Back pain causes headaches for South African employers

Low back pain is one the top five reasons for workplace absenteeism, and a leading cause of disability in South Africa.
An extremely common global health problem, low back pain is among the top ten high burden diseases and injuries globally according to the Global Burden of Disease Study 2010.

A study by the World Health Organization revealed that 37% of low back pain was deemed attributable to occupational risk factors.

South Africa is no exception, and low back pain is causing significant financial loss and a decrease in quality of life which in turn affects performance at work. Employers should focus on occupational exposures that result in preventable measures.

Between 60-70% of people can expect to experience low back pain during their lifetime, peaking at between the age of 35 and 55. As the population ages, low back pain will increase substantially due to the deterioration of bones and cartilage in the back.

Low back pain is non-specific. Symptoms vary across patients and may be experienced as aching, burning, stabbing, sharp or dull, well-defined, or vague with intensity ranging from mild to severe. The pain may begin suddenly or develop gradually.

Many patients with self-limiting episodes of acute low back pain did not seek medical care and instead self-medicated with over-the-counter medication. But up to one third of patients report persistent back pain of moderate intensity one year after an acute episode and have substantial limitations in activity. At present low back pain is treated with analgesia and rehabilitation, with the aim of decreasing pain. Surgical intervention is a last resort.

Exposure to stressors in the workplace such as heavy lifting and unnatural body postures result in preventable back pain, which is a modifiable risk factor, meaning something can be done about it. Manual labourers and professions that involve lifting, such as nurses, need to be taught correct lifting procedures and aids to assist in heavy lifting. In addition, workplace monitoring and regular reminders need to be implemented to prevent injuries.

Office workers can spend up to eight hours in a seated position that is not natural. Ergonomic office furniture, regular breaks and wellness programmes in an office environment can alleviate incidence rates.

Psychosocial factors also appear to play a substantial role in the frequency of low back pain.

People with depression, increased level of stress and anxiety are more prone to low back pain.

With the modifiable risk factors identified, the most promising approach for employers includes exercise, appropriate education and support at the workplace. Each industry needs to tailor-make their own approach to form the foundation of an integrated wellness approach. With continued momentum and monitoring, this will result in a happier and healthier workplace.

Dr Fathima Docrat is the medical advisor at Alexander Forbes Health Management Solutions.

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