Wednesday, October 28, 2009

Low Back Pain, Workplace Prevention.

Often times, when we are preoccupied with the challenges of daily living, we do things that will place our backs at risk for herniations, end plate fractures ( loss of nuclear fluid), strains and other painful conditions. Although the individual workers play a role in their relative wellness, the employer must be a partner to provide successful outcomes.
Many feel that wearing a abdominal bracing belt will prevent injuries to the low back. This has been well studied and has been frequently noted to cause a loss of range of motion in the lower back. Additionally, during lifting exercises back belts have been linked to increases in blood pressure and heart rate. (Hunter and Colleages, 1989)It appears that during lifting activities with the belt on the blood pressure was elevated by up to 15mmHg, the heart rate was also significantly effected. This leaves individuals that have a compromised cardiovascular system at risk for vascular problems, and possible stroke. Additional studies have also shown that belts lower mean oxygen consumption. (Low Back Pain, Stuart McGill, 2007)
A better approach is to develop programs to help the employee learn better strategies to execute the work needed. Some individuals simply do not move in ways that are back sparing. In a study by McGill in 2003, they noted that workers who had a history of back troubles has a history of "adopting motion patterns that resulted in higher spinal loads!" They concluded that "Kinematic patterns need to be practiced and grooved into movement repertoires." It is evident certain individuals need to practice spine- saving movement patterns every day, especially prior to any heavy lifting to ensure that the movement pattern is successful. Even high performance athletes, it is noted, should practice grooved motion patterns on a daily basis.
Another strategy to prevent over-stressed tissue damage is the optimizing the workers rest break to ensure that the opposite muscle group is activated. It is suggested that a administrative secretary uses their rest break to perform a dynamic movement break. In a study in the 1960's, operators in a power plant responded to a buzzer at 10 minute intervals. The controllers needed to get up out of their chairs and going around the corner to the control panel to make adjustments. There were no incidents of back problems. There were changes made, due to the impression that getting up so frequently was "too strenuous." The job was redesigned so that workers remained seated through the 12 hour shift. There was an increase in back problems, and other related problems. In the final analysis, it appears it is crucial for back health to stand up and take "active" breaks regularly.
More successful programs incorporate the use of variable positioning, or multi-tasking. It has been noted that human beings were not meant to perform repetitive work that emphasizes only a few muscles, or tissues. It has also been noted that "too little activity can be just as problematic as too much. Krismer and colleagues' study (2001) strongly reinforced the idea that the object of good work design is not to make the job easier; in fact some jobs should be made more demanding for optimal health. Good occupational health from a musculoskeletal perspective is achieved when people perform a variety of tasks with well designed rest activities, along with traditional components such as proper nutrition, stress management, sleep, and avoidance of alcohol and cigarettes." (Stuart McGill PhD, Low Back Pain, 2007)
Another aspect in workplace prevention is the designing of ergonomic work areas. The seating and all equipment should be "user friendly." When companies look for effective ways of cutting cost in Workers Compensation cases related to low back injuries they nee d to consider working hand-in-hand- with the worker to eliminate undo stress do to unnatural postures, with creates stress upon tissue, creating pain and damage. In conjunction with a physical activity plan, a personalized plan for each persons work station should be implemented. This avoids many claims, costs and injuries in the long run. Often the worker will have the greatest insight into a solution for any intervention from their experience/s. Another added benefit to having the worker/s involved is that they are more likely to comply is they are part of the process.
These are a few key ideas that have been well studied, and documented, in regard to the very costly, and painful, topic of low back pain in relation to the workplace. It is estimated that 80 percent of all adults in North America will experience low back pain. It is the most common reason for visits to seek help from a physician. We have to think in terms of prevention, and seek spine saving alternatives to how we currently operate.

No comments:

Post a Comment