Missing Work Due to Lower Back Pain? Recommended Treatments Are the Answer

Missing Work Due to Lower Back Pain? Recommended Treatments Are the Answer

Back pain can interfere with many parts of a person's life, including their ability to get work done. In fact, new research finds that people who don't receive the proper treatment miss more days of work compared to those who do.

Scientists from the University of Utah Health and MDGuidelines found that people with a lower back pain injury missed 11 more days of work in a year when they only received treatments that were not recommended by medical guidelines compared to those who were.

The researchers used a cohort of nearly 60,000 people whose data was taken from California’s workers’ compensation claims reported to the Department of Industrial Relations Workers’ Compensation Information System from May 2009 to 2018.

To evaluate whether someone was given the recommended treatment, researchers used the American College of Occupational and Environmental Medicine (ACOEM)’s Low Back Disorders Practice Guidelines.

Some of these recommended treatments included:

The study was published in the PLOS ONEjournal in mid-June.

The majority of people included in the study received at least some non-recommended treatments for lower back pain. Researchers found that:

The guidelines recommend that doctors refrain from treating with electrical stimulation and opioids. And one bright spot in these findings points to a dramatic 86% decrease in opioid prescriptions from 2009 to 2018.

Overall, the researchers found that "workers receiving only recommended interventions incurred 11.5 fewer lost workdays, a 29.3% reduction, compared with those who received only non-recommended interventions."

"I'm not surprised at all that people will be far more productive if it's properly treated," Neel Anand, MD, professor of orthopedic surgery and director of spine trauma at Cedars-Sinai Spine Center, tells Verywell. "The problem is ignored immensely."

For people who experience acute lower back pain, it can be easy to brush it off as a non-issue. Lower back pain does not always need medical care, but there are steps that people can take to help take control of their back pain if it starts to interfere with their day-to-day.

Acute lower back pain, which lasts for less than four weeks according to the Centers for Disease Control and Prevention, becomes chronic when it lasts for more than 12 weeks.

Anti-inflammatory medications can also be useful in addressing lower back pain.

"The best way to approach into this we use a short course of anti-inflammatory because the muscles, the ligaments, and the tendons are all inflamed," Medhat Mikhael, MD, pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center, tells Verywell.

People can even use this anti-inflammatory medication at the onset of the pain by purchasing over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen sodium.

Some alternatives can include muscle relaxants, which the ACOEM’s Low Back Disorders Practice Guideline moderately recommends.

When experiencing acute pain, many people may be tempted to lie in bed. Mikhael and Anand both recommend against this.

Although some rest is OK, it is important for people to still use their back muscles. People also may want to consider sitting in a firmer chair, while it may be a bit uncomfortable.

"You don't want to sit in a soft sofa seat," Anand says. "Sitting usually causes more pain than standing so if you're in the acute phase of pain, maybe you want to stand."

While moving is important, Anand recommends "staying away from particular activities that are causing the pain."

Massages can be helpful in managing different types of pain, but people should be cautious about going to a chiropractor.

"Sometimes chiropractors can get very aggressive on that and try to do a lot of manipulation, adjustments that sometimes flare up the symptoms even further and delay the healing process," Mikhael says.

Instead, Mikhael recommends people attend a couple of physical therapy sessions to see if this improves their pain levels.

For people who have a job that requires them to sit in front of a computer during most of the day, there are still steps that they can take to prevent or limit them from developing lower back pain.

"My number one recommendation is adequate ergonomics of the desk job," Mikhael says. "People are sitting on their [spinal] discs and the computer is way higher than their head. Their chairs are terrible and they do not have good back support."

He suggests investing in a better chair and also paying attention to the positioning of their computer if possible.

A November 2019 study published in Applied Ergonomics journal linked lower back pain among people who have desk jobs with their habits of staying still for most of the day. “Individuals with chronic LBP demonstrated a possible trend…towards more static sitting behaviour compared to their pain-free counterparts,” the researchers wrote.

Because of this, Mikhael encourages people to take advantage of times that they can move around. "Always take your 10-minute breaks and use it for your advantage," he says. "Stand up and walk around to ease the pressure on your discs, your nerves, and ligaments."

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