Sukh Padda: The burden of neck and back pain in the UK

Back pain is a widespread health issue globally, with approximately 80% of individuals in the UK expected to experience it at some point in their lives. The National Institute for Health and Care Excellence (NICE) states that back pain is among the top reasons people seek medical advice. It can stem from various causes, ranging from mild to severe, often attributed to factors like sprains, strains, poor physical condition, and posture issues, rather than spinal damage or other health conditions. Non-specific back pain is categorised into acute (lasting less than six weeks) and chronic (lasting longer than six weeks).

A significant portion of back pain cases in the UK is linked to work-related factors, such as jobs involving heavy lifting, prolonged sitting, or awkward postures. *According to Health and Safety Executive statistics, an estimated 35.2 million working days were lost in 2022/23 due to work-related ill health and injuries. Stress, depression, anxiety, and musculoskeletal disorders accounted for the majority of days lost, totalling 17.1 million and 6.6 million, respectively.

On average, each affected individual took approximately 15.8 days off work, with variations based on the nature of the condition. Back pain stands out as a major contributor to work absences, resulting in more than 12 million lost days annually. Musculoskeletal conditions, including back pain, reportedly cost the UK economy £20 billion each year, according to Arthritis Research UK. Before the COVID-19 pandemic, the rate of working days lost per worker due to work-related illness or injury had been relatively stable, with the current rate (1.31 working days lost per worker) higher than the pre-coronavirus levels of 2018/19.

Back pain is a prevalent issue in the workplace, often stemming from various factors associated with the nature of work and working conditions. Here are key points to consider regarding back pain in the workplace:

Sedentary Jobs

Jobs involving prolonged sitting, like desk jobs, can contribute to back pain. Poor ergonomics, incorrect chair and desk height, and insufficient breaks for movement can all be contributing factors. Additionally, spending excessive time on mobile phones can lead to neck issues.

Manual Labour

Occupations requiring heavy lifting, repetitive movements, or awkward postures can strain the back, increasing the risk of injuries. Examples include construction workers, healthcare professionals, and those in manufacturing.

Poor Ergonomics

Back pain can result from workstations that are not properly set up. This encompasses factors like desk and chair height, computer monitor positioning, and the design of office furniture. Proper desk and chair setup are crucial, and standing desks can also be beneficial.

Stress and Mental Health

Stress and mental health issues can influence the perception of pain, including back pain. High stress levels or an unfavourable work environment may exacerbate existing back problems.

Workplace Culture

A workplace culture that does not prioritise employee well-being, health, and safety may contribute to a higher prevalence of back pain. Factors like a lack of awareness about proper lifting techniques and the importance of breaks can play a role.

Lack of Physical Activity

Sedentary jobs may lead to insufficient physical activity, weakening muscles and contributing to back pain. Encouraging regular breaks for movement or integrating workplace wellness programs can be beneficial.

Ageing Workforce

As the workforce ages, there may be an increased prevalence of back pain due to age-related changes in the spine and musculoskeletal system.

To tackle and prevent workplace-related back pain, employers can implement ergonomic interventions, offer training on proper lifting techniques, encourage physical activity, and cultivate a positive and supportive work environment. It is crucial for employers to adhere to occupational health and safety regulations to establish a safe and healthy work environment for their employees.

Individuals facing persistent or severe back pain should seek medical advice and, if needed, inform their employers to explore potential workplace adjustments. This proactive approach ensures both the well-being of the employees and compliance with health and safety standards in the workplace.

The importance of strengthening core muscle to help address back pain

If the core is weak, your spine is less stable, and this results in extra pressure being put on the discs and the facet joints. The lower back is under the stress of supporting your entire upper body. Surrounding muscles in the back need to be toned to support the spine and reduce pressure on the lower back. Core muscles are rarely used during everyday activities, so they need to be toned through specific, targeted exercises. Take a few minutes each day to do a couple of simple core exercises. Here are some suggestions:

Note: Remember to listen to your body and start with a duration and intensity that is suitable for your fitness level. If you have any pre-existing health conditions or concerns, it’s advisable to consult with a fitness professional or healthcare provider before beginning a new exercise regimen.

1. Knee to Chest – lying on your back gently hug both knees toward your chest.

2. Bridging –

Lie on your back with knees bent and feet flat.

Engage core muscles and lift hips toward the ceiling.

Hold the bridge position briefly, focusing on glute and core engagement.

Lower hips back down in a controlled manner.

Repeat for the desired number of reps (e.g., 10-15).

Breathe in as you lower hips, and exhale as you lift.

3. Wall Sits –

Locate a clear, flat wall where you can perform the exercise. Ensure that the wall is free from obstacles.

Stand with your back against the wall, and your feet shoulder-width apart, about two feet away from the wall. Place your entire back on it.

Slowly slide down the wall by bending your knees. Be sure you keep your entire back placed firmly on the wall.

Continue sliding down until your knees form a 90-degree angle. Your thighs should be parallel to the floor and your feet directly under your knees.

Hold for 30 secs.

4. Toe Touches –

Lay on your back, with your legs extending up vertically towards the ceiling.

Extend your arms forward, keeping them straight. They should be parallel to your legs.

Crunch forwards, reaching up to your toes with your outstretched arms. Your head, shoulders, and upper back should come off the ground when performing a toe touch.

Lower yourself and repeat steps 2 and 3. Aim for 8-12 reps and 3 sets.

Stretching, walking and hydration is crucial

Stretching is a crucial aspect of daily care, as tight muscles often contribute to back problems, putting added stress on the spine and joints. Regular stretching promotes spinal health and can be particularly beneficial in alleviating back pain.

When back pain strikes, engaging in low-impact activities such as walking, aerobics, yoga, pilates, water aerobics, or swimming can help. These activities may loosen tense muscles and trigger the release of endorphins, the brain’s natural pain relievers.

Exploring other remedies like infrared sauna sessions, cold water showers, foam rollers, and massage guns can also aid in managing back pain. Additionally, paying attention to sitting posture is crucial, as poor posture can contribute to back pain. Taking breaks, incorporating walks or stretches every hour, and setting computer prompts for breaks can mitigate the impact of prolonged sitting.

Brisk walking, especially during lunch breaks, is a safe and effective exercise that supports weight management (which can exacerbate back problems) and reduces pressure on the back. Hydration is essential too, as the discs in the back require adequate water to maintain their size, shape, and function. In a work environment where tea and coffee are common, ensuring sufficient water intake becomes crucial for overall back health.

Don’t underestimate the impact of stress

Neck and back pain is a frequently underestimated consequence of stress. Prolonged exposure to stress can lead to musculoskeletal problems in these areas over time. To relieve stress, a person can try:

• Mindfulness Meditation

**Mindfulness meditation has proven effective in reducing pain by promoting awareness of the body’s actions.

• Deep Breathing

Engaging in deep breathing exercises can help stabilise the torso, as demonstrated in a 2016 study.

Combatting muscle spasms

Whether at home or work, improper lifting can result in muscle spasms and pain. To prevent this:

– Use proper body mechanics, engaging leg muscles rather than the back when lifting heavier items.

– Seek assistance for items too heavy to lift alone.

Remember – sleep is key!

Quality sleep is crucial for back health. Improve sleep posture by:

– Elevating knees slightly with a pillow when sleeping on your back.

– Placing a pillow between your knees if you’re a side sleeper to reduce back pressure.

Other tips for employers to reduce workplace back pain

Employers can reduce the risk of back pain in the workplace:

• Identify what activities can cause back pain and decide whether they can be avoided or changed.
• Ask your employees for input – they have first-hand knowledge of the work and can suggest changes.
• Think about how you can make jobs physically easier, for example, by moving loads on wheels.
• Make sure controls, for example lifting aids, are available, used and maintained.
• Look for signs of back pain among your workers, such as a reluctance to do a particular task, which may suggest your controls are not working.
• Encourage employees to report problems early to you or their worker representative so they get the right help
• People with back pain usually recover completely if the problem is recognised early and treated appropriately.

References:

*Days Lost to Work Related Illness:

https://www.hse.gov.uk/statistics/dayslost.htm

**Ref Mindfulness Meditation and Pain: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4941786/#:~:text=Mindfulness%20meditation%20is%20a%20technique,in%20experimental%20and%20clinical%20settings.