Back pain - returning to work

Exercise helps to prevent future back pain:

• Exercise a little every day. Walking is a good way to keep your heart healthy and your muscles strong. If walking is too hard for you, work with a physical therapist to develop an exercise plan that you can do.
• Keep doing the exercises you have been shown to strengthen your core muscles, which support your back. A stronger core helps lower your risk for further back injuries.

If you are overweight, ask your health care provider about ways you can lose some weight. Carrying around extra weight adds stress to your back no matter what kind of work you do.

Long car rides and getting in and out of the car can be hard on your back. If you have a long commute to work, consider some of these changes:

• Adjust your car seat to make it easier to enter, sit in, and get out of your car. Bring your seat as far forward as possible to avoid bending forward when you are driving.
• If you drive long distances, stop and walk around every hour.
• Do not lift heavy objects right after a long car ride.

Know how much you can safely lift. Think about how much you have lifted in the past and how easy or hard that was. If an object seems too heavy or awkward, get help to move or lift it.

If your work requires you to do lifting that may not be safe for your back, talk with your boss. Try to find out the most weight you should have to lift. You may need to meet with a physical therapist or occupational therapist to learn how to safely lift this amount of weight.

Follow these steps when you bend and lift to help prevent back pain and injury:

• Spread your feet apart to give your body a wide base of support.
• Stand as close as possible to the object you are lifting.
• Bend at your knees, not at your waist.
• Tighten your stomach muscles as you lift the object up or lower it down.
• Hold the object as close to your body as you can.
• Lift slowly, using the muscles in your hips and knees.
• As you stand up with the object, do not bend forward.
• Do not twist your back while you bend to reach the object, lift the object up, or carry the object.
• Squat as you set the object down, using the muscles in your knees and hips.

Some providers recommend using a back brace to help support the spine. A brace may help prevent injuries for workers who have to lift heavy objects. But, using a brace too much can allow the core muscles that support your back to weaken, making back pain problems worse.

If your back pain is worse at work, it may be that your work station is not set up correctly.

• If you sit at a computer at work, make sure that your chair has a straight back with an adjustable seat and back, armrests, and a swivel seat.
• Ask about having a trained therapist assess your workspace or movements to see if changes, such as a new chair or a cushioned mat under your feet, would help.
• Get up and move around during the workday. If you are able, take a 10 to 15 minute walk in the morning before work and at lunchtime.

If your work involves physical activity, review the needed motions and activities with your physical therapist. Your therapist may be able to suggest helpful changes. Also, ask about exercises or stretches for the muscles you use most during work.

Avoid standing for long periods. If you must stand at work, try resting one foot on a stool, then the other foot. Keep switching off during the day.

Take medicines as needed. Let your boss or supervisor know if you need to take medicines that make you sleepy, such as narcotic pain relievers and muscle relaxant medicines.

Nonspecific back pain - work; Backache - work; Lumbar pain - work; Pain - back - chronic; Low back pain - work; Lumbago - work

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Becker BA, Childress MA. Nonspecific low back pain and return to work. Am Fam Physician. 2019;100(11):697-703. PMID: 31790184 pubmed.ncbi.nlm.nih.gov/31790184/.

El Abd OH, Amadera JED. Low back strain or sprain. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 48.

Will JS, Bury DC, Miller JA. Mechanical low back pain. Am Fam Physician. 2018;98(7):421-428. PMID: 30252425 pubmed.ncbi.nlm.nih.gov/30252425/.

Updated by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.