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Looking after your back while you’re working is key to being able to earn a living over the long-term. Everyone can get the odd backache after a day on the job but if you have chronic or acute pain, you need to visit your GP. DAVID MAIDA reports.
“When you have an acute episode of back pain the reality is chances are it’s self-limiting. It will go away within six weeks,” he says. But in five percent of cases, back pain might be an indicator of something like cancer, an infection or a blood vessel irregularity. Once a GP rules out anything sinister, they might tell you to take paracetamol or anti-inflammatories for the first few days. But Neff says it’s crucial to keep moving. If pain persists you should see a chiropractor or physiotherapist sooner rather than later. “A good physiotherapist will do many things which a chiropractor may equally do and vice versa,” Neff says. Chiropractor Dr David Kay of Dynamic Family Chiropractic in Auckland says lifting and twisting injuries and overuse injuries are the quite common. “The most common condition we get is acute muscle spasm. That would coincide with a lifting injury,” Kay says. People often neglect the standard guidelines for lifting with your legs and not your back or they lift too much. “The people who aren’t in very good condition are the ones who throw their back out the easiest.” When the back detects a serious strain it goes into a defensive mode. The muscles begin to spasm to lockdown the area. They become inflamed and cause pain. “Often when you go through that experience, your body is never going to get back to its original state because it is going to start locking up,” Kay says. Pain can limit the range of motion and there is a temptation to reduce movement in the area. But the most important thing is to keep moving and do stretching exercises. Kay also uses trigger point work, chiropractic adjustments and massage. Working with machines can cause a number of stress injuries. Whether the pain is caused by gripping, vibration, kick backs or awkward movements, it can often be treated with heat or ice. Use ice for acute injuries and heat for chronic pain. Kay says medication will only ever mask the symptoms of pain and won’t solve the root problem. Anti inflammatory pills can also be extremely harsh on the stomach. Massage creams or heat gels can be used without affecting the stomach. However, Lorraine Gardner Wood, programme manager for the Accident Compensation Corporation (ACC) recommends using pain medication. “Stay mobile. Take pain relief. And, within reasonable bounds, get back to what you were doing before.” Gardner Wood agrees that continuing activities is the best medicine for a back injury. “All our studies have shown that the best thing to do for back pain is trying to continue on with normal activities. The best place to get better is in the workplace.” If you put your back out, don’t count on ACC to come to the rescue as they are primarily focused on prevention. “Prevention is our biggest interest. Our biggest focus is in ensuring people realise all the factors that are potentially involved behind someone experiencing a back injury,” Gardner Wood says. Legally, you have to be off work at least a week before ACC will start to pay 80 percent of your earnings. Your employer often pays for the first week off but may garnish your sick days in return depending on your individual employment agreement. Gardner Wood says you shouldn’t expect to be completely pain-free before returning to normal duties. “Most back pain is simply that – it’s pain with little diagnosable injury of any description.” Don’t expect the ACC to fund a bunch of tests to determine the source of your pain. “There’s no objective test for back pain... We will decline tests because unfortunately they don’t show what people think they do.” Another important thing to realise is that at the time you throw your back out, it’s often more about what’s going on in your mind than your body. Gardner Wood says often significant events occur in people’s lives within 24 to 48 hours before an injury. Being distracted by relationship problems, financial woes or workplace tensions leave you more prone to an accident or strain. If a workplace accident does occur, first secure the immediate environment. Don’t move the victim unless there is imminent danger of further injury. But regardless of whether back pain is caused by injury or strain, don’t tolerate it for more than six to eight weeks. Go back to your GP who might need to refer you to a pain specialist. For more tips on preventing back injury take a look at www.acc.co.nz/injury-prevention/back-injury-prevention/index.htm. Contractor Vol.32 No.2 March 2008 |
Pain specialist Dr Stephan Neff says 95 percent of back pain cases are benign.