7 Easy Tips for Reducing Back Strains

I think every person has experienced a lumbar strain at some point in their lives.  Whether it be from an acute trauma such as a fall or impact, or from simply lifting too much too fast, the end result is no fun. Lumbar strains are very common workplace injuries, if not the most common injury. These strains cost the employer thousands of dollars in claims expense and lost productivity.

So how do you address this problem?  It would be fantastic if there were some sort of universal answer, but sadly there is not.  Every employer is different, and more importantly every employee is different.  Everyone brings different risk exposures to the table, so you have to look within your own shop and see where to try and reduce the risk.  We list seven factors to take into account. (WCxKit)
1. Rotate job duties and staff tasks
If an employee’s job is to lift 10lb boxes off the line and place onto a pallet to wrap up and take to shipping, after a few hours that 10lb box feels like it weighs 50lbs.  Then imagine that is your job day in and day out, week after week, month after month.  Combined with the lifting are the ergonomic factors, body habitus, and overall strength. So just lifting what seems to be a “light weight” box is more complicated than it seems.
A lot of companies have started job rotation. This means that every hour or two, employees move to another part of the plant and do a different type of job for a while, and then they move again and so on until the end of the day.  The list could change every week, and the duration and job lists change, so each employee is not doing the exact same thing at the exact same time every day. 
The theory behind this is in different tasks, at different times, one can only exert certain muscles while giving other muscles a much needed break, especially in a heavy manual labor type job.  Companies that have implemented this theory have had decreases in injuries, and better work performance.
2. Teach proper lifting techniques
Every employer I have been to has a sign on the wall by the loading dock that talks about using smart lifting techniques.  “Lift with your legs, not your back” the sign might say, or my personal favorite, “work smarter not harder.”  Getting employees to utilize proper lifting techniques is not an easy task, but it is something that must be a constant reminder re-enforced with proper training.  Make another employee the “lifting coach” so workers can go to them with questions or concerns.  Have a contest to see who can catch the first person lifting with an improper technique and hand out a gas card as a reward.  There is a large variety of ways to get workers involved and you will see reduced claim activity because of it.
3. If that fails, bring in a therapist or physician to review ergonomics
Sometimes workers will not listen to anything you have to say about lifting techniques.  Sometimes the only way a person learns is by experiencing it themselves.  To avoid this have a therapist or doctor come in to talk about the importance of exercises and stretching before heavy work commences.  They could also talk about lifting techniques and the risks involved if these techniques are not followed.  If only 2-3 workers get the hint and take it to heart, you may see 2-3 less serious back injury claims.
4. Pre-employment physicals
If there is heavy work that needs to be done on a regular basis, properly screen candidates to see if they can do this work without difficulty before starting the job.  I have seen several claims in the past where people are injured because they weigh 140lbs, are 5’6”, and are trying to manually lift and move 150lbs. There is no way lifting more than your body weight is safe, no matter how great of shape you are in.  So before assigning workers to certain jobs, get a physical to better understand their capabilities. The employee will be grateful if there is a way to prevent them from injuring their back or from sustaining a hernia.
5. Palletizing
This is pretty simple, instead of moving box after box after box onto your trucks for delivery, always stack them on a pallet and get a pallet jack or hi-lo to load the pallet onto the truck.  This way workers are not going in and out of the truck a million times not carrying various weights, which could lead to injury.  Being able to palletize will depend on the product and demand, but may be an idea not implemented before.
6. Use boxes that have reinforced handles.
If there is a decent amount of boxed weight or you have had a problem with handles breaking or ripping in the past, consider moving the product to a box or packing material with reinforced handles. A lot of distributors make this an option these days and the costs associated are not as bad as one would think.  Do research, trend injuries, and try some products out to see if a difference is made.  At the very least it does not hurt to have a more-stable product that workers can easily maneuver.
7. Reduce weights or products from suppliers
I know of grocery stores that had constant problems with 80-100lb boxes of meat because the handles constantly kept ripping or breaking, leading to shoulder injuries.  They saw many problems they demanded their meat provider break the boxes down to 40-50lb with reinforced handles, or else they were going to be searching for a new meat provider.  Sure enough, the provider did as they demanded and the grocery store saw a significant decrease in the amount of shoulder and back strains.
Providers may have this option available, but because you never asked, they never gave it to you.  Now this does not mean to call up your providers and demand that they do whatever you say, just ask them if they have any other packing options, or packaging options, and see what they say, then go from there. (WCxKit)
Use this as a To-Do list to investigate what options exist for reducing your strain injuries in your workplace.  Remember to keep track of the numbers, and see which techniques help and which ones do not.  This will vary per employer, so think about where your high risk areas are and what you can do to reduce your exposure.  Any safety implementation is better than nothing at all.

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com. Contact: RShafer@ReduceYourWorkersComp.com.


Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com Contact mstack@reduceyourworkerscomp.com


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©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact  Info@ReduceYourWorkersComp.com.

Occupational Low Back Pain Part III: Treatment Options

Authors: Brian Anderson DC, CCN, MPH and David Radford DC, MSc


In the first article of this series, we discussed the huge impact Occupational Low Back Pain (OLBP) has on both employers and employees.  The statistics on prevalence and disability due to OLBP cannot be ignored.  In part two, strategies that employers can take which may prove effective in reducing the burden of OLBP were discussed.  Now, in the final article of this series, we will discuss the all-important topic of treatment options for those suffering from OLBP.



There are a few variables related to the treatment low back pain (LBP) that make it particularly challenging.  First, it is estimated that approximately 80% of LBP is non-specific, which means there is no well-defined cause.   Second, imaging studies (x-ray, MRI) are not particularly helpful in determining those with LBP vs. those who are asymptomatic.  A 1994 study in the New England Journal of Medicine concluded, “Given the high prevalence of these findings and of back pain, the discovery by MRI of disc bulges or protrusions in people with low back pain may frequently be coincidental.”  Another source states that “The false positive rate for identifying clinically significant herniated discs or degenerative conditions with imaging is so high as to make the tests clinically inappropriate as screening procedures”.  Unfortunately, the “biomedical model” employed by the majority of the medical community is dependent on diagnosing an abnormality on an imaging study, and treating this abnormality with medications, rest, injections and surgery. (WCxKit)



What we are recommending, and what the current literature is supporting, is a “bio psychosocial” approach to treating LBP.  This model recognizes that the experience of pain has many components, and that all these components must be addressed for long term healing.  Patients with LBP experience what is called fear-avoidance behaviors; they anticipate worsening of symptoms with certain activities or movements.  This anticipation sets up a vicious cycle, which goes something like this

fear of painàactivity avoidanceàdeconditioningàacute tissue overloadà chronic sensitization to pain


Those LBP sufferers with “yellow flags” must get involved in a bio psychosocial program very early on, or are at high risk for developing chronic pain syndromes.  These yellow flags are included.

  • ·      radiating (travelling) pain
  • ·      poor self-rated general health
  • ·      anxiety/depression
  • ·      self-perceived inability to control symptoms
  • ·      self-perceived inability to perform normal activities


People with LBP must be educated that hurt does not equal harm; in other words, they should continue to participate in normal daily activities even if there is some pain during these activities.  Patients with acute LBP may experience some benefits in pain relief and functional improvement from advice to stay active compared to advice to rest in bed.



In an ideal situation, a treatment team would be developed to deal with OLBP.  This team would consist of: a return to work coordinator; an occupational health provider (MD or nurse); a health psychologist; a Chiropractic Physician; a Physical Therapist; and a Physiatrist/Neurosurgeon/Orthopedic surgeon for possible consultation.  We are suggesting that all cases of OLBP be triaged by the occupational health provider and automatically referred for consultation with a Chiropractic Physician, due to their unique expertise dealing with this particular condition.  This scenario would no doubt save countless healthcare dollars by preventing unnecessary imaging studies, medication use and interventional procedures such as injections and surgery.



Regarding conservative treatment of LBP, very high quality evidence exists that supports various treatment modalities.  Below is a review of some of this research.


  • ·      There is good evidence that cognitive-behavioral therapy, exercise, spinal manipulation, and interdisciplinary rehabilitation are all moderately effective for chronic or sub acute (>4 weeks’ duration) LBP
  • ·      Fair evidence that acupuncture, massage, yoga, and functional restoration are also effective for chronic LBP
  • ·      For acute LBP (<4 weeks’ duration), the only non-pharmacologic therapies with evidence of efficacy are superficial heat and spinal manipulation
  • ·      There is moderate quality evidence that post-treatment exercises can reduce both the rate and the number of recurrences of back pain.
  • There is moderate scientific evidence showing that multidisciplinary rehabilitation, which includes a workplace visit or more comprehensive occupational health care intervention, helps patients to return to work faster, results in fewer sick leaves and alleviates subjective disability.
  • Spinal manipulation was more effective in reducing pain and improving the ability to perform everyday activities than sham (fake) therapy and therapies already known to be unhelpful.  It was no more or less effective (but no doubt less costly) than medication for pain, physical therapy, exercises, back school or the care given by a general practitioner.


Significant evidence also exists suggesting that invasive treatments, such as injections and surgery, are questionable treatment options for most patients. (WCxKit)


  •       There is no strong evidence for or against the use of any type of injection therapy for individuals with sub acute or chronic low- back pain.
  •       There is serious lack of scientific evidence supporting surgical management for spinal arthritis
  •       There is no acceptable evidence of the efficacy of any form of fusion for spinal arthritis, back pain or instability
  •        38% of surgeries performed in two university based neurosurgical units were prospectively evaluated and were determine to be inappropriate


As mentioned in the opening of part I of this series, employers are unlikely to find another issue that leads to more absenteeism and detracts from productivity in the workplace more than OLBP.  We hope that, after this three part series, readers are more educated as to how to prevent and treat this serious issue.  We encourage safety managers and coordinators of care to consider a comprehensive approach to dealing with OLBP.  For further information or questions, please contact the authors.



Dr. Anderson works as a supervising clinician and instructor at National University of Health Sciences in Lombard IL.  He has been in private practice, as well as part of a team in a University based Integrative Medicine setting.  In addition, Dr. Anderson has experience in the medico-legal field, serving as an expert for various insurance companies and legal firms.  He earned a Masters Degree in Public Health, as well as a Certified Clinical Nutritionist designation. He is currently working toward a specialty diplomate in Functional Rehabilitation.  Contact Dr. Anderson for more information at banderson@nuhs.edu


Dr. Radford is in private practice. He is a third generation Doctor of Chiropractic Medicine. He earned a Master’s Degree in Advanced Clinical Practice and he provides conservative primary care. He has treated work related injuries for more than 30 years. Dr. Radford has found that treating the co-morbidities that often accompany injured workers like obesity, medication overuse, and addiction lead to a more complete recovery. He was a founding member of the Cleveland Orthopaedic and Spine Hospital, Cleveland, Ohio.  Contact for more information at DCR8888@aol.com or phone: (440)-248-8888.



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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.


©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact



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