Q:  What are your top five tips for low back pain?

A:  1) Prevention
Protecting your back while in the workplace is no different than any other part of your life. Whether you are a weekend warrior athlete or avid do-it-your-selfer, a few tips can go a long way in avoiding any injury and reducing time lost from your personal life or in the workplace.

As we age, changes occur within the spine; in particular, deterioration of the disks between the vertebrae begins to take place. Much like the shock absorbers on a car wearing out with time, the same is true for the intervertebral disks. Fortunately, most back pain is muscular in origin and heals over time. Prevention is not difficult; in fact, with a little insight and some planning before each activity, you can minimize injury to your back.

2) Ergonomics of Lifting
All of us have heard the phrase, "Lift smarter, not harder;" but, what exactly does that mean? There things you can do to lift with better efficiency, so that you do not injure your back. The spine is similar to a construction crane. It generally works better in the upright position, rather than bent over. Therefore, avoid any unnatural bending, particularly leaning forward while lifting, as this can be harmful. Lift using your knees, legs, and hips when rising from a bent-knee position to a standing one. Keep your back straight and upright throughout. Finally, hold the object close to your body as much as possible. Go ahead and try to lift something up while holding it out in front of you rather than close to your body. You will be surprised as to how much more difficult this can be.

3) Weight Limits and Back Braces
The Occupational Safety and Health Administration (OHSA) does not have a set requirement limiting the amount of weight a person can be required to lift in the performance of his job. However, they do have guidelines and expect employers to set safe lifting limits for their employees. OSHA suggests that employers follow the lifting guidelines of the National Institute for Occupational Safety and Health. Generally, most people should be able to lift 50 lbs without assistance. For heavier loads, seek the help of another person, or use assistive devices depending on the circumstances.

A back brace can help prevent injury if used properly. We have all seen the body builders in the gym use them, so they obviously make sense for certain recreational activities. However, in the workplace they are more controversial. When you are at your local home improvement warehouse, be sure to notice if the employees are wearing their back braces in addition to their orange vests. In my observations, the back braces are usually undone, but when they begin a task they are then immediately secured into place before getting on the forklift, or starting any physical activity. It is obvious that certain employers require employees to wear them, yet others discourage their use in the workplace.  Ask your occupational safety officer about the use of a protective brace as it pertains to your specific job and inquire as to your employer's specific policy regarding these devices.

4) Smoking
Everyone is aware that smoking negatively affects most organ systems in the body. The spine is no exception. Nicotine is the culprit and its by-products can persist in the body for up to 60 days. They harm the disk itself and cause premature aging and damage. Nicotine can also increase the number of small pain fibers in the disk, worsening back pain.

Finally, long-term smoking can decrease bone quality and strength. Stopping smoking is suggested for all patients with degenerative disk disease as a source of their back pain, as it can speed the spine's aging process.

5) Warning Signs
Although most low back pain has its origins in muscle strain or sprain, there are some symptoms that deserve special attention, as they indicate something potentially more serious. First, the development of any pain or numbness radiating down into the legs indicates that the nerve is compressed (pinched), not muscular injury.

Second, any type of movement weakness such as an inability to pick up the leg or foot may also reflect more serious nerve compression. Catching the foot on objects or an audible "slap" of the foot with walking may reflect a condition called "foot drop." Third, a loss of feeling in the saddle area (buttocks and groin), accompanied by loss of bowel and bladder control may indicate a very serious form of nerve compression.

If low back pain is accompanied by any of these symptoms, please consult your physician immediately. Your doctor needs to make a diagnosis, as there are certain conditions that may result in permanent injury if left untreated.

In summary, back pain affects millions of Americans. Thoughtful consideration of some of the basics can go a long way towards making your life pain-free and avoid the risk of serious injury. 

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