Evaluation and management of occupational low back disorders

Abstract

This clinical practice review of occupational low back disorders describes work‐related risk factors, occupational history, physical evaluation, clinical tests, diagnosis, care, and prevention. It is part of a quality assurance (QA) and quality improvement (QI) effort to establish exemplary occupational practice standards. It emphasizes the involvement of occupational medicine physicians in exposure assessment, care of injured workers, and disease prevention. Important occupational risk factors such as lifting, awkward body posture and vibration, in addition to psychosocial, socio‐economic and other factors are summarized. The focus is on mechanical back disorders. Return‐to‐work, rehabilitation and prevention strategies are discussed as part of integrated disability management involving the injured worker, the primary care provider, employers and other relevant parties. Am. J. Ind. Med. 37:94–111, 2000. © 2000 Wiley‐Liss, Inc.

Association between sitting and occupational LBP

“…1, the prevalence rate of reported LBP in those occupations that require the worker to sit for the majority of a working day is significantly higher than the prevalence rate of the general population [61,77]. Physical factors, psychosocial factors, and individual characteristics contributed to these findings [12,25,47,67,79], but only the physical factors will be discussed here.…”

“…Among the occupational exposures identified, sitting is commonly cited as a risk factor in the literature, in addition to heavy physical work, heavy or frequent lifting, non-neutral postures (i.e., trunk rotation, forward bending), pushing and pulling, and exposure to whole body vibration (WBV) (i.e., motor vehicle driving) [12,20,25,31,35,37,39,47,51,53,76,79].…”

“…Workers in occupations who performed tasks while sitting may also be exposed to WBV and/or awkward posture, and these exposures are independently analyzed in the literature. Awkward posture represents a non-neutral trunk posture (i.e., bending forward and/or twisting of the trunk) [10,12,25,30,51]. ''Postural load'' [7] and ''unfavorable posture'' [49] are terms used in the literature that refer to awkward posture.…”

Ant colony optimization approach for classification of occupational low back disorder risks

“…About 100 million workdays are lost each year due to back disabilities. LBD disables 5.4 million Americans per year and it is the most frequent reason for Þling a workers' compensation claim (Johanning, 2000)-about 16% of all workers' compensation claims and 33% of total claims costs (Webster & Snook, 1994). Total direct and indirect costs of LBDs is also extremely high-$11 billion and $50 billion per year in the United Kingdom and United with the elevated risk of LBD.…”

Differential Diagnosis of Whole-Body Vibration Related Disorders

“…3 4 The medical diagnosis, treatment and prevention of occupational low back disorders has been reviewed in a clinical consensus protocol. 5 A prototype health surveillance scheme for WBV has been proposed. 6 However, many physicians and occupational safety and health experts seem not to be familiar with the wide spectrum of health complaints and the proper diagnostic evaluation of WBV-exposed patients.…”