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Back/Spinal Problems

Introduction
Over 1.1 million people experience musculoskeletal disorders caused by work, with an estimated 12.3 million days lost annually. Back pain is a major cause of sickness absence from work. Nationally it is estimated that there are around half a million people with some form of back complaint caused by work. A report by Backcare, the Forum of Private Business and the TUC suggested that back pain is a problem for almost two thirds (63%) of small businesses. They found one in five people working in small firms had back strain, with the average small firm losing approximately 22 days of work a year from back strain.

Industry statistics sight back pain and injuries to the lumbar spine as one of the main causes of injury in the work environment, and the second most common reason for absenteeism from work. Back pain and lumbar spine injuries are a leading reason for disability for those in the age group of 19 to 45. A problematic area is standing or sitting in the same position for a lengthy period of time. Also problematic is poor blood circulation as a result of standing on hard surfaces. This problem can be eradicated by the provision of anti-fatigue matting.

Clearly back pain is a very serious problem for employers and employees alike. For employers it can result in overly high absenteeism, having to pay the employee when they are off sick thus reducing profitability and efficiency. It is certainly in the employers own interest to provide the necessary training to make employees aware of the correct way to handle heavy objects. Provision of any equipment that may aid in the reducing of potential back pain should be provided and/or suitable areas and times for the employee to relax. For the person who suffers a back injury the pain can be serious. Not only can it affect a persons ability to work but also his social life and everyday tasks that the person wishes to perform. More serious back pain can lead to internal problems such as bladder weakness and in some cases complete loss of control. Take all measures appropriate to reduce the likelihood of a back injury.

About back pain
Back pain, whether it's lower back pain or pain in other parts of the back, can affect anyone at any age, although people are most likely to get it between the ages of 35 and 55. If the pain lasts for less than three months, it's called acute back pain. Acute refers to how long it's lasted for rather than how severe it is. If the problem goes on for longer, it's known as chronic back pain.

How the back works
The spine is made up of many small bones called vertebrae. These are separated by discs, which allow the spine to bend. This structure of vertebrae and discs is supported along its length by muscles and ligaments. The spine threads through the centre of each vertebra, carrying nerves from the brain to the rest of the body.

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The Spine - Image courtesy of BUPA

Back pain in 19 out of 20 people is linked to the way the bones, ligaments and muscles of the back work together. This is called simple back pain. The pain can begin suddenly but can also come on gradually due to strain over time. Usually nothing unusual shows up in tests such as X-rays and nothing is permanently damaged.
Simple back pain is most common in adults aged 35 to 55 who are otherwise healthy. The pain is often in the lower back (lumbar region), and this lower back pain may also spread to the buttocks and thighs. It will come and go at different times, and depending on your level of activity.
Triggers for simple back pain, including lower back pain, include:

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Your spine is a very strong part of your body and is not easily damaged. If you have back pain, it's important that you stay physically active. This is good for your back because keeping active will help speed up your recovery from simple back pain. Nine out of ten people with back pain recover completely within six weeks.

Nerve root pain
Nerve root pain is rare - it's the cause in less than one in 20 cases of back pain. It's usually caused by one of the discs in the spine bulging out from its normal position. This is called a slipped disc. Nerve root pain is normally felt in the lower part of the back. You may have pain down one or both of your legs to the calves, feet or toes. The pain is also called sciatica because the nerve that runs down each leg is called the sciatic nerve.

Other causes of back pain
In rare cases, there may be a more serious underlying cause of back pain, such as an problem with the spine, an infection or collapse of the vertebrae, tuberculosis or cancer. These are more likely to be the case if your back pain starts gradually, gets worse over time and seems unrelated to your level of activity.

When to see a doctor about back pain
Most simple back pain only lasts a few days and gets better on its own. You should see a doctor as soon as possible if, as well as back pain, you have:

You should also see your doctor about back pain if:

Diagnosis of back pain
Usually your doctor will only need to discuss your symptoms and examine you. If the pain lasts longer than six weeks, or if your doctor suspects there is some underlying cause of the pain, then he or she may recommend more tests.
These tests might include:

Your mental wellbeing can also have a role in back pain. If the condition is chronic, your doctor may recommend that you have an assessment of your wellbeing in a pain clinic.

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Treatment of back pain
There are a number of steps you can take to help yourself.
Stay active - It's important to return to your normal level of physical activity as soon as possible. Staying active will help your back to get better, and reduces your risk of getting simple back pain again.
Stay positive - remember that back pain usually goes away quickly.
Set yourself goals - this will help you get back to your normal levels of physical activity.

Medicines
Taking a painkiller that you would normally take for a headache (eg paracetamol or ibuprofen) is usually enough to relieve simple back pain and can help you keep active. It is best to get into a routine and take this at the same time every day. Always follow the instructions on the patient information leaflet that comes with the medicine and speak to your pharmacist.
Prescription-only muscle relaxants such as diazepam may help with muscle spasms. Doctors rarely prescribe these as they can be addictive. Using a hot water bottle or an ice pack on the painful area can help reduce the pain. Don't put ice directly on your skin, as this can cause an ice burn.

Physiotherapy

Physiotherapists can assess your back pain and help to relieve discomfort, increase your movement and help you manage the pain, giving you some pain relief.

Manipulation

Osteopathy and chiropractic are treatments involving manipulation of the spine. You should always see your GP first. Your GP may then refer you to a qualified osteopath or chiropractor.

Pain clinics

If you have chronic back pain, your doctor may refer you to a pain clinic. Pain clinics work with you to help relieve your back pain by treating your symptoms and also by giving you counselling to help you deal with the pain.

Epidural

This is an injection of a painkiller or steroid directly into the bottom of your spine to decrease the inflammation, which may be causing the pain.

Complementary therapies -which can include:

If your chronic back pain isn't helped by exercises, painkillers or manipulation, then surgery is considered as a last resort. There are different types of back surgery. Your doctor will discuss the different options with you in more detail.

Prevention of back pain
Good back care can greatly reduce your risk of back pain. To look after your back, make sure you:

Further Reading
The information above has been reproduced from the HSE and BUPA websites. Both company websites offer a great deal of information relating to back pain and back related problems. Please use the links below to locate further information on this subject.

Back Care - Charity for Healthier Backs
Health Information - BUPA
Back Pain in the Workplace - HSE

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