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- The United States Border Patrol-San Diego Sector and
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- Low back pain is the most common work-related medical problem in the
United States and the second most common reason for doctor visits a=
mong
U.S. citizens, according to the National Center for Health Statisti=
cs.
It affects more than 20 million Americans and is the leading cause =
of
disability among people ages 19 - 45. It hits the bottom line fairly
hard, also:
- low back is the No. 1 leading cause of missed work days, costing
Americans $60 billion per year in treatments and American business=
es
about $15 billion annually. It's estimated that at least 80 percen=
t of
all Americans will experience some form of low back pain at some p=
oint
in their lives.
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- Last year, about 500,000 back and neck surgeries were performed in =
the
United States. Since there are many non-surgical treatments for low=
back
pain some experts believe that many of these operations were
unnecessary.
- For a comparison there are about 600,000 Cardiac Artery Bypass procedures performed in the United St=
ates
each year. Other "open heart" surgeries include 80,000 va=
lve
surgeries, and 2,300 heart transplants annually for a total of 682,=
300.
- Approximately 200,000 appendectomies are performed annually in the =
US.
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- Interestingly, while many Americans know the role cholesterol, diet=
and
exercise plays in preventing heart attack, few Americans know how to
prevent spine problems, or a "back attack." While everyone
understands that chest pain is a signal from the body that somethin=
g is
wrong, random bouts of back pain are largely ignored until the prob=
lem
becomes more serious, and a disc is herniated.
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- The spine includes vertebrae (bones), discs (cartilaginous pads or =
shock
absorbers), the spinal cord and nerve roots (neurological wiring
system), and blood vessels (nourishment). Ligaments link bones toge=
ther,
and tendons connect muscles to bones and discs. The ligaments, musc=
les,
and tendons work together to handle the external forces the spine
encounters during movement, such as bending forward and lifting.
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- Some back injuries involve the “soft tissue” that is the
muscle, ligament type injury.
- A more serious injury occurs when the discs of the spine are involv=
ed.
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- The spine is composed of:
- Vertebra
- Discs
- Spinal Cord and Nerves
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- The vertebrae are separated by intervertebral discs which act as
cushions between the bones.
- Each disc is made up of two parts. The hard, tough outer layer call=
ed
the annulus surrounds a mushy, moist center termed the nucleus.
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- In between each of the five lumbar vertebrae (bones) is a disc, a t=
ough
fibrous shock-absorbing pad. Endplates line the ends of each verteb=
ra
and help hold individual discs in place.
- Excess spinal pressure can cause these discs to be compressed until=
they
rupture.
- Disc herniation occurs when the annulus breaks open or cracks, allo=
wing
the nucleus to escape. This is called a Herniated Disc.
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- Many factors increase the risk for disc herniation:
- Lifestyle choices such as tobacco use, lack of regular exercise, a=
nd
inadequate nutrition substantially contribute to poor disc health.=
- As the body ages, natural biochemical changes cause discs to gradu=
ally
dry out affecting disc strength and resiliency.
- Poor posture combined with the habitual use of incorrect body mech=
anics
stresses the lumbar spine and affects its normal ability to carry =
the
bulk of the body's weight.
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- Disc Degeneration: chemical changes associated with aging causes di=
scs
to weaken, but without a herniation.
- Prolapse: the form or position of the disc changes with some slight
impingement into the spinal canal. Also called a bulge or protrusio=
n.
- Extrusion: the gel-like nucleus pulposus breaks through the tire-li=
ke
wall (annulus fibrosus) but remains within the disc.
- Sequestration or Sequestered Disc: the nucleus pulposus breaks thro=
ugh
the annulus fibrosus and lies outside the disc in the spinal canal
(HNP).
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- Combine these factors with the affects from daily wear and tear, in=
jury,
incorrect lifting, or twisting and it is easy to understand why a d=
isc
may herniate. For example, lifting something incorrectly can cause =
disc
pressure to rise to several hundred pounds per square inch!
- A herniation may develop suddenly or gradually over weeks or months=
.
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- Never Bend, Lift, and Twist at the same time!
- Use mechanical aids or assistance when possible.
- Bend your knees and use your legs to lift!
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- Plan the Lift.
- Before attempting to lift or move something heavy, it is important=
to
step back and analyze what needs to be accomplished. Think about h=
ow
heavy the object is, how far it has to be moved, where it is going=
to
end up? What is the shape of the object? Is it cumbersome, will it=
be
easily manipulated? Is it a two-person job? Is there anything in t=
he
way that needs to be moved prior to lifting? Stand directly in fro=
nt of
the load, with feet about shoulder width apart. One foot should be=
in
front of the other for balance. ( See Figure 1)
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- Lift with the legs -- NOT THE BACK.
- Since leg muscles are stronger than back muscles, lift with the le=
gs,
until they are straightened. Avoid jerky movements. Keep the natur=
al
curve in the spine; don't bend at the waist. To turn, move the feet
around by pivoting on the toes, not by twisting at the stomach. (See Figure 4)
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- When it is time to set the load down, it is very important that it =
is
done correctly. Reverse the procedures for lifting to minimize the
strain on the back. If the load is going to set on the floor, bend =
the
knees and position the load in front of you. If the load is to go at
table height, set it down and keep in contact with the load until i=
t is
secure on the table.
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- There is one final important rule: "THINK BEFORE YOU LIFT"=
;. It
is better for workers to use their own common sense than to teach t=
hem
specific lifting, pushing, pulling, walking, climbing or jumping
procedures. This is not to imply that unsafe behaviors should not be
pointed out to others and corrected. For example, "common
sense" may tell certain people to jump down from heights of se=
veral
feet. Certainly, when people exhibit this type of behavior or when =
they
attempt to carry two hundred pounds, the errors of their behavior s=
hould
be brought to their attention. Remember, in lifting, you are the ma=
jor
cause of your injuries; therefore, you have the major responsibilit=
y for
preventing them.
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