sss employee health sss

Page Up to Reverse Employee Health Page Down to Advance

Employee Health

1


BACK INJURYPREVENTION

A guide for healthcare workers

SLUH

SLU


BACK INJURY

PREVENTION

SLUH

SLU


Most back problems are NOT caused by a single injury, but instead a

combination of factors over a period of months or years.

Congenital Anatomical AbnormalitiesPoor physical fitness level

Decreased flexibilityPoor posture

Using poor body mechanics during activity


PREVENTING a BACK INJURYis easier than

REPAIRING A BACK INJURYIt is EASY to learn how to best prevent back

injuries STEPS #1 LEARN the FACTS about your BACK

#2 LEARN the FACTS about BACK INJURY

#3 LEARN how to get your BACK in GOOD SHAPE

#4 LEARN how to LIFT with good BODY MECHANICS


This is PART 1 of a four part series

BACKFACTS

LIFE STYLEFACTORS

MATERIALS HANDLING

PATIENT TRANSFERS & MOVING


BACKFACTS

Back pain is a very common complaint4 out of 5 people will have back pain during their livesBack pain occurs most commonly between 30-50 years of ageThe majority of back pain will resolve on its own within 8 weeksRecurrence of back pain is commonWork related back injuries in the US cost billions of dollars per year and cause loss of workOf all the money spent on back pain, very little is spent on preventative care


BACKFACTS

The human spine has 24 vertebrae: individual bonesThe spine has different parts:

CERVICAL – neckTHORACIC – chestLUMBAR – low backSACRUM – “tailbone” section –

attaches to the pelvis

ANATOMY


BACKFACTS

LUMBAR – The low back or LUMBAR area has five vertebrae

SACROILIAC JOINT is a joint between the sacrum and the pelvis

ANATOMY


BACKFACTS

SACROILIAC JOINT is a joint between the sacrum and the pelvis

ANATOMY


BACKFACTS

DISCS are structures in between the vertebrae that act as “shock absorbers” between the bodies of two adjacent vertebrae

ANATOMY


BACKFACTS

DISC has two parts:

ANATOMY

ANNULUS – outside layer rubbery and tough

NUCLEUS – “gel” like center


BACKFACTS

FACET JOINTS are joints in between

two individual vertebrae

ANATOMY


BACKFACTS

MUSCLES contract and allow us to move

TENDONS connect the muscles to the bones

LIGAMENTS are tough band like structures that hold bones together

ANATOMY


BACKFACTS

SPINAL CORD is composed of nerve fibers coming from the brain

The spinal cord runs through each vertebra in a big central hole

The spinal cord stops growing earlier in development than the vertebra (bones) do - Therefore the vertebral (bone) column is longer than the spinal cord

ANATOMY


BACKFACTS

The spinal cord stops growing earlier in development than the vertebra (bones) do - Therefore the vertebral (bone) column is longer than the spinal cord

ANATOMY

The spinal cord does NOT extend into the lower lumbar segmentsInstead, at these lowest levels of the vertebral column, there are nerve roots extending from the spinal cord which is higher above through to the neural foramen exit below


BACKFACTS

NERVES then branch out from the spinal cord both to the left and to the right at each vertebraThe nerves exit through a NEURAL FORAMEN on the left and the right at each vertebraThe NERVES carry signals from the brain to the muscles to make the muscles of the body move

ANATOMY


BACKFACTS

BACK DISORDERS

The complaint of BACK PAINmay be brought on by an injury --

HOWEVER other pre-injury factors are often involved


BACKFACTS

BACK DISORDERS

Back strains – injury to the back muscles – caused by sudden falls, heavy and/or improper liftingHerniated (ruptured) disc – The outer layer of the disc, annulus, can tear or give way causing the gel inner portion, nucleus, to protrude and can in some cases cause pressure on the nerve branching out from the spinal cord at that vertebral level. Symptoms include: leg pain, numbness, and leg muscle weakness


BACKFACTS

BACK DISORDERS

Sciatica pain extending down the legpressure to the sciatic nerve caused by: *tightening or spasms of muscles in lumbar area *tightening or spasms of muscles in buttocks area *herniated disc *degenerative changes of bone structures by nerveFractures – broken back bones – falls, contusions, trauma


BACKFACTS

BACK DISORDERS

Compression Fractureinjury to the body of the vertebraecausing loss of height of the vertebral bodyusually trauma to an already weakened vertebra

Osteoporosis – weakening of the bone – usually occurs in older people with women being at higher risk – falls in a person with this condition can lead to a increase incidence of fractures including vertebra compression fractures


BACKFACTS

BACK DISORDERS

Osteoarthritis – degenerative process not related to a specific injury or incident – bone changes develop in the back over time – can involve the facet joints, the vertebral canal, the neural foramina.Spinal Stenosis – degenerative process causing narrowing of the vertebral canal where the spinal cord runs – symptoms can include lower leg weakness, pain, numbness


BACKFACTS

BACK DISORDERS

Tumors – rare cause of low back pain – can be a primary bone cancer or a spread of cancer from another area of the body


BACKFACTS

BACK DISORDERS

The complaint of BACK PAIN may be brought on by an injury – but it may be the combination of other problems that existed prior to the injury causing some of the symptomsSymptoms often are not caused by a disruption in one isolate structure: often back pain is a results of disruption of many of the structures in the back:

ligamentsmusclesjointsdiscsnerves


BACKFACTS

TREATMENT

Since most back pain resolves in about 8 weeks, the outlook for the majority of persons with back pain is good. Most cases of back pain can be treated successfully by a primary care physician and do not require specialty referral. The occupational medicine physician, primary care physician, Orthopedic physician, Physical Medicine and Rehabilitation physician, the physical therapist, the occupational therapist, and the Pain Management team may be involved in the care of person with back pain.


BACKFACTS

TREATMENT

However, the person with back pain plays the major role in their own future good back health. This future hopefully includes a lower risk of a recurrent back pain episode. Neither the physician nor the therapist is going to be with the patient after the acute injury is over to make sure that regular aerobic and back exercise programs are done consistently as instructed during treatment. The person with back pain does best when changes in lifestyle aimed at back injury prevention are adopted after recovery from the acute episode.


BACKFACTS

TREATMENT

Persons with back pain that are irresponsible, blame the pain on everything else, have poor attitudes, and lack commitment to getting better, do not usually fair very well in the long run. These persons usually do not attend physician or therapist appointments faithfully and do not do the things that the therapist or physician has requested during treatment and are very unlikely to change lifestyle habits to include back injury prevention.


BACKFACTS

TREATMENT

Medications are often a part of the treatment plan.


BACKFACTS

TREATMENT

Physical therapy is often a part of treatment plan. Physical therapy may consist of:

*Modalities to ease symptoms Heat packs, Cold packs, Ultrasound*Flexibility exercises*Strengthening exercises*Aerobic exercise ( treadmill, stationary bike, etc)*Education on proper lifting techniques*Education on prevention of a recurrent back pain


BACKFACTS

DIAGNOSTIC TESTS

The physician’s first job when starting to treat each person with back pain is to take a history and do a good thorough physical exam. A good history and physical examination gives the physician clinical information needed to make a diagnosis and to prescribe appropriate therapy. Many patients do not need diagnostic tests.


BACKFACTS

DIAGNOSTIC TESTS

X-RAYS – Plain x-rays show the bones only. These are often done if there is a fall, contusion, or other trauma. These are usually not helpful in a back strain


BACKFACTS

DIAGNOSTIC TESTS

CT scan (Computerized Axial Tomography) – An x-ray test where thin horizontal section pictures of the back are obtained. In addition to the bones, other structures of the back can be seen on the x-ray pictures


BACKFACTS

DIAGNOSTIC TESTS

MRI (Magnetic Resonance Imaging) uses signals from a magnet to obtain thin horizontal section pictures of the back. The pictures from the MRI show not only the bones but also other structures such as the discs


BACKFACTS

DIAGNOSTIC TESTS

Bone Scan – Nuclear medicine test where radioactive tracers are injected into the body. A scan is then done later to help determine bony problems that may not be present on plain x-rays


BACKFACTS

DIAGNOSTIC TESTS

Myelogram – Special x-ray procedure where radiological dye is injected into the spinal canal. This test may give information about what might be causing pressure on the nerves


BACKFACTS

DIAGNOSTIC TESTS

EMG-NCV (Electromyogram – Nerve Conduction Test) – Neurophysiology test usually done under the guidance of a neurologist (or a similarly trained physician). This is not a picture test but instead information is obtained to tell if the nerve if functioning normally or slowly. In addition, it can tell if the nerve is sending signals to the muscles normally


BACKFACTS

WARNING SIGNSDO NOT HESITATE TO SEEK MEDICAL ATTENTION

Medical attention should be sought especially if these symptoms are present:

Back pain associated with leg painLeg numbnessLeg weakness


BACKFACTS

EMERGENCY WARNING SIGNS

GO IMMEDIATELY TO YOUR DOCTOR OR EMERGENCY ROOM for loss of control of bowel or bladder. Incontinence of bowel or bladder is an emergent situation in a person with back pain and requires prompt medical evaluation.


BACKFACTS

As with many health conditions, persons can educate themselves and practice prevention to lessen the likelihood that a condition will occur. Learning about back pain prevention BEFORE an episode of back pain occurs can have a BIG payoff for your health


Employee Health

sss employee health sss

Documents