Occupational Back Injuries: Predicting the Need for Lumbar Spine Surgery

In a study published by the U.S. Department of Health and Human Services, researchers found that nearly 10 percent of workplace back injuries resulted in the need for lumbar spine surgery within three years after injury. The study, often referred to as the Keeney Study, also identified early predictors, or signs and symptoms that were present in workers who needed spinal surgery.1

Workplace back injuries very common

Musculoskeletal injuries, particularly back injuries, are the most common workplace injury. Overexertion, heavy lifting, and prolonged sitting increase the risk of a back injury. Research by the Centers for Disease Control (CDC) and the National Institute of Occupational Safety and Health (NIOSH) show that improper lifting and poor seated workstation ergonomics were frequently the cause of back injuries.

Seeking treatment

The Keeney Study showed that workers with symptomatic radiculopathy (e.g. pinched nerves) and workers with reflex, sensory, or motor abnormalities had the highest likelihood of needing surgery following a back injury.

If you injure your back at work or feel that working conditions are the cause of back pain, visiting a doctor sooner rather than later usually expands your treatment options. If you experience trauma – falling or being involved in a vehicle accident – you should always seek medical treatment. But the extent of a back injury isn’t always immediately present. Watch for symptoms like numbness or tingling (a pins and needles feeling), pain only at night, prolonged pain of six weeks or more or abnormalities like dragging your toes of one foot when you walk or loss of bladder or bowel control. These symptoms should be reviewed by a doctor.

An ounce of prevention…

Maintaining an active lifestyle and getting plenty of exercise has been shown to aid in preventing back injuries – both at and away from work. Resistance training to build muscle strength and balance work (like yoga or Pilates) not only helps prevent injury, it is also recommended as therapy for existing back pain.

You might have received workplace safety training when you started your job and it might have included injury-prevention information. Most employees are trained to lift with their legs, not their backs, but over time, they become lax about form. Review material about proper lifting technique and be mindful when lifting to avoid injuring your back.

If you spend most of your work time sitting, there are immediate changes you can make to avoid back injury:

  • NEVER cradle your phone between your ear and your shoulder.
  • Adjust the height of your chair so your feet are naturally flat on the floor.
  • Your lower back should be supported by the lumbar support area of your chair.
  • Avoid leaning forward to reach your keyboard or mouse.
  • Your computer screen should be about arm’s length from your body and directly in front of you.

Surgery for a workplace back injury is not inevitable, but seeking treatment early is an important first step following an injury in order to reduce the possibility of needing surgery. Following your doctor’s recommendations, keeping all follow up appointments and having open conversations with your doctor’s at appointments are all important tools that contribute to your healing and help determine next steps.

  1. Keeney BJ, Fulton-Kehoe D, Turner JA, Wickizer TM, Chan KC, Franklin GM. Early predictors of lumbar spine surgery after occupational back injury: results from a prospective study of workers in Washington State. Spine (Phila Pa 1976). May 15 2013;38(11):953-964. doi:10.1097/BRS.0b013e3182814ed5

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