkCover Certificates
WorkCover Certificates
 
How to avoid missing something serious in the spine
How to avoid missing something serious in the spineHow to avoid missing something serious in the spine
How to avoid missing something serious in the spine
 
What to do if the spine x-ray shows a ---? – Part 2
What to do if the spine x-ray shows a ---? – Part 2What to do if the spine x-ray shows a ---? – Part 2
What to do if the spine x-ray shows a ---? – Part 2
 
Progressive rehabilitation for low back pain
Progressive rehabilitation for low back painProgressive rehabilitation for low back pain
Progressive rehabilitation for low back pain
 
What to do if the spine x-ray shows a ---? – Part 1
What to do if the spine x-ray shows a ---? – Part 1What to do if the spine x-ray shows a ---? – Part 1
What to do if the spine x-ray shows a ---? – Part 1
 
Medications for low back pain
Medications for low back painMedications for low back pain
Medications for low back pain
 
Non-operative treatment for common back conditions
Non-operative treatment for common back conditions Non-operative treatment for common back conditions
Non-operative treatment for common back conditions
 
Surgery for common lumbar conditions
Surgery for common lumbar conditionsSurgery for common lumbar conditions
Surgery for common lumbar conditions
 
Pain management
Pain managementPain management
Pain management
 
Licina low back pain
Licina low back painLicina low back pain
Licina low back pain
 
Licina lumbar disc herniation
Licina lumbar disc herniationLicina lumbar disc herniation
Licina lumbar disc herniation
 
How we think about back pain?
How we think about back pain?How we think about back pain?
How we think about back pain?
 
Where do I fit in?
Where do I fit in?Where do I fit in?
Where do I fit in?
 
This unbearable pain
This unbearable painThis unbearable pain
This unbearable pain
 
Where do I fit in?
Where do I fit in?Where do I fit in?
Where do I fit in?
 
Surgery for low back pain
Surgery for low back painSurgery for low back pain
Surgery for low back pain
 
Core Stability Programme
Core Stability ProgrammeCore Stability Programme
Core Stability Programme
 

Similar to Does a heavy job wear out your back?

Cervical spondylosis; Physiotherapy approach
Cervical spondylosis; Physiotherapy approachCervical spondylosis; Physiotherapy approach
Cervical spondylosis; Physiotherapy approach
enweluntaobed
 
Ankylosing Spondylosis PPT.pptx
Ankylosing Spondylosis PPT.pptxAnkylosing Spondylosis PPT.pptx
Ankylosing Spondylosis PPT.pptx
Divya Patel
 
AHS13 James Steel — An Ancient Perspective on Deconditioning in Low Back Pain
AHS13 James Steel — An Ancient Perspective on Deconditioning in Low Back Pain AHS13 James Steel — An Ancient Perspective on Deconditioning in Low Back Pain
AHS13 James Steel — An Ancient Perspective on Deconditioning in Low Back Pain
Ancestral Health Society
 
Subacromial pain daniel
Subacromial pain danielSubacromial pain daniel
Subacromial pain daniel
Daniel Major
 
Assessment and rehabilitation in Spondyloarthropathy
Assessment and rehabilitation in SpondyloarthropathyAssessment and rehabilitation in Spondyloarthropathy
Assessment and rehabilitation in Spondyloarthropathy
Darendrajit Longjam
 
Women after giving birth to a child is backache (fix bad back visit https://b...
Women after giving birth to a child is backache (fix bad back visit https://b...Women after giving birth to a child is backache (fix bad back visit https://b...
Women after giving birth to a child is backache (fix bad back visit https://b...
uniprint
 
Unlocking the black box posture & pain
Unlocking the black box posture & painUnlocking the black box posture & pain
Unlocking the black box posture & pain
Firmansyah Purwanto
 
Osteoporosis 2016 | Fracture Risk Assessment: Vertebral fractures: Dr Emma Cl...
Osteoporosis 2016 | Fracture Risk Assessment: Vertebral fractures: Dr Emma Cl...Osteoporosis 2016 | Fracture Risk Assessment: Vertebral fractures: Dr Emma Cl...
Osteoporosis 2016 | Fracture Risk Assessment: Vertebral fractures: Dr Emma Cl...
National Osteoporosis Society
 
Sporting Hip and Groin
Sporting Hip and Groin Sporting Hip and Groin
Sporting Hip and Groin
Tony Tompos
 
Male Pelvic Floor Dysfunction in Elite Sport
Male Pelvic Floor Dysfunction in Elite Sport Male Pelvic Floor Dysfunction in Elite Sport
Male Pelvic Floor Dysfunction in Elite Sport
Gerard Greene Physio
 
Spondylolisthesis
SpondylolisthesisSpondylolisthesis
Spondylolisthesis
Ponnilavan Ponz
 
Low back pain (lumbago)
Low back pain (lumbago) Low back pain (lumbago)
Low back pain (lumbago)
SHERIFFMUIDEEN1
 
Lumbar degenerative spondylolisthesis
Lumbar degenerative spondylolisthesisLumbar degenerative spondylolisthesis
Lumbar degenerative spondylolisthesis
PrakashPaudel19
 
Musculoskeletal Health Concerns of the Aging Population
Musculoskeletal Health Concerns of the Aging PopulationMusculoskeletal Health Concerns of the Aging Population
Musculoskeletal Health Concerns of the Aging Population
Allan Corpuz
 
PostureTek Full Version
PostureTek Full VersionPostureTek Full Version
PostureTek Full Version
perseusathletics
 
PostureTek PPT
PostureTek PPTPostureTek PPT
PostureTek PPT
guest634b4c
 
Itrac and renuva disc updated- Morooco
Itrac and renuva disc updated- MoroocoItrac and renuva disc updated- Morooco
Itrac and renuva disc updated- Morooco
Renuvadisc
 
RenuvaDisc PPP Australia
RenuvaDisc PPP AustraliaRenuvaDisc PPP Australia
RenuvaDisc PPP Australia
Renuvadisc
 
The Painful Adult Shoulder: evidence based history, exam and approach
The Painful Adult Shoulder: evidence based history, exam and approachThe Painful Adult Shoulder: evidence based history, exam and approach
The Painful Adult Shoulder: evidence based history, exam and approach
thegraymatters
 

Similar to Does a heavy job wear out your back? (20)

Cervical spondylosis; Physiotherapy approach
Cervical spondylosis; Physiotherapy approachCervical spondylosis; Physiotherapy approach
Cervical spondylosis; Physiotherapy approach
 
Ankylosing Spondylosis PPT.pptx
Ankylosing Spondylosis PPT.pptxAnkylosing Spondylosis PPT.pptx
Ankylosing Spondylosis PPT.pptx
 
AHS13 James Steel — An Ancient Perspective on Deconditioning in Low Back Pain
AHS13 James Steel — An Ancient Perspective on Deconditioning in Low Back Pain AHS13 James Steel — An Ancient Perspective on Deconditioning in Low Back Pain
AHS13 James Steel — An Ancient Perspective on Deconditioning in Low Back Pain
 
Spinal injury..whats new ..dr g s patnaik
Spinal injury..whats new ..dr g s patnaikSpinal injury..whats new ..dr g s patnaik
Spinal injury..whats new ..dr g s patnaik
 
Subacromial pain daniel
Subacromial pain danielSubacromial pain daniel
Subacromial pain daniel
 
Assessment and rehabilitation in Spondyloarthropathy
Assessment and rehabilitation in SpondyloarthropathyAssessment and rehabilitation in Spondyloarthropathy
Assessment and rehabilitation in Spondyloarthropathy
 
Women after giving birth to a child is backache (fix bad back visit https://b...
Women after giving birth to a child is backache (fix bad back visit https://b...Women after giving birth to a child is backache (fix bad back visit https://b...
Women after giving birth to a child is backache (fix bad back visit https://b...
 
Unlocking the black box posture & pain
Unlocking the black box posture & painUnlocking the black box posture & pain
Unlocking the black box posture & pain
 
Osteoporosis 2016 | Fracture Risk Assessment: Vertebral fractures: Dr Emma Cl...
Osteoporosis 2016 | Fracture Risk Assessment: Vertebral fractures: Dr Emma Cl...Osteoporosis 2016 | Fracture Risk Assessment: Vertebral fractures: Dr Emma Cl...
Osteoporosis 2016 | Fracture Risk Assessment: Vertebral fractures: Dr Emma Cl...
 
Sporting Hip and Groin
Sporting Hip and Groin Sporting Hip and Groin
Sporting Hip and Groin
 
Male Pelvic Floor Dysfunction in Elite Sport
Male Pelvic Floor Dysfunction in Elite Sport Male Pelvic Floor Dysfunction in Elite Sport
Male Pelvic Floor Dysfunction in Elite Sport
 
Spondylolisthesis
SpondylolisthesisSpondylolisthesis
Spondylolisthesis
 
Low back pain (lumbago)
Low back pain (lumbago) Low back pain (lumbago)
Low back pain (lumbago)
 
Lumbar degenerative spondylolisthesis
Lumbar degenerative spondylolisthesisLumbar degenerative spondylolisthesis
Lumbar degenerative spondylolisthesis
 
Musculoskeletal Health Concerns of the Aging Population
Musculoskeletal Health Concerns of the Aging PopulationMusculoskeletal Health Concerns of the Aging Population
Musculoskeletal Health Concerns of the Aging Population
 
PostureTek Full Version
PostureTek Full VersionPostureTek Full Version
PostureTek Full Version
 
PostureTek PPT
PostureTek PPTPostureTek PPT
PostureTek PPT
 
Itrac and renuva disc updated- Morooco
Itrac and renuva disc updated- MoroocoItrac and renuva disc updated- Morooco
Itrac and renuva disc updated- Morooco
 
RenuvaDisc PPP Australia
RenuvaDisc PPP AustraliaRenuvaDisc PPP Australia
RenuvaDisc PPP Australia
 
The Painful Adult Shoulder: evidence based history, exam and approach
The Painful Adult Shoulder: evidence based history, exam and approachThe Painful Adult Shoulder: evidence based history, exam and approach
The Painful Adult Shoulder: evidence based history, exam and approach
 

More from SpinePlus

Some WorkCover fusions work
Some WorkCover fusions workSome WorkCover fusions work
Some WorkCover fusions work
SpinePlus
 
Pain management
Pain managementPain management
Pain management
SpinePlus
 
Imaging for back pain
Imaging for back pain Imaging for back pain
Imaging for back pain
SpinePlus
 
Non-operative management for common back conditions
Non-operative management for common back conditionsNon-operative management for common back conditions
Non-operative management for common back conditions
SpinePlus
 
Patient cases
Patient casesPatient cases
Patient cases
SpinePlus
 
Lumbar Stretching
Lumbar StretchingLumbar Stretching
Lumbar Stretching
SpinePlus
 
Lumbar Stabilisation
Lumbar StabilisationLumbar Stabilisation
Lumbar Stabilisation
SpinePlus
 
Discectomy Activity Guide
Discectomy Activity GuideDiscectomy Activity Guide
Discectomy Activity Guide
SpinePlus
 
6 week discectomy
6 week discectomy6 week discectomy
6 week discectomy
SpinePlus
 
3 week discectomy
3 week discectomy3 week discectomy
3 week discectomy
SpinePlus
 
Initial Discectomy
Initial DiscectomyInitial Discectomy
Initial Discectomy
SpinePlus
 
Pain diagram and questionnaire
Pain diagram and questionnairePain diagram and questionnaire
Pain diagram and questionnaire
SpinePlus
 
Rehabilitation for back pain
Rehabilitation for back painRehabilitation for back pain
Rehabilitation for back pain
SpinePlus
 
Interventional Procedures and Opioids
Interventional Procedures and OpioidsInterventional Procedures and Opioids
Interventional Procedures and Opioids
SpinePlus
 
This Unbearable Pain
This Unbearable PainThis Unbearable Pain
This Unbearable Pain
SpinePlus
 
Appropriate imaging for back pain
Appropriate imaging for back painAppropriate imaging for back pain
Appropriate imaging for back pain
SpinePlus
 
My crook back
My crook backMy crook back
My crook back
SpinePlus
 
Discectomy Patient Pathway
Discectomy Patient PathwayDiscectomy Patient Pathway
Discectomy Patient Pathway
SpinePlus
 
Surgery for Lower Back Pain
Surgery for Lower Back PainSurgery for Lower Back Pain
Surgery for Lower Back Pain
SpinePlus
 

More from SpinePlus (19)

Some WorkCover fusions work
Some WorkCover fusions workSome WorkCover fusions work
Some WorkCover fusions work
 
Pain management
Pain managementPain management
Pain management
 
Imaging for back pain
Imaging for back pain Imaging for back pain
Imaging for back pain
 
Non-operative management for common back conditions
Non-operative management for common back conditionsNon-operative management for common back conditions
Non-operative management for common back conditions
 
Patient cases
Patient casesPatient cases
Patient cases
 
Lumbar Stretching
Lumbar StretchingLumbar Stretching
Lumbar Stretching
 
Lumbar Stabilisation
Lumbar StabilisationLumbar Stabilisation
Lumbar Stabilisation
 
Discectomy Activity Guide
Discectomy Activity GuideDiscectomy Activity Guide
Discectomy Activity Guide
 
6 week discectomy
6 week discectomy6 week discectomy
6 week discectomy
 
3 week discectomy
3 week discectomy3 week discectomy
3 week discectomy
 
Initial Discectomy
Initial DiscectomyInitial Discectomy
Initial Discectomy
 
Pain diagram and questionnaire
Pain diagram and questionnairePain diagram and questionnaire
Pain diagram and questionnaire
 
Rehabilitation for back pain
Rehabilitation for back painRehabilitation for back pain
Rehabilitation for back pain
 
Interventional Procedures and Opioids
Interventional Procedures and OpioidsInterventional Procedures and Opioids
Interventional Procedures and Opioids
 
This Unbearable Pain
This Unbearable PainThis Unbearable Pain
This Unbearable Pain
 
Appropriate imaging for back pain
Appropriate imaging for back painAppropriate imaging for back pain
Appropriate imaging for back pain
 
My crook back
My crook backMy crook back
My crook back
 
Discectomy Patient Pathway
Discectomy Patient PathwayDiscectomy Patient Pathway
Discectomy Patient Pathway
 
Surgery for Lower Back Pain
Surgery for Lower Back PainSurgery for Lower Back Pain
Surgery for Lower Back Pain
 

Recently uploaded

BRACHYTHERAPY OVERVIEW AND APPLICATORS
BRACHYTHERAPY OVERVIEW  AND  APPLICATORSBRACHYTHERAPY OVERVIEW  AND  APPLICATORS
BRACHYTHERAPY OVERVIEW AND APPLICATORS
Krishan Murari
 
The Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of IIThe Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of II
MedicoseAcademics
 
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 UpakalpaniyaadhyayaCharaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Dr KHALID B.M
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
touseefaziz1
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
aljamhori teaching hospital
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
MedicoseAcademics
 
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptxTriangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
24 Upakrama.pptx class ppt useful in all
24 Upakrama.pptx class ppt useful in all24 Upakrama.pptx class ppt useful in all
24 Upakrama.pptx class ppt useful in all
DrSathishMS1
 
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
bkling
 
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...
kevinkariuki227
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
NephroTube - Dr.Gawad
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTSARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
Dr. Vinay Pareek
 
Evaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animalsEvaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animals
Shweta
 
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
i3 Health
 
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
VarunMahajani
 
micro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdfmicro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdf
Anurag Sharma
 
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Savita Shen $i11
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Dr Jeenal Mistry
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
greendigital
 

Recently uploaded (20)

BRACHYTHERAPY OVERVIEW AND APPLICATORS
BRACHYTHERAPY OVERVIEW  AND  APPLICATORSBRACHYTHERAPY OVERVIEW  AND  APPLICATORS
BRACHYTHERAPY OVERVIEW AND APPLICATORS
 
The Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of IIThe Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of II
 
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 UpakalpaniyaadhyayaCharaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
 
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptxTriangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
 
24 Upakrama.pptx class ppt useful in all
24 Upakrama.pptx class ppt useful in all24 Upakrama.pptx class ppt useful in all
24 Upakrama.pptx class ppt useful in all
 
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
 
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
 
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTSARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
 
Evaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animalsEvaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animals
 
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
 
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
 
micro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdfmicro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdf
 
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
 

Does a heavy job wear out your back?

  • 1. Does  a  heavy  job  wear  out  your   back?   Dr  Angus  Forbes   Occupa9onal  Physician  
  • 2.
  • 3. Lumbar  spine   •  Studies  limited  by  the  nature  of  back  pain  and   diagnosis   •  Life9me  prevalence  up  to  80%   •  Ac9vity  limi9ng  pain  has  a  1  year  recurrence   of  24-­‐80%  
  • 4. Lumbar  spine   •  Lumbar  disc  degenera9on  is  almost  universal   •  Proposed  (but  not  validated)  as  a  cause  of   back  pain   •  Degenera9on  largely  based  on  gene9cs(1)   BaLe,  videman.The  twins  spine  study.   2009  
  • 5. Lumbar  spine   •  Pathology  and  disability  do  not  appear  to  be   related   – Degenera9ve  changes  occur  later  in  women,  but   cohort  studies  do  not  demonstrate  a  difference  in   back  pain  
  • 6. Lumbar  spine   •  Work  percep9on  and  psychosocial  factors  are   predic9ve  of  acute  low  back  pain(1)   (1)  Bigos  et  al  
  • 7. Lumbar  spine   •  Heavy  physical  work   – A  number  of  studies  report  no  sta9s9cally   significant  rela9onship  with  back  pain.   – Some  studies  show  a  weak  link   – Sta9s9cally  significant  links  in  high  manual   handling  of  materials  in  scaffolders,  and  liUing  and   standing  in  smokers.  
  • 8. Lumbar  spine   •  Physical  load  not  associated  with  occurrence   of  back  pain,  but  was  a  risk  factor  for  sickness   absence(1)   (1)  Burdorf,  Jansen  2006  
  • 9. Lumbar  spine   •  SiLng   – Strong  evidence  this  is  not  associated  with  back   pain   – Belief  that  siLng  increases  disc  pressure  is  not   founded  in  evidence(1)   (1)  Claus,  Hides  2006  
  • 10. Lumbar  spine   •  AGE   – Strong  evidence  no  associa9on  with  back  pain   •  Obesity   – Conflic9ng  evidence   •  History  of  back  pain   (1)  Claus,  Hides  2006  
  • 11. Lumbar  spine   •  Psychosocial   – Weak  associa9on  with  job  sa9sfac9on   •  Support   – Strong  evidence  that  a  lack  of  social  and   supervisory  support  is  a  risk  factor  for  absence   with  low  back  pain.   (1)  Claus,  Hides  2006  
  • 12.
  • 13. Cervical  Spine   •  Life9me  incidence  of  neck  pain:  14  –  71%   •  1  year  prevalence:  16  –  75%   •  “Heritability”  73%(1)   1.  Macgregor  1999,  204  
  • 14. Cervical  spine   •  Heavy  work   •  Prospec9ve  studies  
  • 15. Cervical  spine   – “insufficient  evidence(1)”   – LiUing  >50kg/hr  above  shoulder  height  weakly   associated  with  neck  and/or  shoulder  pain   – Pushing  and  pulling  not  associated   (1)  AMA  guide  to  disease  and  injury   causa9on  2014    
  • 16. Cervical  spine   •  Insufficient  evidence(1)  for:   – Neck  posture   – Prolonged  work  in  sedentary  posi9on   – Repe99ve  and  precision  work   (1)  AMA  guide  to  disease  and  injury   causa9on  2014    
  • 17. Cervical  spine   •  Age   –  Significant  increase  in  neck  pain  with  increasing  age  (>50   years)   •  Gender   –  Strong  data  for  increase  in  women  >  men   •  BMI,  smoking   –  Uncertain   •  Past  neck  pain   –  significant  
  • 18.
  • 19. Whole  body  vibra9on     •  No  iden9fied  associa9on  or  causal  rela9onship   between  WBV  and  imaging  findings   •  No  iden9fied  discrete  condi9on   •  No  known  dose  response   •  Withdrawl  from  WBV  has  not  been  shown  to   stop  symptoms,  or  alter  aging  degenera9on