Most causes of low back pain are preventable and easily remedied at little to no cost to employees and/or the employer. As we get older, the spine naturally degenerates as an effect of the natural aging process. When we put unnecessary stress on our spine with awkward postures and overexertion, the degeneration process is sped up and the instance of low back pain can become an even more serious disease process. When muscles remain in a contracted state, blood and oxygen cannot circulate and the muscles start to atrophy and pain begins to set in. Pain from muscle tissue degeneration or nerve compression, in the case of herniated or bulging disks, can be debilitating.

Traumatic back injuries are more difficult to prevent and treat. Most traumatic back injuries are caused by automobile or industrial accidents or are related to sports injuries. They happen suddenly due to unforeseen circumstances.

One of the most common idiopathic low back disorders is sciatica. Sciatica affects the low back area as well as one or both lower extremities and can present as sharp, acute pain, or a chronic burning ache. Other disorders with a potential for occurrence include herniated or bulging disks, back strain or sprain, and structural abnormalities.

Awkward positions are a causative factor for low back pain. Awkward postures and positions can be defined by bending, twisting, kneeling, stooping and squatting. The positions listed above were noted by NIOSH to have a serious effect on low back pain and injury to employees. Static work postures also have an effect on low back pain. Static work postures are defined as sedentary work, sitting, cramped work spaces, or working where very little movement occurs. Though static work postures are not a main contributing factor, according to studies provided by NIOSH, there was a notable impact on incidence of low back pain relation.

One of the most common factors contributing to low back pain, but more commonly the most overlooked risk factor, is stress, whether it is emotional stress or muscular tension, according to a 2010 University of Maryland report. Stress causes muscles to contract and when there is a significant emotional stress associated with the employee, the muscles will remain in a contracted state no matter what position the employee is in or how often an object is lifted or how heavy that object is. When muscles are chronically contracted, blood circulation ceases at that level and oxygen is cut off to the muscle group, causing the muscle to lose some function, or perhaps die.

Signs and symptoms

Low back strain and lumbar sprains are the most common injuries to the lower back. A strain is defined as muscle fibers being stretched abnormally or torn and a sprain is the complete detachment of ligaments from their attachments. Some of the most common symptoms of a lumbar strain or sprain include pain around the lower back and buttock area, low back muscle spasms, and pain associated with activity that subsides during rest periods, according to Jonathan Cluett, M.D.

When a muscle is strained or sprained, inflammation in the soft tissue causes the muscles to press against nerves, resulting in pain in the affected area. The pain from a strain or sprain of lumbar tissue can be debilitating and long-lasting. Since the muscles of the back are responsible for so much of our body’s weight-bearing and are needed for so many different activities, the lumbar spine is prone to frequent injury. When a person suffers from an injury to these muscles, they are prevented from performing many common daily activities.

Nearly everyone experiences a low back injury sooner or later. These injuries have a tendency to cause many lost workdays due to their pain. A single low back injury can cost $23,820 per injury on average, according to the U.S. Bureau of Labor Statistics in 2007.


What to do? The most effective way to prevent low back pain is to train employees on lifting procedures and protocol used by the organization. NIOSH has published helpful lifting recommendations, such as not lifting objects over a certain weight and keeping objects close to the body when lifting. If lifting is done on a regular basis, alternating tasks to limit the time spent lifting and using proper technique, such as preventing twisting while picking an object up, is recommended. Exercise also helps. When muscles are prepared for use, the tendency to cramp or spasm is reduced. Simple exercises at the beginning of each shift can be done to prepare muscles and to lessen the incidence of injury.

Gaining support

Management, both at upper and middle levels of your organization, must buy into your ergonomic improvement program. But many managers are unfamiliar with ergonomics, or tend to think solutions come with expensive price tags. Educate managers when necessary to the low cost of many preventive measures. And the high average cost of a lost-time back injury.

Stress the importance of suggestions and input on improvements to push employee participation.

Finally, the role of your facility physician is key. Educate your physician on the policies and procedures implemented by the facility, such as the return to work policy and the ergonomic improvements already in place, so the physician can readily participate in getting employees back to work as soon as medically possible. Show some of the exercises performed and some of the improvements that have been implemented, along with a copy of the ergonomics and return to work policy, so the physician knows where the organization stands on prevention and maintenance of the ergonomic program.


The first step: conduct a job task analysis for each individual job task done within the facility. As the job is being performed, risk factors should be identified and a constant thinking process should identify smaller, not as recognizable factors.

As mentioned, encourage employees to make suggestions, show what is being done, and solicit their input on improvements that have been made. Perform the task yourself at the side of your employee to get a better feel for what the employee is doing, and what muscle groups are affected every day. Performing the task is an easy way to get the full impact of what the employee goes through on a daily basis.

Training should be done at the time the employee is hired and annually thereafter. When new improvements are made, the employee and the supervisor should be trained on the correct use of any additional equipment and procedures for correct use and maintenance of the equipment.

The checklist

In addition to mandatory OSHA injury and illness records, documenting your job task analyses can help improve problem areas. An initial checklist describes what is being done by the employee while performing a job. More in-depth details can be gleaned in a separate section of the checklist for those jobs being performed to include how objects are lifted and transported from place to place throughout the facility.

Important notes to include on your checklist are the common risk factors immediately observed while performing lifting procedures; observation of an employee performing lifting procedures and a description of what was being lifted; measuring lighting and noise volume; weighing objects common to the task being performed; and notations of any awkward postures used while performing the job task.

Spaces should be provided to list what actions were observed with the potential for correction; what suggestions were given to the employee; whether the suggestions were plausible; and what was done to implement the new procedure. There should be room for a complete evaluation of the improvement, with input from the employees using the new procedure included. Other items to note might include obstacles to implementing the improvements and the problem-solving tactics used to overcome those obstacles.


Measuring effectiveness and constantly monitoring improvements is necessary to ensure the success of your program. In order to monitor an improvement, observe the job being performed in normal, everyday working conditions, without letting the employee performing the task know what is taking place.

Constant monitoring and maintenance of upper and middle management leadership is necessary to maintain the success of the program. Your physician can also be included in this monitoring process. It is the physician who monitors the injury or illness the employee has presented with. Invitations to the facility are recommended so your management team can physically see the work being performed and the improvements being utilized.

Remember, your employees are your pipeline to realities on the shop floor. You need them to be an integral part of your entire ergonomics process. Find “ergo champions” among your workforce. Employees will listen to their peers more readily than take to a program they feel is being shoved at them from the top.


Elizabeth Shackelford wrote this paper for “Ergonomics Process and Practice,” a course at Eastern Kentucky University taught by Dr. Thomas Schneid.