Ask the Expert
John Pracyk, MD, PhD, FAANS
Affinity Medical Group
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. Have a question for our experts? Click here.
Workplace Wellness Tip
Exercise loves company. For extra motivation in starting - and sticking with - a running program this spring and summer, enlist the solidarity of some co-workers to form a running club. Follow licensed athletic trainer Jim Tonn's advice on how to ease into and maintain your workouts (see article at right). Set a goal to run together in a local 5K by mid-summer or fall. Ask your company's wellness team to sponsor your club with matching T-shirts, then move those feet for a good cause!
with the Experts
Wednesday, May 11
7:30 - 9:30 a.m.
Bridgewood Resort and Conference Center
1000 Cameron Way
DOT Medical Exams
Richard Menet, MD, MPH, Affinity Occupational Health
Ensure your drivers stay safe and meet the current medical standards for commercial vehicle operators by attending this important update. Dr. Menet will cover a variety of relevant topics including:
--FMCSA regulations/standards vs. guidance
--The proposed National Registry of Certified Medical Examiners
--FMCSA guidance on obstructive sleep apnea
--FMCSA sources including the Medical Examiner Handbook
--Vision and Diabetes waiver programs
--Skill performance testing
To register for this free seminar, contact Tammy Davis at (920) 628-1532 or email@example.com.
Has an article in Health e-News made an impact on your wellness initiatives? We'd love to hear about it! Please send us your feedback
This month's edition contains some key messages for employee health, namely our new telephonic coaching program - led by Affinity Occupational Health staff - as well as tips for starting a successful running program, coping with low back pain, creating healthier Easter baskets, and more. We encourage you to pass Health e-News along to your employees. Their version of this month's edition can be found at: http://conta.cc/hu8z7P
All of us at Affinity Occupational Health wish you and your family a happy, healthy start to the spring season!
In good health,
Director, Employer Solutions and Urgent Care
Telephonic health coaching from Affinity Occupational Health
When your employees are struggling with a health issue, one-on-one support makes a difference. Affinity HealthCalls is a confidential, telephone-based coaching program available to participants who completed a health questionnaire or have an outcome-based scorecard. By phone, our health coaches will work with each individual to develop a personalized health plan designed to meet a person's specific health needs.
Health coaching is based on risk stratification, and specific protocols can be personalized to each company's needs. All calls are made by Affinity Occupational Health professionals who are committed to improving the overall health of your workforce.
What are the benefits of health coaching?
- The telephonic health coaching program is FREE to participants!
- Health coaching can reduce health risks including blood pressure, cholesterol, blood sugar, exercise, nutrition, stress, weight management, depression, alcohol use, and smoking cessation.
- One-on-one sessions enable us to design a personalized plan to improve each individual's health.
- Participants can set and track their health goals with the support of a coach.
Telephonic coaching sessions
Telephonic coaches help participants set specific, action-oriented goals to improve their modifiable lifestyle risks. A typical coaching session lasts about 10 minutes and will cover a variety of health topics. The telephonic coach will give participants an overview of their entire health summary and will serve as a valuable resource for credible health information and educational materials. A telephonic coach will elicit the participant's best thinking and spark intrinsic motivation to achieve lifestyle changes.
For more information on providing health coaching to your organization, call Riley McDermid, employer health and wellness consultant, at (920) 628-1533.
Practical advice for starting a running program
By Jim Tonn, licensed athletic trainer for Affinity Health System
As the days grow longer and the snow melts away, we cannot help but want to shed our winter clothes and get outside to enjoy the fresh air. For many, this is the time to lace the shoes tight and begin pounding the pavement. Whether you have a New Year's resolution to meet, a bucket list item to cross off, or want to add a new, healthy habit to your repertoire, running has a place for all takers.
When you first begin any exercise program, make sure to check with your physician if you have any pre-existing health conditions or if you have led a sedentary lifestyle for more than five years. Try to approach your new habit not as work or a punishment. You are trying to better yourself, improve your health, and make a difference in your life.
In the beginning, it's more important to put in time moving versus going for a certain distance. Make your first few times about going out for at least 20 minutes. For any beginning runner, it's not important to run the entire time. You should set distance markers and jog to a point. I find it best to choose an intersection if you're in town, or a telephone pole running out in the country. Alternating between walking and running will help you develop a cardio base and ease your body into running form. Truly early workouts look like this:
- Try to arrange a minimum of 20 to 30 minutes in your day to run/walk.
- Walk the first three to five minutes to warm up your body. It's the simplest, easiest way to get your body ready for activity. Try to avoid the holding, static stretch at the beginning of a workout. To get that limber feeling, try a dynamic stretch. Bouncing on the toes, hopping from foot to foot, jumping jacks, and light kicks are dynamic warm-ups that get blood to the muscles and help to loosen your body for activity.
- Pick a distance where you will run 30 to 60 seconds at a time. After your jog, do a resting walk for one to two minutes, and then jog again. Continue to alternate your runs and walks during your exercise time. To cool down, just walk the last three to five minutes.
- Remember to stretch! Now you can do your static stretching. The best time to work on your flexibility is when your muscles are warm and activity is done. Make sure to stretch both the front and back of your legs, as well as your lower legs. There are many stretches and variations to try. Any quick Internet search can show you a bevy of stretches.
Picking up momentum
The more you go, the sooner you'll see changes start to occur. In as little as three weeks, you could change from a walker to a runner who can sustain a 15-20 minute jog. Listen to your body; follow the above pattern for a week or two. You can walk every day, but I would advise only running three to four times in a week, making sure you have a resting day between runs.
Once you can start to easily hold a run for a minute, begin to work on running for a timed goal. I recommend having a watch at this point. Try to hold your run for three minutes, four minutes, five minutes! Still hold that goal of a minimum 20 to 30 minutes in your mind. Keep your total time for activity in mind and keep walking breaks built into your total time. An example would be run five, walk two, run five, walk two, run five, and walk five to cool down. There you have a 24-minute workout!
Going the distance
The next challenge comes in running for a sustained time, then a distance. If you are able to run for 10 to 12 minutes without rest, chances are you have just run a mile!
- Start to plan your exercise sessions to be just 10 to 12 minutes of running. If you are comfortable doing this, I would suggest using sites such as mapymyrun.com or active.com to plan running routes. Find a good mile route around your running area.
- You can expand on your run by trying to push distances as well - 1.2 to 1.4 to 1.7. It's ok to take small breaks as you need them, as you start approaching distances you haven't done before.
- For training, I suggest trying to go two to three times during the week, and plan a "long" slow run on a weekend day. For example, Monday would be a 25-minute run/walk, Wednesday would be 1.4 miles, Friday would be 1 mile, and Sunday would be 2 miles. On your weekend run, take the breaks that you need to, but push for the distance you set.
Everyone will adapt differently to running. Some might experience fast results and great changes right away. Don't get frustrated! Do your best. Good advice to follow would be to try increasing your running times in the first two weeks by 15 to 30 seconds by the end of the first week, and 30 seconds again the next weekend. When you are planning solid runs, try running one to two minutes longer each week. Going by distances, I try to improve .2 miles a week until I reach my goal. Remember, a 5K is roughly 3.3 miles, so plan accordingly!
GAP can help
Even with following good instructions and listening to your body, sometimes problems can develop for which you can't find a reason. To help with that, Affinity Health System has the Gait Analysis Program (GAP). This is a comprehensive exam of your running habits. We'll also look at your foot type, lower body strength, flexibility, and will test your balance. We will film you running and walking to examine how your body naturally moves, and give advice for form corrections. This program is used by the novice who wants to begin a running program as well as the marathon runner who is looking for correction to his running form. You can call (920) 223-7075 if you would like to schedule an appointment, or contact the program administrator, Joe Fox, MS, LAT, at firstname.lastname@example.org.
Remember, nothing worth doing is ever easy. Happy running!
What's Happening at Affinity?
Leaders in Green Health Care
April 22 is Earth Day, an annual observance encouraging all people around the globe to take good care of our planet. Affinity Health System is proud to be a champion of environmental stewardship, serving as a model to other health care facilities nationwide.
Did you know?
- St. Elizabeth Hospital and Mercy Medical Center are Energy Star rated hospitals, which means that in health care and square footage, they use energy efficiently. The baseline to be an Energy Star rated facility is scoring 75/100. St. Elizabeth is currently 83/100 and Mercy is 76/100.
- Seven of Affinity's building projects are LEED-certified (Leadership in Energy and Environmental Design) through the U.S. Green Building Council. In fact, Affinity has more LEED-certified facilities than any other health care organization in the nation. These include the St. Elizabeth Hospital south addition, St. Elizabeth Hospital Heart, Lung & Vascular Center, and clinic buildings in Brillion, Darboy, Greenville, Little Chute and Neenah/Town of Menasha.
- Affinity's hospitals recently eliminated Styrofoam from their cafeterias, and now offer biodegradable containers made from earth-friendly materials.
- St. Elizabeth and Mercy now utilize reusable isolation gowns rather than disposable.
- St. Elizabeth and Mercy are also implementing an environmental management system to move beyond environmental compliance and further reduce waste in our landfills, particularly items such as batteries and lamps. The environmental management system looks at the supply chain and waste streams of all activities and products. Materials are followed from purchasing to consumption and disposal. Waste is eliminated wherever possible and helps Affinity drive performance. Environmental compliance is a baseline; going beyond is our standard.
Making strides in energy and recycling
St. Elizabeth Hospital is currently undergoing a major renovation and expansion. With the updated facility, Affinity has set a goal of reducing energy consumption by 30 percent compared to 2010 as a baseline. Specific energy conservation measures will help significantly lower the hospital's electrical and natural gas needs. Electricity emission savings will be equivalent to taking 469 passenger vehicles off the road for a year, conserving 268,355 gallons of oil (or 5,567 barrels), powering 291 homes for a year. The emissions saved from natural gas equate to 157 tons of waste avoided to the landfill or burning 2.4 railcars' worth of coal. The energy saved from this reduction goal not only lowers CO2 output, but captures large savings from a utilities standpoint. Furthermore, Affinity plans to reduce water use for all of its hospitals in 2011.
In addition to energy conservation, Affinity is committed to maintaining high recycling rates during deconstruction and renovation at St. Elizabeth Hospital. To illustrate:
June - December 2010, construction waste management from metals, GWB, wood, concrete, asphalt, cardboard, paper, aluminum cans, plastics, ceiling tiles, trash, rubble, commingles, glass, batteries, tires, and carpet tiles:
- Recycled Materials = 503.5 Tons
- Trash and Waste = 251.45 Tons
- Total = 754.95 Tons
Recycling Rate = 66.69%
Affinity continues to receive national recognition for our efforts in sustainability. This month, St. Elizabeth Hospital and Mercy Medical Center are both receiving Practice Greenhealth's Partner Recognition Award, a national honor for an elite group of health systems making a major impact on environmental progress. The criteria for the award not only measures reduction of annual solid waste, regulated medical waste, hazardous waste and recycling rates (greater than 5 percent of the total waste stream), but it also looks at ongoing sustainability efforts such as energy efficiency.
This marks the fifth award from Practice Greenhealth for Affinity as we continue the journey of environmental performance improvement. Next year, St. Elizabeth and Mercy will target Practice Greenhealth's Partner of Chance Award, which sets even higher goals of reduction.
Healthy Easter Baskets
What are your kids getting in their Easter baskets this year? Before you load them up on Cadbury Eggs and Peeps, consider some healthier alternatives.
Not ready to give up the hollow chocolate bunnies? Tradition doesn't have to be overruled completely. Just aim to fill at least half the basket with stuff you don't mind them noshing on. Pretzels, animal crackers, sugarless gum, string cheese, tangerines, granola bars, dried fruit or trail mix packets are all good ideas.
Fun and games
Better yet, opt for non-edibles. Charm the kids with enough stickers, books, DVDs, jump ropes, puzzles and other small activities, and they may not even miss the jelly beans.
On the move
Send your kids on a scavenger hunt to search for their Easter baskets. If the weather cooperates, take the fun outside where they can burn some calories hunting before snacking. Go a step further and set up an old-fashioned potato sack race with (low-sugar) prizes.
Pay it forward
Give Easter extra meaning by encouraging your children to fill a basket for a sick friend, elderly neighbor or a family in need. If you can, include a gift card for groceries or homemade "coupons" for help with household chores or errands. Deliver the basket together as a family, reminding your kids that Easter is above all about God's love and grace.