Lighten Your Load - How To Prevent Back Problems: Back Pain

Content provided by the Faculty of the Harvard Medical School

Lighten your load

Backpacks have become ubiquitous — at school, at work, at play. But an overstuffed backpack can signal more than a healthy workout at the gym: It can be a harbinger of back pain.

Most orthopedic doctors have long recognized that backpacks increase the risk of certain types of back pain, especially in students. In a 1999 survey, for example, the American Academy of Orthopaedic Surgeons found that nearly 60% of the doctors responding had treated school-age patients complaining of back and shoulder pain caused by heavy backpacks. Hauling an overloaded backpack can also cause muscle fatigue and strain and encourage the wearer to bend forward unnaturally.

If you use a backpack, you can take steps to protect yourself. For starters, use both the pack's straps instead of slinging one strap over a shoulder, try to carry only the essentials, and lighten your load whenever possible. Opt for backpacks that have different-sized compartments to help distribute weight more evenly. And look for wide, padded straps, and a padded back. When carrying a heavy load, put the heaviest items as close as possible to the center of the back, and use the hip strap for support. For very heavy loads use a backpack with wheels. Above all, remember to bend from your knees when picking up your pack.

Back belts: Not a panacea

Once only sported by weight lifters, back belts have gained popularity among workers who must often lift goods — from grocery store clerks to airline baggage handlers. With back problems accounting for nearly 20% of all workplace injuries and costing anywhere from $20–$50 billion a year, it's no surprise that some companies require their workers to use these belts.

But most studies cast doubt on whether this strategy can protect workers' backs or reduce sick time and workers' compensation claims. For instance, a study published in 2000 in the Journal of the American Medical Association found that these belts didn't curtail back injuries. The two-year study, which included several thousand employees who handled merchandise, found that using back belts reduced neither the incidence of low back pain nor the number of back injury claims.

Although a few studies have found them to be protective, the consensus is that back belts do not reduce back injuries. And the National Institute of Occupational Safety and Health (NIOSH) has expressed concern that these belts may even do harm by giving workers a false sense of security. According to NIOSH, there is evidence that workers think they can lift heavier items when wearing the belts.

NIOSH also points out that there is no scientific evidence to back up claims that these belts decrease the force exerted on the spine, that they remind wearers to lift properly, or that they reduce workplace injuries. As a result, the agency doesn't recommend that employers insist that their workers use back belts to prevent back injuries.

Figure 6: The laws of lifting Follow these basic steps whenever you need to lift something: Face the object and position yourself close to it. Bend at your knees, not your waist, and squat down as far as you comfortably can. Tighten your stomach and keep your buttocks tucked in. Lift with your legs, not your back muscles. Don't try to lift the object too high. Don't raise a heavy load any higher than your waist; keep a light load below shoulder level. Keep the object close to you as you lift it. If you need to turn to set something down, don't twist your upper body. Instead, turn your entire body, moving your shoulders, hips, and feet at the same time. Ask for help with lifting anything that's too heavy.

Last updated:	January 23, 2007