One of the biggest reasons workers go out on comp is due to low back pain (LBP). For many people it is a recurring problem. A new study even shows that having an episode of LBP is the main risk factor for having recurring episodes.

But your workers don’t need to keep experiencing LBP, and you don’t have to lose their productivity. There is no quick fix for chronic LBP but there is a relatively easy answer: exercise.

Recurring LBP

Surprisingly, many people who’ve had chronic LBP don’t seem to understand that, or, for whatever reason, don’t engage in it. The study, published by the American Physical Therapy Association, shows that after an acute episode of LBP, “one-third of patients will experience a recurrent episode,” and experiencing more than 2 previous episodes of LBP “triples the odds of a recurrence within 1 year.”

The study included nearly 1,000 adults in Australia who sought medical care for LBP between October 2011 and November 2012. The researchers tracked their progress over the course of a year.

The study included a variety of factors to see what might drive higher risks of chronic LBP, but found none. “The results … showed that only 1 factor, multiple previous episodes of LBP, was associated with a recurrence within 1 year. … Nearly half of those with multiple previous episodes of LBP had a recurrence. No other factors were associated with recurrences.”

LBP specifics

Workers of all ages get LBP, although their symptoms are somewhat different. People over the age of 40 often have degenerative changes driving their LBP, while younger workers tend to have more soft tissue problems; but both can have recurring issues. It’s very common among workers we treat.

We often talk about acute or chronic pain LBP. The main difference is duration.

• Acute LBP. This may feel like a severe, sharp pain or a dull ache, and lasts for no longer than six weeks. Injured workers with acute LBP typically have limited flexibility and range of motion, and may have a difficult time standing up straight.
•  Chronic LBP. This feels more like a deep, dull or burning pain that continues for at least three months. While it’s in the lower back, the pain can travel down the legs. Injured workers suffering from chronic LBP may have pain from sitting too long or staying in one position — such as while driving.

Treatments

The treatment for each type of LBP is different.

The main remedy for acute LBP is rest, although that does not mean bed rest. We’re talking more about just taking it easy, not overdoing things. The injured worker should avoid movements that aggravate the pain; no heavy exercise, for example. Simple movements like bending down to pick up something can aggravate the condition. For a day or two, depending on the severity, the person should find a balance between resting and moving to let the body heal. If he’s prescribed anti-inflammatory drugs or muscle relaxers this will give the medication a chance to help the body.

Chronic LBP does require movement. Avoiding movement is one of the worst things a person can do. The injured worker needs to engage in exercises to help reduce the pain and prevent recurrence of the LBP.

It’s important to work on flexibility, strengthening and stability, to help with mobility and range of motion so the person can move in a functional manner. Otherwise, the muscles are tight and the joints don’t go through the proper range of motion when moving. The idea is to change tight, weak muscles into strong, flexible muscles.

Exercises

Yoga, Pilates, strengthening exercises — any of these and many others will help. Ideally, the injured worker should work on a combination of exercises that help his flexibility and mobility. Here are some and how they help with LBP:

• Strengthening exercises, specifically those that strengthen the core, or the muscles in the front and back of the spine. People always think of the abdominals and having 6-pack abs, but that’s not really what we are talking about. Those are the heavy lifter muscles. It is the deeper, transverse abdominis that need to be worked. Those muscles really support the spine. There are a whole variety of great exercises that can help, although not the common, crunch-type exercises. Planks, for example, are among the best. These exercises can also help the intrinsic, tiny muscles that attach to each vertebrae. These provide postural support and are very important.
•  Flexibility exercises to the lower extremities are extremely important. The lumbopelvic hip complex, as it’s called, includes muscles that attach from the lower extremities. The hip rotators, hamstrings, hip flexors — all are included. Again, there are many effective exercises that can relieve tight hips, which in turn helps relieve chronic LBP.
• Posture. Practicing sound posture and good body mechanics and lifting habits are important for everyone. Having a neutral spine is the goal. Some of the things to concentrate on are: 

• Keep the feet about shoulder-width apart.
• Let the arms hand naturally.
• Stand straight and tall with the shoulders pulled back, but not exaggerated.
• Tuck the stomach in.
• Keep the head level; don’t push the head backward or forward or to either side.

Conclusion

LBP does not need to be nearly as pervasive as it is. Workers with chronic LBP can be taught to make some simple lifestyle changes — like engaging in regular exercise, to get relief.