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What are the causes of back pain (and solutions for office workers)?



Back pain is one of the most common conditions leading to trips to the doctor or making you miss work. In the United States, lower back pain is a reason 149 million work days are lost every year, costing it’s economy $98 billion. When indirect costs are factored in, this reaches an unfathomable $200 billion annually, two-thirds accounting for lost wages and productivity (1, 2, 5).


In the UK lower back pain affects one third of adults yearly (3), and is the most common cause of disability in young adults, with more than 100 million workdays lost per year, and costs UK’s economy over £10 billion (taking into account only direct costs) (4).


Having lower back pain can have detrimental effects on an individual’s professional, personal and family life (6). It is among the top 10 diseases and injuries that account for the highest number of DALYs (life years lost to ill-health, disability and mortality) worldwide (2).


So, the scale of the issue is immense and the effects are wide-reaching. What causes back pain, what are the risk factors for office workers and what should both employees and employers do?

Causes of back pain


The exact cause of lower back pain usually can’t be perfectly pinpointed, and this condition is called ‘non-specific lower back pain’. This accounts for 90% of all low back pain cases (7). In industrialised countries, between 60% to 70% of people will get non-specific low back pain at some point in their life (2).


If your pain lasts for more than 3 months, then it is considered chronic. The majority of chronic back pain is non-specific. Pain can range from mild to severe and in some cases have a hugely negative impact on your social, work and personal life (8). Various anatomical parts of your back can be affected by injuries and certain conditions:


1. Muscle and ligament strains and sprains - Your lower back is surrounded by various ligaments and muscles of different sizes, connecting and supporting the structures of the spine and facilitating movement at the joints. Inappropriate movements and excess stress e.g. during lifting high load or twisting can injure them. These are the most frequent causes of low back pain.

2. Disc damage - Discs are designed to cushion movement between bones in your spine and absorb excessive forces. Disc prolapse (slipped disc) occurs when the inner fluid matter of the disc protrudes out. It can cause pain in the area, inability to move properly, as well as can press on nerves coming out of the spine and going to your lower body.


3. Nerve compression - As mentioned above, a compressed nerve which can be caused by, for instance, a disc bulge, can lead to tingling, pain, weakness and numbness in the lower limb. Also, muscles that run closely to the nerve such as piriformis muscle in your buttocks region can get tight and press on a nerve causing symptoms similar to those mentioned above.


4. Joints and bone issues - Osteoarthritis is a condition frequently affecting joints, which means wear and tear of them. Some of the joints in your back can also get locked in an inappropriate way causing a lot of pain when trying to move. Joint health is closely related to the state of muscles and ligaments. Unhealthy joints are frequently associated with weak, painful or overworked muscles.



Another, more rare case is when one of the bones in the spine slip forward of it’s position, the condition called spondylolisthesis. The change of position may cause stiffness, pain and in some cases could even progress to the more serious state in which it creates pressure on the neural tissue in the spine.


Also, due to aging or underlying hormonal imbalances or mineral and vitamin deficiencies, bones in the spine can become brittle. Sometimes it can lead to painful fractures which change the architecture of the bones and disrupt normal curves of the spine.


5. Skeletal deformity - abnormal curves (scoliosis, increased kyphosis, increased lordosis). Adult spine has 3 natural curves throughout, in your neck region, mid back and lower back, which ensures proper movement, posture, and function of internal organs. If the curves become abnormal that will lead to changes in movement, irritation of spine structures and pain.


6. Internal organ issues - Back pain coming from disease of internal organs such as in women having gynaecological issues.


There are also some rarer causes of back pain that aren’t discussed in this blog such as infections, autoimmune and genetic conditions.




Risk Factors for Office Workers


Lower back pain is the most common cause of work-related disability in people under 45 years of age (9). Although the workers that need to perform some heavy duty tasks such as lifting boxes are particularly susceptible, a calm, seated office job can also bear some dangers to your lower back which are often underestimated.


Office-related risk factors:


  • Sitting for more than half a workday day in an awkward posture or bent forward position

  • Using Display Screen Equipment (in simple terms: a computer! Especially a laptop without a laptop stand)

  • Seating in a place where you need to twist or reach for items

  • Poor workplace setup (we built our workplace and desk assessment software VIDA to create personalised recommendations for this and you can read some top tips at this blog post on 6 simple changes to your work from home set-up

  • Persistent stress and other psychosocial aspects such as high workload, tight deadlines, lack of control of the work (Read more on the 5 Stages of Burnout and how it can lead to development of physical symptoms)


The risk also increases in the presence of individual clinical factors such as abnormal spinal curves, poor core muscle strength and abnormal mobility (9). An employee is also more likely to get lower back pain if they have already experienced an episode of it before.


Our Recommendations

For employees:


1. Most back pain cases resolve with physical therapy and time. If you have ongoing back pain or with additional symptoms such as leg weakness, tingling or numbness spreading down the legs, changes in bladder and bowel function, see a specialist to get a diagnosis and treatment plan. Act early for the most effective results.


2. Take action to prevent lower back pain by strengthening your core through exercise. During work, take breaks frequently to stand up, move around and stretch your back. Frequent movement and exercise help blood flow into the area delivering needed nutrients to keep the muscle, ligament, joint and bone tissues healthy (10). Also, practicing good posture will reduce risks of lower back pain and you will generally feel more uplifted and energised!


3. Get psychological support if constant stress at work is an issue. Discuss your workload with your manager. You can also use an employee assistance program if one is available at your company. See our blog about burnout symptoms and risks above if this is of concern.


4. Take ownership of your musculoskeletal health and learn what a good desk setup is and what factors can put you at risk.


5. Manage lifestyle factors that otherwise could be holding you back such as maintaining healthy weight and quitting smoking. Get proper rest regularly as if your life depends on it. Simple things like a warm bath for 15-20 minutes after a long work day can relax muscles and help alleviate pain.


6. Take care of your quality night sleep. Ensure your mattress and bedding system is not aggravating any back pain symptoms, promotes comfort and makes you feel rested in the morning.



For employers:

1. Based on HSE guidelines (11, 12), employees should identify people susceptible to workplace risks or demonstrating problems. VIDA is designed to do workplace risk assessments and then highlight these across individual teams and the business at large.


2. Prioritise interventions for early those in pain, this way they will have a higher chance of complete recovery. Also, encourage employees to report their pain to be able to take action early. VIDA will highlight the actions an employer can take that will yield the greatest impact. All recommendations to employees are personalised actions to encourage self-correction (where beneficial) whether working from home or in offices.


3. Encourage your team to take small breaks throughout the day by leading by example.


4. Seek advice from professional services which can assess risks of employees’ office and home desk setups, symptoms and give personalised recommendations. Vitrue VIDA’s desk assessment does this for you using advanced computer vision technology with recommendations based on the latest scientific evidence and DSE assessment guidelines. It takes 5 minutes to get setup, and 5 minutes for employees to complete their desk assessments making your business compliant!



Vitrue VIDA is an AI-powered wellbeing and desk assessment that takes a holistic approach to assess and advise employees on the optimal in-office or remote workplace setup to prevent physical health issues, burnout and boost productivity. If you’d like to become compliant across your company in 5 minutes, test it out for free at www.VitrueVIDA.com



References


1. https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906

2. https://www.who.int/medicines/areas/priority_medicines/Ch6_24LBP.pdf

3. https://www.ncbi.nlm.nih.gov/books/NBK11709/

4. https://pubmed.ncbi.nlm.nih.gov/10601677/

5.https://www.researchgate.net/publication/264985763_Prevalence_of_low_back_pain_by_anatomic_location_and_intensity_in_an_occupational_population

6. https://www.hse.gov.uk/statistics/cost.htm

7. https://jhmhp.amegroups.com/article/view/6055/html

8. https://www.who.int/bulletin/volumes/81/9/Ehrlich.pdf

9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036671/

10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934575/

11. https://www.hse.gov.uk/msd/health-monitoring.htm

12. https://www.hse.gov.uk/msd/backpain/index.htm


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