Backpain is a serious problem among working people. It is most common between the age of 30 and 50 years and men and women are equally affected. Rapid industrialization attracts more people to the industrial set up and by the year 2000 already 42% of the world population has migrated towards industries. Certain jobs have more risk of developing backpain. Lifting unaccustomed weights, lifting unmanageable weights, lifting weights inappropriately, doing the same movement repeatedly, assuming incorrect posture while working at the machines or sitting continuously in one position are some of the hazards of industries and can create problems to the back. Given choice no body likes to have backpain. But it comes like an unwelcome visitor and remains for a long time. Once the friendship is developed, it returns very frequently.

To overcome such problems it is important to have a strong spinal musculature. Normally the ratio between posterior spinal extension muscles and abdominal muscles has to be 3:2. The extension of spine should be able to produce resistance equivalent to at least one’s body weight. It is interesting to note that workers involved in very hard manual work like fisherfolk, athletes and long distance runners can provide resistance up to 200 times their body weight. Factory workers can barely match their body weight, peons, stenos, clerks and superintendents reach up to 70% and executives who do not indulge in recreational activities cannot even reach 60% of their body weight.

Backache to day is considered as the most common affliction in the industrialized world. In developed countries 80% suffer from backpain sometime or another in their life. Industrialisation brings in affluence and men devise innumerable modes of relaxation and spends more time in this hobby.The back muscles start getting weak Affluence also helps to put on weight and this produces further strain on the spine.Once the muscles become weak there is high risk of developing backpain.

Industrial factors which produces strain on the spine
Given below are some of the factors which produces strain on the spine. Hard manual work, carrying heavy weights, carrying unacceptable loads, accumulated effect of increased mechanical stress and strain on the spine of 15 years duration, rapid repetitive handling, inappropriate working heights, poor sitting, continuous forward bending and inadequate working space for mobility can all play havoc with the back.The most important factor is unacceptable workload. The load may be less than 50% of body weight but if it is lifted by an untrained worker or the load may be even less than 40% of body weight but if it is carried repeatedly over the years it produces stress on the spine.

Who is at risk and what is the risk
Men and women are equally affected. The period between 30 and 50 years is the worst period for backpain essentially because of increased occupational and social demands including handling of children. Industrial survey shows that manual workers and industrial labourers have 22% risk, nurses 17%, long distance drivers 15% and static work posture, bending, reaching and repetitive handling 14% risk of developing backpain.

Loss of industrial working hours
The loss of industrial working hours as a result of backpain is quite staggering and has detrimental effect on production. The 1992 Netherlands study shows that the incidence of backpain varies from country to country but the incidence is uniformly high in industrialized nations and on an average 1:200 workforce is absent every day. In USA and Sweden these figures are still higher and under the age of 45 or the most productive time of life backpain is the single greatest cause of loss of industrial working hours.

Interesting industrial point: It is generally presumed that because of pregnancies and childbirth women have a weaker back and are more prone to backpain. But men take more time off work than women.On an average 627 days per 1000 males are lost per year against 347 days per 1000 females.

Myth and Reality
It is generally presumed that once one gets backpain, however severe it may be 45% recover within 2 weeks and 90% recover within 4 weeks.This sort of concept has come from our ancestors who had significantly less incidence of backpain essentially because they were basically involved in activities like growing food, gathering food and hunting with very little social activity. Their life style involved on an average only 50 lifting and carrying movements per day at a time when they had strong muscles in the spine. As against this the reality is that 85% of industrialized population gets backpain sometimes or another. In 30% the sufferings last for more than 3 months and at least 1.30 requires to be admitted to the hospital and of then 1:6 will undergo surgery.

Ergonomics : Fit the job to the person. Do not fit the person to the job.
This less understood science is now being forcefully persuid by most industrial units in developed countries. It is interesting to note that neglect of ergonomics start at home.Most houses do not have chairs designed for children. They sit in chairs designed for adults and lays the foundation for backpain. There are several smaller points in a given industrial unit which can be taken care of to make sure the worker do not get backpain. For example if a worker has to bend and work at the machine, if he is provided with a small foot stool to keep his right leg he will be most confortable at work with less stress on the spine.

The healthy spine
Human spine is a superb and fascinating example of a piece of engineering design. It is the central support system for the whole body and yet it is involved in most intricate movements of the body at a time when it has to support and protect the spinal cord. It absorbs shock vertically and its curvature (S shaped) provide necessary resilience. The intervertebral disc which is soft is the shoc absorber of the spine and it is most vulnerable to injury between the ages of 30 and 50 years. Its water content is very high but with repetitive stress it looses its water and turgor and then gradually looses elasticity. It has then greater risk of injury. The greatest pressure on the spine is on standing.It is advisable to learn to stand as less as is possible.The pressure on the spine in standing is 100%. Lying on one side the pressure is 75% and lying flat is the most confortable position for spine with only 25% pressure. At times one finds a person whose bad posture has resulted in the creation of hollow in the back giving rise to sway back or hollow back. Person with sway back has excessive flexibility with slack abdominal muscles and tilting of pelvis forward. Pregnancy creates further weakness in abdominal muscles giving exaggerated sway back. The spinous processes, at the back of the spine, then touch each other in what is known as kissing spine. Bone rubbing against each other gives rise to backpain. High-heeled shoes help to tilt the pelvis forward and exaggerate or mimic sway back.

Pressure and stress on the spine
No sooner one sits up or stands there is pressure produced on the spine.Depending on the intensity and the time the spine becomes the victim of abnormal load and starts giving way resulting in backpain. It has been estimated that the pressure on the spine in standing or in sitting position is 100%. It gets reduced to 75% in lying down position on one side and the pressure on the spine is least to 25% in lying down flat position.