Back Pain at Work


Healing Work-related Back Pain in Macomb County One Spine at a Time – Dr. Aaron Lundgaard

Most back pain and neck pain research is devoted to identifying risk factors for acute neck and low back pain, or pain that is severe and short-lasting.  That is counter to what spine experts see clinically at Total Health Systems of Macomb County.  We see that long-term, chronic back pain and neck pain is responsible for far more days missed, dollars lost and healthcare dollars spent. Risk factors for chronic back pain and neck pain are different than those for acute pain; chronic pain cases involve more individual, psychological, and workplace variables. Is it possible to identify which acute back and neck pain cases will progress into costly chronic pain cases?

The authors of a study, published recently in Spine, examined workers’ compensation claims to determine if a variety of factors reported by acute back pain sufferers at their initial time of injury claim could distinguish those at high risk for chronic back pain. Three high-risk groups were assessed: nurses and nurses’ aides, manual workers, and truck drivers.

Of the 24% of claimants still receiving monetary compensation three months after their initial claim, job dissatisfaction and poor workplace relations were not linked to chronic back pain. Factors associated with progression from acute to chronic back pain were moderate-to-severe disability, severe leg pain, obesity, and no “light” duties available upon returning to work.

The occupational health services department of a major Dutch airline took part in a randomized, controlled trial comparing traditional spine care utilizing prescription medications, to physical therapy and behavior-oriented “graded” activity. Employees who had been absent from work due to back pain were assigned to receive physical therapy and rehabilitation or prescription medications from their doctor for three months, or until they returned to work. The physical therapy program showed impressive results, with patients missing an average of 58 days (over six months of follow-up), versus 87 days for those under the prescription medication regime.

In this study, physical therapy and rehabilitation consisted of aerobic exercise (i.e., rowing, cycling); strengthening exercises (i.e., sit-ups, leg presses, latissimus pull-downs); and those tailored to each worker’s regular duties (such as lifting and setting down suitcases, e.g., for baggage handlers). This was combined with praise and consistent feedback from the treating physical therapist, with attention paid more to “improvements rather than pain.”

You have a healthcare choice: You can place your recovery in the hands of the “usual” healthcare providers, who often rely on pain medications, or you can utilize the services of an expert in treating back pain and getting you back on the job as soon as possible.

If you injure your back on the job or at home, be sure to talk to the medical physicians, chiropractors, and physical therapists at Total Health Systems of Macomb County. Discuss any symptoms that appear after injury, even if they may seem unrelated. By obtaining the most state of the art diagnostics and treatment, Total Health Systems chiropractors, medical doctors and physical therapists can help get you back on your feet and working again in a short amount of time.

Reference: Staal JB, Hlobil H, Twisk JWR, Smid T, Kške AJA, van Mechelen W. Graded activity for low back pain in occupational health care. Annals of Internal Medicine, Jan. 20, 2004:140(2), pp77-84.

Reference: Fransen M, Woodward M, Norton R, et al. Risk factors associated with the transition from acute to chronic occupational back pain. Spine 2002:27(1), pp. 92-98.

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