Watch Your Back

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Back pain will strike nearly 85 percent of the population at some time in their life, according to the American Academy of Orthopedic Surgeons. Although back pain can result from workers who do a lot of lifting, it is just as common in people who lead sedentary lives. In fact, the amount of people with back pain has increased as more workers are spending their days sitting in front of computers. Inactivity, combined with long periods of sitting, frequently leads to back pain.

Office workers who spend anywhere from 25 hours to 40 hours a week in a static position are not getting the movement needed in order to maintain a healthy back. In addition to movement and exercise, proper support is essential to back health. Unfortunately, there are many factors that cause back injuries, including reaching too high or too far; lifting, bending twisting and turning activities; pushing and pulling movements; sitting and standing for prolonged periods; slips and falls as well as automobile accidents.

Since these factors involve most people at some point in their lives, it comes as no surprise that the Department of Labor classifies back injuries as the most frequently injured body part. And four out of five people will experience back pain in their lifetime, according to the National Center for Health Statistics.

The majority of back pain is caused by strains or sprains of the back's muscles, ligaments and tendons. With so many people leading inactive lives, the muscles become lax and lose the ability to support the spine properly. In time, the ligaments and tendons also can lose their ability to function properly.

Basic Back Care at Home

The lowest region of the back--the lumbar region--is the most vulnerable area. This is because the lower part of the spine bears the entire weight of the upper body and it is flexed, twisted and bent more than any other part of the body, according to research by Frost and Sullivan, San Jose, Calif.

Research by the U.S. Department of Health and Human Services, shows that no other health problem affects working-age Americans more than low back dysfunction. The National Institute of Occupational Safety and Health estimates that back injuries account for nearly 20 percent of all illnesses in the workplace and cost the nation an estimated $20 billion to $50 billion dollars per year.

Minneapolis-based Prevention First Inc., a health care solutions company specializing in reducing employer costs associated with back injuries, has started a HealthyBack program that isolates and strengthens low-back muscles. Used in clinical and industrial settings, the program has consistently reduced low back injuries and related compensation costs by more than 75 percent, according to the company.

The HealthyBack program targets companies that face significant workers' compensation payments due to low-back injuries. For employers with large concentrations of employees, the HealthyBack program provides the equipment and professional staffing needed to operate the program on-site at customer locations.

"Employers who invest in the HealthyBack program stand to gain healthy returns," said B. Jeffrey Jolley, director of prevention at the Center for Total Back Care. "In addition to workers' compensation savings, companies using HealthyBack can expect to realize a number of other benefits, including days lost due to injury, whether the injury occurs on or off the job."

Developed by Brian Nelson, M.D., and an orthopedic surgeon, the program uses a specially designed exercise machine that isolates the lower-back muscles so that they are exercised and


As with many conditions, the best defense against back pain is prevention.
strengthened. Employees exercise for 10 minutes once a week. Studies conducted by the company show that low-back strength improves dramatically in 12 weeks.

Prevention and Products

As with many conditions, the best defense against back pain is prevention. Strengthening the body's core muscles is essential in preventing back pain. Recommendations for preventing back pain include regular exercise, stretching, quitting smoking, using comfortable seats, maintaining correct posture, losing weight, bending at the knee rather than the waist, reducing emotional stress, and avoiding standing in the same position for too long. In addition, those concerned with back pain should sleep on their sides with their knees drawn up or on their back with a pillow under bent knees.

Home medical equipment providers offer a variety of products for back pain prevention and treatment.

Ball Dynamics International Inc., Longmont, Colo., offers the FitBall as an alternative to an office chair to improve posture and back health by strengthening the muscles around the spine.

"The FitBall exercise ball has been used in therapy and rehabilitation for over 25 years," said Dayna Gutru, marketing and education director of Ball Dynamics International.

"Sitting on the ball for a few minutes each day, or at your desk, helps to strengthen core muscles. These include not only your abdominal muscles, but also the lower back, obliques and the gluteus maximus," Gutru said.

The user of the FitBall cannot completely relax their muscles--like they do with an office chair--because the ball is not stable and the back muscles along the spine make tiny adjustments to balance, which helps strengthen core muscles while working.

"What better way to strengthen these muscles while you work on your computer," Gutru added.

Sitting on these balls, while working or studying at a desk--even for small periods of time--improves posture and back health by strengthening the muscles around the spine."Sitting on the ball also helps increase blood flow to key muscle groups, which helps people to stay more alert," Gutru explained.

"The fitball also is an excellent tool for stretching and releasing back muscles," she said.

Maintaining balance on the Fitball provides a workout for hard-to-reach areas, such as the lower abdomen, lower back, hip flexors and the tiny muscles that surround the spine. It is important to have correct posture when sitting on a ball, making sure your knees are at a 90-degree angle.

The balls also are convenient because they inflate and deflate in minutes, and can be easily stored.

Physicians today recommend physical activity with the use of supports to promote exercise while supporting back muscles. Orthopedic back braces and supports are often suggested by physicians to help patients as a result of an injury, strain or sprain of their lower back muscles.

"There are so many different types of back problems that one or two styles can't cover them all," said Pam Compton, vice president of sales at CMO Inc., Barberton, Ohio. CMO offers an extensive line of lumbar supports with a variety of custom designs.

"In addition to our well known CrissCross, of which there are 10 variations, we do several varieties of pain-relieving traditional lumbar support. We can make any product to fit a person of any size, and we often incorporate custom features like an ostomy opening and strategically placed hernia reinforcements," Compton said.

CMO also offers many styles of moldable inserts which allow the support belts to provide maximum support without stays and relieves pain without immobilization.

Compton said their market is comprised of people suffering from an acute injury or post-operative; those managing a chronic back problem or pre-operative as well as people who are trying to prevent recurrence of the problem.

"This is most assuredly a growing market," Compton said.

Smith and Nephew Inc., Rehabilitation Division, Germantown, Wis. is offering two new back supports this year. The first is the Rolyan Air Back Support, featuring an air-filled bladder to provide a custom fit and focusing compression in the lumbar area. "Mesh panels and ventilation holes help increase breathability and enhance comfort," said Kim Kreutzer, COTA and associate


No other health problem affects working-age Americans more than low back dysfunction.
product manager of Smith and Nephew Inc., Rehabilitation Division.

"Overlapping double-pull straps add support to the lumbar and abdominal areas, and the product has grip strips to prevent the product from migrating on the patient," Kreutzer said.

The second product is the Rolyan Fit Back Support, with a compression formed lumbar pad to provide firm, but comfortable lumbar support.

"Treating back pain is a growing business, but now people are looking into prevention. Corporations are looking to prevent back pain in the workplace and the trend of the population is toward prevention," Kreutzer said.

Kreutzer explained that one of the huge markets for back supports this year is maternity support, helping consumers to support the weight of pregnancy while providing relief and comfort to the back.

"During pregnancy this belt helps relieve discomfort caused by stretching and expansion of the abdomen and distortion of the lower back. Straps adjust to accommodate all stages of pregnancy," she said.

"Maternity supports are a large market for HME providers," Kreutzer said.

The Impact of Back Pain

Back pain is one of the leading causes of disability and time lost from work. Recent studies indicate that direct medical costs for lower back pain approach the $24 billion mark each year.

The American Council on Exercise predicts that core strength training will increase in popularity this year as exercisers recognize their value for weight management, osteoporosis and overall health.

As a result of the aging workforce and the rising number of sedentary jobs, the market for back pain-related products is expected to grow. As a person ages, the likelihood that they will choose surgery as a remedy to back pain diminishes, and they are more likely to turn to back braces, supports and other rehabilitation products.

Back pain is a potential problem to both active and inactive people. Baby boomers who maintain active lifestyles may develop back pain if they over exert themselves and others who have a sedentary life also are at risk. The high rate of back injury, combined with the fact that most will continue to use back supports throughout their lives, secures the market for the future.


Basic Back Care at Home

The following tips were provided by BackCare, The National Organization for Healthy Backs, Teddington, Middlesex, England. For more information, contact BackCare at (44) 20 8977 5474 or visit their Web site at www.backpain.org.

  • Try lumbar support rolls
  • Do not slump over sink, straining your lower back, sit down to prepare vegetables, etc.
  • Check the suitability of your mattress with a simple test. Lie on your back and slide your hand (palm down) into the small of your back. If there is a large gap, the mattress is probably too hard. If you have to squeeze your hand in, then it is probably too soft. If your hand slides in fairly easily, the mattress is probably just right.
  • If you have neck pain, try making a butterfly pillow. Tie a bandage or stocking around the center of a pillow and place your neck in the middle.
  • In the office, try not to slouch. Make full use of the chair movement. Make the effort to adjust your chair so it is comfortable for you. *Change your posture and take breaks from sitting to keep your muscles working. Place your keyboard directly in front of you and keep your monitor square so you don't have to turn your head to look at it.
  • When vacuuming, keep your upper body upright, and with the cleaner close to your body, use short sweeping movements.
  • Only iron essential items and make sure your ironing board is waist high. Most people have the ironing board too low.
  • Use a shopping cart instead of carrying a basket. For carrying, try to use both arms so that your load is balanced.
  • When gardening, do some warm-up exercises first and kneel instead of stooping.

This article originally appeared in the May 2001 issue of HME Business.

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