LOW BACK PAIN: RISK FACTORS AND PREVENTION

Approximately 80 percent of all Americans will experience low back pain at some point. Some of these low back pain (LBP) episodes may result from muscular damage and be short-lived and acute, others may involve dislocations, fractures, or other problems with spinal vertebrae or discs, resulting in chronic pain or requiring surgery. Low back pain is epidemic throughout the world. It is the major cause of disability for people age 20 to 45 in the United States, who suffer more frequently and severely from this problem than older people do.

LBP causes more lost work time in the United States than any other illness except upper respiratory infections. In fact, costs associated with back injury exceeded those associated with all other industrial injuries combined. Back injuries are the most frequently mentioned complaints in injury-related lawsuits and result in high medical and rehabilitation bills, costing businesses and industries in the United States over 50 billion dollars annually in direct and indirect costs. As a result, employers throughout the country have become increasingly interested in preventing these injuries. Note that these figures do not include the costs of human suffering, self-worth, and other emotional problems that occur when a person becomes disabled.

Risk Factors for Low Back Pain

Health experts believe that the following factors contribute to LBP:

• Age. People between the ages of 20 and 45 run the greatest risk of LBP. At age 50, the condition becomes less common. After age 65, the incidence again rises, apparently because of bone and joint deterioration.
• Body types. Many studies have indicated that people who are very tall, are overweight, or have lanky body types run an increased risk of LBP. However, much of this research is controversial.
• Posture. Poor posture may be one of the greatest risk factors for LBP. If you routinely slouch, particularly during daily tasks, you run an increased risk.s
• Strength and fitness. People with LBP tend to have less overall trunk strength than do other people. Weak abdominal muscles and weak back muscles also increase risk. In addition, total level of fitness and conditioning is a factor. The more fit you are, the lower your risk.
• Psychological factors. Numerous psychological factors appear to increase risk for LBP Depression, apathy, inattentiveness, boredom, emotional upsets, drug abuse, and family and financial problems all heighten risk.
• Occupational risks. Evidence indicates that employees who are new to a particular job run the greatest risk of LBP problems. In addition, type of work and work conditions greatly affect risk. For example, truck drivers, who must endure the bumps and jolts of the road while in a sitting position, frequently suffer from back pain.

Preventing Back Pain and Injury

What can you do to protect yourself from possible back injury? First, you need to know what area of the spinal column is most at risk and then protect that area as much as possible. Almost 90 percent of all back problems occur in the lumbar spine region (lower back). You can avoid many problems by consciously attempting to maintain good posture. Other preventive hints include the following:

• Purchase a firm mattress, and avoid sleeping on your stomach.
• Avoid high-heeled shoes, which often tilt the pelvis forward.
• Control your weight.
• Lift objects with your legs, not your back.
• Buy a good chair for doing your work, preferably one with lumbar support.
• Move your car seat forward so that your knees are elevated slightly.
• Warm up before exercising.
• Strengthen abdominal and back muscles.
• Exercise, particularly exercises that strengthen the abdominal muscles and stretch the back muscles, is important.