Last reviewed 14 October 2016
From managers hunched over desks to construction workers shifting loads and carers lifting people, back problems can affect everyone in the workplace — from short-term muscular aches to debilitating and chronic pain. Mary Stevens shares her personal experience of how movement can help manage and mitigate workplace back pain.
Data from the Health and Safety Executive (HSE) finds that back pain accounted for 31% of sick leave in Great Britain 2014/15 — that’s nearly three million working days lost. The time taken as sick leave per incident was around two weeks. These absences impact on the workload of colleagues and the overall performance of an organisation as well as our national economy.
I write this as someone who worked through and found solutions to two years of excruciating back pain, initially diagnosed as psychosomatic, but ultimately found to be spondylolisthesis — misaligned vertebrae (cause unknown) — a condition, in my case, exacerbated by sitting at a desk writing.
Is work bad for backs?
Work in the sense of activity is good for us — we need to move to maintain a healthy spine as well as overall fitness. However, many jobs can lead to, or aggravate, back problems. Jobs involving lifting, whether goods or people, and the twisting required by trades like plumbing or car mechanics, are commonly recognised as a cause of back injury and pain.
However, with increasing specialisation in many workplaces and mechanisation of many tasks, more of us are static at a workstation — like a desk or a driving seat — for hours at a time. Maintaining one position for long periods is not good for our spines. Like sitting, prolonged standing can bring on back pain, and wearing unsuitable footwear will make the problem worse.
While it is often important to dress to impress, running an event or working at a trade show or exhibition in high heels is not good for your posture. Wearing shoes that put less strain on the spine is a simple adjustment that can be made. This is just one example where both employer and employee need to be aware of the work situations that can bring on back problems or aggravate existing conditions.
repetitive movement — eg fruit picking, factory work, keyboard use
heavy lifting — eg in health care, construction, catering or distribution
twisting — eg reaching awkward spaces in maintenance or construction work
long periods standing — eg factory workers, security staff, teaching, promotional staff
very little movement — eg sitting at a keyboard, supermarket checkout, working in a call centre, driving.
In fact, in whatever we do we need to be aware that our activity and posture can impact our backs. It’s not just work — often how people spend their leisure time contributes to back problems. Following a day at work, it’s all too tempting to slump on the sofa staring at phones, televisions or laptops — or transition from a sedentary day to an energetic gym or sport session without warming up. Lack of movement coupled with poor posture can contribute to or aggravate an existing back problem, just as muscles can be strained and spine alignment damaged by overdoing it — whether “it” is work or play.
Do health and safety regulations address back pain?
Guidance and legislation are in place that aim to reduce back problems arising at work. For these to be effective, both employers and employees need to take responsibility for ensuring good working practices are followed and ergonomic workstations are in place. For any work involving lifting, carrying or moving goods, people or animals, the Manual Handling Operations Regulations 1992 (as amended) apply. Under these regulations, employers are responsible for mitigating any risk of injury and employees are responsible for undertaking working practices specified by their employer to minimise risk of injury. The HSE provides guidance on managing the risks of workplace manual handling which includes provision of a safe working environment and procedures, handling aids and correct posture when lifting is unavoidable.
Over recent years it has been increasingly recognised that working at a desk has its own risks. Poorly set up workstations, past-their-sell-by-date chairs, bad posture and insufficient breaks to stretch and realign spines that have been slumping, can all lead to back pain or aggravate an existing condition. For any employees who use a screen daily for over an hour, the Health and Safety (Display Screen Equipment) Regulations 1992 apply. Again, guidance is available from the HSE: INDG 36 recommends that employers work with employees to ensure workstations are adjusted to reduce the risk of back pain (as well as eye strain and repetitive strain on arms and wrists). The regulations state: “Every employer shall so plan the activities of users at work in his undertaking that their daily work on display screen equipment is periodically interrupted by such breaks or changes of activity as reduce their workload at that equipment.” However, where employees and employers are unaware of, or ignore, this stipulation, costly problems can arise.
Managing back pain at work
As an employee of a small charity I developed severe, long-term back pain, made worse by sitting, during a period of working long hours and not taking the periodic breaks set out in the regulations. I addressed the problem by creating my own standing workstation balancing screen, mouse and documents on books and boxes. Following an eventual workplace assessment by Access to Work, my employer provided, at a cost of several hundred pounds, an adjustable desk (a source of much amusement for colleagues), document holder and fully adjustable chair — which enabled me to vary between sitting and standing throughout the day. It did, however, lead to me becoming that annoying person who constantly tells colleagues to stop slouching and adjust their working position — as I don’t want to see them ending up like me! This was in 2008. Now I continue to ensure that throughout the day I take regular breaks from my desk. Moving around the office and talking to colleagues rather than sending emails or phoning is just one way to incorporate activity into the working day.
In 2015, I was delighted to see my self-discovered strategy being endorsed as Public Health England supported a study looking at the health impacts of sitting all day on office workers. This international research recommends that for overall better health, as well as less back pain, office workers should be enabled to switch between standing and sitting throughout the day. It worked for me and although being diagnosed eight years ago with permanent damage to my back, I continue to mostly work at a desk. However, becoming pain-free was a long and costly process both for my employer (purchase of equipment) and me (numerous visits to physios, chiropractors, yoga classes, etc).
Employers have a duty to reduce the risk of back pain arising — and some now provide adjustable desks, and even offer yoga or Pilates classes to employees. To stand the best chance of avoiding back pain, employees also need to be encouraged to look after their spines. The theme for World Spine Day on 16 October 2016 is “Straighten Up and Move” — and medical students from UCL London have made a fun promotional video that should encourage any employee to take a break and move correctly.