Preventing Back Pain

Joe O'Connor

August 2007

Check your Occupational Safety and Health Administration logs and workers’ compensation records. If you’re like most organizations, back injuries will be on the top of the list. Industry-wide back pain accounts for more than 25 percent of workplace injuries. Eight out of every 10 Americans will be affected by back pain at some point in their life. The pain may be from any number of factors, but regardless of the cause the burden often falls on the workplace. Employers must take action to help employees protect their backs from injury.

Understanding back pain is the first step in preventing injuries. The spine is a complex structure made up of vertebrae or bones, disks, nerves, muscles, tendons and ligaments. Most back pain occurs in the lower back. This area bears most of the weight. The pain usually comes from one of the following:

Injured or stressed muscles, ligaments or tendons.
-Stress or damage to a disk that provides the cushioning between the vertebrae. A herniated disk occurs when the outer layer of the disk weakens allowing the soft gel inside to bulge out and press on nerves.

-Loss of fluid in disk due to normal aging.

-Arthritis or others diseases that affect the spinal nerves or vertebrae.

-Stress and injury to muscles and disks result when they are not strong enough for the job. This means that increasing their strength and/or reducing the stress can help prevent pain. Strengthening of the body comes from a proper diet, exercise and rest. These actions also help to slow down the normal aging process. Educating employees to address these needs may prepare them better for their job.

-Managing stress must be addressed on two fronts. Mental stress can tighten muscles and affect your digestion, breaking down your body’s strength. Helping employees deal with this type of stress may be offered in the form of Employee Assistance Programs, training on relaxation methods or advice on where to seek help. Physical stress can be managed through administrative and engineering controls.

Proper Lifting
Training on the topics previously described as well as proper lifting techniques is a must. Making sure employees are directed to seek help when lifting objects that are too heavy for one individual or requiring scheduled break periods during repetitive lifts are all ways to administratively control the physical stress. Engineering controls include the use of forklifts, hand trucks, hoists and ramps and lift gates.

As a reminder, here are the proper lifting techniques:

-Know the weight and nature of the object that you are lifting.

-Stabilize unsteady loads. Get help as needed.

-Bend at the knees. This enables your legs to help with the lift rather than placing the whole load on your back.

-Keep your back straight and the load close to your body. Your body will act like a wrench with the back as a pivoting point. The package will be the force of a hand pulling on the wrench. The pressure on your discs and the force of the back muscles are like the force turning the nut. If the package weighs 45 pounds and is 20 inches from the center of your back, the force on your back will be 800 pounds. The further out the package is the greater the force is multiplied.

-Tighten your abdominal muscles. This distributes the forces and relieves pressure on the back.

-Avoid twisting, and do not reach for a load.

Personal Protection
The third category of controls is Personal Protective Equipment. Many employers have included the use of lifting belts as PPE to prevent back injuries. At this time, studies conducted on their value are inconclusive. It has been shown that when belts are worn all the time, muscle atrophy may occur. The results of one particular study even showed that the belt provided no benefit until lifting loads exceeded the National Institute of Occupational Safety and Health lifting limits. Other studies have shown that the belt increases the user’s awareness of the techniques used during a lift. The belt actually may encourage proper lifting. Employers should weigh the results of these studies, seek further information and make a decision on back belts based on conditions in their work place.

There are no comprehensive general industry or construction industry standards that address back injury prevention. OSHA may attempt to abate this hazard by writing violations under the General Duty Clause. The "General Duty” clause of the Occupational Safety and Health Act of 1970 Section 5(a)(1) requires employers to provide a safe and healthful work place for their workers. However, I doubt employers need this motivation; workers’ compensation losses would seem to be cause enough.

In summary, the actions an employer can take begin with an analysis of their OSHA and workers’ comp records. Determine whether the injuries seem to be occurring on a regular or sporadic basis, and whether or not similar injuries occur frequently. Next, inspect the work areas for lifting hazards. Identify hazardous conditions and operations. Conduct a Job Hazard Analysis for each hazardous operation as needed to identify the workers at risk. Provide engineering controls like mechanical lifting equipment whenever possible. Provide administrative controls by modifying work practices or lifting conditions as needed. Ensure that lifting required for the task is within the proper lifting limits. Train employees as described in this article, and record the training.

About the Author
Joe O’Connor is with Intec, Inc., Waverly, Pa. He can be reached at (800) 745.4818.

For More Information
AWCI has taken major innovative steps to assist members in addressing OSHA recordkeeping and the development of written programs. The AWCI Safety Software contains model documents with lifting policies, safety talks for training, and the "NIOSH Lifting Calculator” to determine lifting limits. Special programs have been created for AWCI Chapters that include onsite workshops. For more information visit the AWCI Web site at www.awci.org, or call (703) 538.1600.