Back pain is very common, affecting 60-70% of people. It peaks between ages 35-55 and is a major cause of work disability. The back is structured with vertebrae and discs that can be affected by poor posture, weak muscles, improper lifting, lack of exercise, and other factors. Sitting for long periods at work can cause shoulder, arm, hand, and neck problems. Forward head posture, rounded shoulders, and rotated hips can strain the back. Back pain negatively impacts quality of life through physical, social, mental, and occupational disruptions. Proper lifting technique, posture, stretching, and back strengthening exercises can help prevent and manage back pain.

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

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

24. Truth about back pain

25. Posture tips

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

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

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

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

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