There are numerous occupational factors that can increase the risk of back pain. A fundamental principle to keep in mind is that overdoing any task, whether due to prolonged duration or frequent repetition, can heighten this risk. Seemingly harmless activities may lead to tissue damage and injury if performed excessively. For instance, even lying in bed in a perfect position can eventually lead to bed sores. Similarly, excessive engagement in any work activity without sufficient rest breaks can also increase the risk of back pain.

Occupational Risk Factors

In addition to that overarching principle, the following are some of the primary occupational risk factors that can cause or exacerbate back pain:

1. Bending or twisting your spine while it is under a heavy load, such as when picking up objects or pushing/pulling carts.
Doing this over time leads to disc damage and can result in disc herniations.

2. Bending or twisting your spine as far as it can go repeatedly or for a prolonged period of time.
Doing this stretches the holding elements of your spine, such as the ligaments, and can result in joint laxity and culminate in disc injury. This is especially the case when these positions are followed up by bouts of exertion.  For example, a prolonged period of slouched sitting immediately followed by heavy lifting.

3. Pushing, pulling, carrying, or lifting objects that are excessively heavy or performing these tasks at a high frequency with lighter objects.
Doing this can lead to excessive compression of your spine, resulting in damage to the vertebra and eventually to the discs as well.

4. Prolonged sitting, especially seated vibration.
Doing this increases the risk of disc herniation and/or acceleration of disc degeneration.

Each of these occupational factors can individually cause or exacerbate back pain. When combined, they pose an even greater risk of causing or worsening back pain.

Risk Minimization Strategies

All biological tissues have a tipping point beyond which tissue injury or irritation can occur. Each of the risk factors outlined above represents common ways in which the tipping point of various spinal tissues can be exceeded in occupational settings.

To reduce the risk that these occupational factors present, it is necessary to stop engaging in them before the tipping point is crossed.

As such, the overarching principle to minimize the risk presented by these occupational factors is to perform all activities in moderation and to perform a variety of different activities. Workers who perform a variety of different tasks are less likely to experience back injuries. Additionally, ensure adequate rest breaks that contrast with your work tasks. For instance, if your work involves prolonged sitting, take breaks to walk. Conversely, if your work requires extensive standing, take breaks to sit and rest.

Here are specific strategies to reduce the risk associated with each of the mentioned occupational risk factors:

  1. Keep your spine still when lifting and pushing. This can be done by moving through your hips when you bend and twist. The hip joints are designed to produce power through a wide range of motion in contrast to the spine.
  2. Avoid reaching the extreme limits of spinal bending and twisting. Focus on maximizing movement through your hips while minimizing excessive movement in your spine. When you do need to perform movements that reach the end range of spinal motion, make sure to follow up by spending time standing in a neutral position (such as standing nice and tall) before proceeding with other strenuous tasks.
  3. To decrease the risk of vertebra damage from too much load, there are several things you can do:
    1. Use tools or machines to help with heavy lifting.
    2. Have another person assist you with heavy lifting
    3. Break up repetitive tasks with sufficient breaks and rest periods.
    4. Minimize the load through the spine by
      1. Keeping objects lifted or carried close to your body
      2. Only picking up half of the weight of an object at once. (Eg. When picking up a heavy pipe, lift one end up onto a support and then lift up the other end.
      3. Pushing objects so the force is transmitted through your lower back. (Eg. Push at waist height.)
      4. Pulling objects towards your belly button
  4. To decrease the risk of back pain from sitting, do the following things:
    1. Break up periods of inactivity by getting out of your chair or seat at regular intervals. If you have no back pain, take breaks at least every 50 minutes. If sitting bothers your back, take breaks before the pain starts. When you get out of your chair, stretch overhead and take two deep breaths or walk around for several minutes.
    2. Frequently vary your posture while seated. For instance, lean slightly to the right, then to the left, and occasionally lean backwards. Alternatively, adjust the settings on your chair regularly. There isn’t a single perfect sitting posture you should maintain at all times. Instead, the ideal sitting posture is one that varies over time.