Low back pain (LBP) affects approximately 80% of Australians at some time during their lives and can be a limiting factor for work and life participation. LBP can affect an individual through disrupting sleeping patterns, limiting function and movement and present with pain, numbness and tingling changes in bowel or bladder control. Most episodes of LBP resolve easily with the correct management plans and strategies.
The onset of LBP can be caused by any number of mechanisms; however pain is caused in three ways:
- Muscles Strains – The muscle or tendon tissue that supports the spine and provides movement is damaged. This usually involves some tearing of muscle or tendon tissue due to excessive strain from lifting excessive loads.
- Ligament Sprains – Ligaments connect the vertebral segments to each other. When the ligament tissue is damaged this reduce stability, which causes excessive movement aggravating the surrounding tissues.
- Vertebral Disc injuries – Two main types Disc bulges and Disc prolapses. During a disc bulge the hard-outer wall of the disc becomes damaged. Causing the spongy material inside the disc to bulge through the outer wall. In a disc prolapses however, the disc wall is ruptured allowing the material to exit the disc. In both these cases nerves and blood vessels can be affected and requires professional advice and care.
How can you sustain the injury at work?
Some of the most common causes are:
- Poor lifting technique. Involving bending or twisting through the spine
- Falls and impact injuries.
- Repetitive actions
- Prolonged/sustained positions eg. sitting
- Poor posture
- Poor physical conditioning and sedentary life-style
How do you mitigate injury risk?
The easiest way to prevent these injuries is to ensure that:
- Correct lifting and manual handling technique is practised.
- Bending at the knees maintaining neutral spine, avoiding twisting or bending through the spine (especially with load), knowing weight limitations, use of lifting aids.
- Limiting time spent completing repetitive action, use of aids to ease the job, optimising movements to limit stresses on the spine
- Use of sit /stand workstations, changing position often.
- Strengthening exercises to improve muscle weaknesses to provide better posture, support, stability and joint loading.
Why is rehabilitation and management important?
LBP can be a debilitating condition which often re-occurs because rehabilitation that addressed the cause and effect have not been addressed. In the event of a injury the body experiences a pain response and muscular stiffening to prevent/limit further damage. This causes us to change how we function altering what is called our biomechanics. Alterations in our biomechanics can be beneficial for assisting the injured area to heal but it places extra stresses on surrounding areas and once the injury is healed we do not necessarily revert back to our pre-injury mechanics. In the case of overuse injuries our pre-injury mechanics may have been faulty and is the cause for the injury. In both cases rehabilitation is vital in providing correction to reduce the risk of future injury.
Managing your workplace (Prevention)
An efficient rehabilitation and return to work process reduces the physical, social, mental and financial burden to all stakeholders, however its noteworthy to mention prevention is better than cure. The proactive-systematic approach to risk and injury management is widely used in the workplace. This is often done through educational workshops and courses. In this method giving the worker, the right tools and strategies will effectively reduce risk of injury.
Physical activity and Returning to work.
Physical activity and returning to work play a vital role in the recovery from an episode of LBP. The initial management may involve rest however, prolonged inactivity causes weakening in supporting muscles and reduced mental health.
This causes a downwards spiral of pain, inactivity and reduced physical capacity.
Injury management and rehabilitation programming is necessary for the best outcomes. It is necessary for Individual, Doctor, Rehabilitation specialist and Employer to work towards recovery and return to work.