It is a shocking fact that 80% of us will suffer from serious back pain at some time in our lives. If you have experienced a back problem, you will know it can be very painful and affect everything you do. A third of all manual handling injuries at work affect the back with the average time off work for a back injury around 16 days. We explain how back injuries can occur when lifting or carrying loads, and why some of us are more at risk of injury than others.
To understand how the back can get injured it is worth taking a brief look at the anatomy of the spine.
The spine is the major supporting structure of the body protecting the spinal cord, and enabling movement and flexibility. It is made up of 33 vertebrae joined together by ligaments and bony ‘processes’, and separated by shock absorbers known as discs made up of cartilage. The spine has a natural ‘S’ shape – this is a neutral position which good lifting and carrying techniques should maintain as far as possible.
Most injuries occur in the lumbar region, the lower spine, where incorrect lifting and carrying is most likely to cause disc damage. You will have heard of a slipped, herniated or prolapsed disc – this is where a disc bulges and ruptures out from the vertebrae, pinching the spinal cord and spinal nerves.
The pain from this injury can be severe and will be felt throughout the back, and sometimes in the legs if on the sciatic nerve. Disc problems will often result in your staff needing extended periods of sickness absence to aid recovery. They could also require an adjustment to job activity on return to work to help prevent further injury.
Causes of Injury
There are 2 main causes of back injury. Traumatic stress, where there is an immediate cause and effect, and it is obvious what has caused an injury, for example, lifting a box that is heavier than expected. And cumulative stress over a period of time, which eventually manifests itself as a painful injury.
This is illustrated by the case of a library worker who was instructed by her managers to move books from one area of the library to another over a 4-month period. She developed permanent back problems that meant she could no longer work and had to change her lifestyle to cope with chronic back pain. Her council employers ended up with a compensation bill for £23K. Cumulative stress can be worsened by failing to take sufficient breaks from lifting and carrying activities – it’s estimated we need 6 hours of recovery for every 1 hour of hard physical effort to minimise the risk of injury.
Ensuring your staff recognise the early signs of cumulative stress such as numbness, tingling and twinges, will enable you to make changes in work routine and help prevent the development of a serious back injury.
The 8 Vulnerable Groups
There are some groups of people with characteristics that make it more likely they will suffer a back injury:
- Older Workers – as we get older, cartilage loses elasticity, the spinal bones become less solid and contract slightly. The vertebral discs dehydrate, become thinner and more brittle, making them more prone to damage.
- Obesity – due to the way the spine works, each 1lb of excess weight around the waist adds 10lb of strain to the abdomen. Excess weight around the waist or abdomen can also make it more difficult to hold a load close to the body and to maintain the neutral ‘S’ shape of the spine.
- Poorly Trained Workers – employees without proper training on the causes of back pain and how to avoid it are more likely to use poor lifting and carrying techniques, increasing the likelihood of injury. Consider specifically the training needs of workers whose first language isn’t English, and those with a learning disability.
- Predisposition to Injury – back problems are more likely to be experienced by those who have previously had a back injury, have certain medical conditions such as ankylosing spondylitis, or a disability.
- Tiredness – tiredness can reduce concentration levels and increase the potential to cut corners and use poor lifting techniques. Tired people also recover less quickly leading to cumulative stress.
- Young People – lack of experience and confidence to seek assistance can make young workers more prone to injury. They are always at risk because of pressure to keep up with more experienced colleagues. Young men, in particular, may be at greater risk if they fear being seen as ‘weak’.
- New and Expectant Mothers – hormonal changes during pregnancy lead to the relaxation of supporting ligaments which run the length of the spine. The unborn child also adds weight to the lower back area, causing postural changes. The spine, therefore, lacks the normal level of support and is more susceptible to damage during pregnancy and for around 6 months afterwards.
- Smokers – studies have found a link between smoking and back pain. One study in America concluded that smokers are three times more likely than non-smokers to develop chronic back pain. This is thought to be because the brain pathways involved in addiction are also related to those implicated in the development of chronic pain, making smokers less resilient to the pain of a back injury.