Back pain - advice for employees

This advice will help you to understand the causes of back pain and give advice on what to do if you are a sufferer. Knowing what the risks are can help you to reduce the possibility of developing back pain.

Back pain - benefits of active work

Active work has a positive impact on your physical and mental wellbeing. The idea that manual handling or repetitive movements is ‘bad for employees’ is a myth but it is true active work approached wrongly, can sometimes contribute to health conditions like back pain and other musculoskeletal disorders (MSDS) such as muscular aches and strains.

Benefits your physical health

Just doing your job can help you meet the recommended target for exercise (30 minutes of physical activity at least five days each week). This exercise can be broken down to 10 or 15 minute chunks if more suitable to you.

Benefits your mental health

Being physically active promotes your body to release chemicals that help improve your mood and make you feel more relaxed.

Causes of back pain

Back pain is common. Nearly everyone is affected by it at some time. For most pepople affected by back pain episodes are nearly always short-lived.

The exact cause of back pain is often unclear, but back pain is more common in work roles that involve:

  • repetitive tasks - such as manual packing of goods
  • force - heavy manual labour, handling tasks, pushing, pulling or dragging heavy loads
  • posture - poor/ awkward postures such as stooping, bending over, crouching, stretching, twisting and reaching
  • duration - prolonged periods in one position, for example working with computers or driving long distances or working when physically overtired
  • vibration - operating vibration tools
  • cold temperature - working in low temperature environments e.g. outdoor working in winter

Warning signs

Back pain is not usually due to any serious damage or disease. The pain usually improves within days or a few weeks, at least enough to get on with your life.  

Only a few people have back pain that is caused by a more serious issue such as a slipped disc or a trapped nerve and even these usually get better by themselves.

Investigations (x-rays and MRI scans) in the first four to six weeks are not beneficial unless there are warning signs present.  Such investigations can detect serious spinal injuries which are very rare but they don’t usually help in ordinary back pain.  

If you do have back pain and suddenly notice any of these symptoms, which are rare, you should see a doctor straight away. 

Other warning signs include:

  • difficulty passing or controlling urine
  • numbness around your back passage or genitals
  • numbness, pins and needles, or weakness in both legs
  • unsteadiness on your feet
  • severe pain which gets worse over several weeks (especially at night or when lying down)
  • recent accident/trauma
  • unexplained weight loss
  • history of cancer
  • feeling unwell/ fever

Dealing with back pain

Sometimes the pain can make you miserable but you should still take control of the pain.

In the early stages:

  • avoid bed rest - prolonged bed rest is harmful
  • stay active (including work) - your back is designed for movement so the sooner you start doing your ordinary activities the better
  • use prescribed pain killers preferably taken at regular intervals (Paracetamol or non-steroidal anti-inflammatory drugs)
  • heat or cold applied to the sore area may help
  • seek help from a qualified professional (osteopath, physiotherapist or chiropractor)
  • a short course of manipulation/ acupuncture can help relieve back pain for some
  • a structured exercise programme tailored to your needs (to include aerobic activity, muscle strengthening, postural control and stretches) may help relieve pain
  • stay at work - or early return to work, with modifications if needed

Next stages

  • steadily increase your level of activity
  • do a little bit more each day if the pain has been restricting your movement
  • do not stay in one position for too long
  • get up and stretch regularly
  • move about and take some walks, building up your activity as you get stronger
  • stay at work if you can to keep active and recover from the pain - if you have a lot of lifting or other risk factors in your job, talk to your employer and tell them about tasks that will be difficult to begin with
  • even if the pain is particularly severe you can still try to do most daily activities or hobbies

A summary of good advice can be found in guidance booklets like The Back Book and BackCare website.

NHS choices website is the online 'front door' to the NHS. It is the UK's biggest health website and gives all the information you need to make choices about your health.

Learning and following the correct method for lifting and handling heavy loads can help to prevent injury, see the NHS safe lifting tips webpage.

If you work in an office and use a computer, you can avoid injury by sitting in the right position and arranging your desk correctly, you can follow the tips in the NHS webpage.  

The best ways to deal with pain and help your back to recover are to maintain your mobility and return to work as soon as possible.

Work and back pain

Long-term unemployment can be a serious consequence of  back pain. Your employer and you play a very important role in keeping you at work.

Report back pain to your employer and to your safety representative if there is one in your workplace.

Planned return to work

  • talk to your employer and safety representative about ways to ensure safe return to work
  • develop a plan for progressive return to work as your physical work capacity improves
  • your employer may be able to put you in touch with occupational health support
     

Changes to work activities

It is important to work with your employer to enable a return to work. Helpful strategies for return to work may include:

  • suggesting alternatives and rotation between activities - this may help an early return to normal work
  • reducing the duration of work for the first few week - this may help reduce risk of further pain
  • working a half normal shift (about four hours at first) - this may improve pain tolerance

What your employer can do to help

Your employer has to protect the health and safety of their workforce by law. They must:

  • perform risk assessments and put in place reasonable measures to reduce that risk
  • provide information and training about safe ways of work
  • act on any reports of ill health caused by work - if a worker returns after sick leave, the employer needs to make sure that the worker’s health is not made worse by work
  • make changes to work environment and work style as far as is practical
  • provide equipment to assist in your duties
  • provide reasonable adjustments to the workplace if a worker is disabled under the definition in the Disability Discrimination Act
  • consider basic ‘health promotion in the workplace’ tips, for example walk or cycle to work schemes

Off work and suffering back pain

General information and advice on managing sickness absence and return to work can be found in our Sickness absence section.  I

f there is no occupational health provider available, your GP or safety representative may be able to discuss possible work restrictions or adjustments.  

You can also suggest any practical workplace adaptations or alterations which might help you to cope while you return to full time working.  Also keep in regular contact with your employer to make them aware of your situation, and to discuss what adjustments might be needed once you are ready to return.  

You should also discuss your needs with your employer and occupational health provider.

Help yourself

At work:

  • you have a duty to look after your own health and safety, including your back
  • co-operate with arrangements your employer introduces to reduce risks - this may be through systems or equipment in place for you to use or a system of reporting accidents, near misses or symptoms of ill health
  • ensure you are competent in tasks you do (receive tailored training and follow advice you’re given)
  • think about the movements your job requires you to carry out regularly and try to eliminate movements that are not benefiting your health and limit your productivity - you can achieve this through developing better working postures

Movements you should try to avoid should include:

  • awkward or uncomfortable positions (for example, working with arms away from your body or with your back bent and twisted)
  • using too much force
  • placing too much strain on one side of your body

Report pain or any other symptoms to your employer promptly.

Staying in employment - top tips

  • stay or become more physically active
  • warm up a little, to prepare your body for work for heavy or repetitive work - you should do this at the beginning of the day and after rest periods
  • get up and stretch
  • use good technique/ adopt neutral work postures
  • don’t overstretch to perform a task - move closer
  • make good use of equipment designed to help you with strenuous tasks - more advice is available in the free leaflet Are you making the best use of lifting and handling aids 
  • rotate repetitive activities / vary your tasks to avoid the same movements for prolonged periods using the same parts of your body
  • take rest periods or have ‘micro breaks’ regularly
  • sit up comfortably in a chair that supports your lower back
  • during computer work, ensure that you adjust your chair height so that your forearms are comfortably resting on the desk and your elbows are roughly at right angles - more advice is available in the free leaflets VDU workstation checklist  or Working with VDUs 
  • don’t skip meals and do drink water regularly
  • make sure clothes fit properly so you can move freely and maintain a comfortable temperature - cold muscles are more likely to suffer injury
  • seek advice from a physio about specific exercises that will help you develop the strength your muscles and improve your fitness so you can manage the demands of your job

Good posture

Correct posture and transfer of your body weight in movement is really important for good health.  If you adopt the correct postures for the tasks you do at work and at home:

  • your back, neck and other joints will remain healthy and strong
  • you will breathe deeper and more freely
  • you will be at a reduced risk of developing problems
  • your internal organs will be able to work more efficiently

Poor posture is often the result of bad habits developed over a lifetime, such as slouching, but can also result from:

  • obesity
  • fatigue
  • stress and anxiety
  • poor lifting and handling technique

In good posture, your head, shoulders, spine and hip joints will adopt correct alignment.  Whether you are standing, sitting, or leaning you should aim to avoid undue stress and strain on your joints. This will help you feel:

  • stronger
  • less tired
  • fewer aches and pains