Prevention and Management
of
Neck and Back Injuries
James Grubinskas DC, CEAS
Chiropractor
Alliance Occupational Medicine
Objectives
 Understand proper posture to prevent neck & back
injuries
 Understand the types of neck & back injuries
 Understand risk factors associated with neck & back
injuries
 Understand the common causes of neck & back
injuries
 Identify ways to prevent neck & back injuries
 Identify what to do in the event your neck or back is
injured
Statistics
 Financial impact of occupational injury and
illness in the US is $250 Billion (2007)
affecting 3.8 million injured workers
 Back injuries account for 1 out of 5
workplace injuries or illnesses (Bureau of
Labor Statistics)
 186 million work days are lost each year to
back pain alone.
Impact of Obesity on Musculoskeletal
Disorders and WC Costs
37.5% of adults are currently obese
CA. WC Institute claims with obesity as a comorbity vs.
those without had the following characteristics:
- more claims lost time from work (83% vs. 29%)
- increased lost work days (approx. 80% greater)
- more frequent attorney involvement (approx. 68% vs.
15%)
- greater use of opiods (approx. 69% vs. 19%)
- higher medical cost claims ($51K vs. $7503) and
indemnity costs ($59K vs. $5400)
Non Work Combined Medical
Conditions
-
Age
Gender
Genetic Predisposition
Smoking
Weight
Prior Injuries
Hobbies
Medical Conditions (diabetes, RA, thyroid
disease, heart disease, liver, kidney
disfunction)
Neck Pain
Neck muscle pain can be caused by the following neck muscles
becoming tight.
• Scalene muscles (three pairs of muscles that help rotate the neck)
• Suboccipital muscles (four pairs of muscles used to rotate the
head)
• Pectoralis minor muscles (a pair of thin triangular muscles at the
upper part of the chest)
• Subscapularis muscles (a pair of large triangular muscles near
each shoulder joint)
• Levator scapulae muscles (a pair of muscles located at the back
and side of the neck).
If alignment of head and spine is not optimal, the neck can be
predisposed to injury and/or the degenerative effects of wear and
tear over time.
Top 3 Bad Postures That Can Cause
Neck Pain
1) Hunchback
2) Rounded Shoulder
3) Forward Head
Bad Posture #1 - Hunchback
Cause: Sitting for long hours with bad posture. For instance, sitting hunched
over a computer screen.
Pain: Neck, shoulder, and back.
Problem: The bad sitting posture causes the chest muscles to tighten leading to
an excessively curved back in the upper back or thoracic region. The muscles of
the upper back loosen and eventually weaken.
Recommendation: The following exercises are very effective:
Bad Posture #2 – Rounded
Shoulder
Cause: Sitting with a bad posture while typing, or imbalanced exercise regime
involving excessive chest pressing.
Pain: Neck, shoulder, back
Problem: Sitting in that position results in the chest muscles tightening, causing
the shoulders to rotate forward internally. The muscles of the upper back
weaken and loosen.
Recommendation: Stretching to relax the tight chest muscles
Bad Posture #3 - Forward Head
Cause: Sitting hunched over in an office chair for long hours, staring at a
computer.
Pain: Neck
Problem: Tightness of the muscles of the back of the neck, along with the
muscles of the upper back (levator and upper trapezius).
Recommendation: Stretches to loosen tight muscles in the back of the neck:
Poor Posture
Poor Posture
Correct Posture
Back
Anatomy






Vertebrae (Bones)
Spinal Discs
Muscles and Tendons
Ligaments
Spinal Cord
Nerve Roots
Vertebrae
 Stacked
 Interlocking
 Flexibility – flexion/ extension/
rotation/ lateral bending
 Protect spinal cord
 Center of gravity located in
front of the sacrum
Spinal Discs
 Cushioning – “Shock Absorber”
 Like a jelly donut
 Disc anatomy
- Tough outer covering
- Soft gelatinous center
- No blood supply
- Few nerve endings
- Helps the spine be flexible
 Mostly water that dehydrates with age
 Can deteriorate, protrude, herniate
Types of Back Injuries





Strain and Fatigue
Nerve Injury
Fractured Vertebrae
Tears in Disks
Disc Fractures and
Ruptures
Risk Factors





Posture
Force
Repetition
Stress
Other Factors-Physical Fitness,
Aging, Diet, Smoking.
Posture
What posture are you exhibiting?
Causes of Back Injuries
 Improper lifting techniques (95%)
 Overexertion
 Work Area Conditions
- Path of travel
- Arrangement of work area
Risky Moves
Certain actions are more likely to cause back injuries than others. If you
are doing these things think: DANGER! I’m at Risk!
 Heavy Lifting
 Repetitive Lifting
 Twisting at the Waist
 Reaching and Lifting Overhead
 Lifting Objects with Unusual or Awkward Shapes
 Working in Awkward Uncomfortable Positions
 Standing or Sitting for Long Periods
Lifting Hazards
Safe Lifting Zone
 Lifting items
between the hips and
shoulders is the safest
The further from
the lift zone, the
riskier the lift
Safe Lifting Zones
Lifting Ratio
 Your waist acts like the fulcrum in a lever system
 Your lifting ration is about 10:1. Lifting a 10lb object puts
100 lbs of stress on your lower back
 Add in the 106lbs of the average human upper torso, lifting a
10lb object actually puts 1,150 lbs of pressure on your lower
back!
 It is easy to see how repetitive lifting and bending can lead to
back problems
 Even leaning forward while sitting at a desk can eventually
lead to back injuries.
Correct Lifting
 Keep your lumbar spine in ”neutral.” To find your lumbar
neutral arch and bow your back to the maximum in each
direction. Mid-range is your lumbar neutral
 Engage your abdominal muscles
 Use your legs/thigh muscles to lift
 Hold the load as close as you can to your center of gravity.
This decreases the stress on your back
 Always remember DO NOT lift heavy loads higher than waistheight and lighter ones higher than chest height
Proper Lifting Technique
Plan Lift, Then Lift
Tighten
Abdominals
Get Close
Lift with
your legs
Hold
Close
Turn by
stepping
Prevention
 Always be aware of your technique
- Poor body mechanics e.g. stooping,
repetitive bending
- Prolonged activity e.g. sitting or
standing
- Fatigue (take a small break)
- Heavy loads (use tools/machines
when possible)
 Adjust workplace to the worker
 Do not adjust worker to the workplace
Thank You!
Any Questions?
James Grubinskas, DC., CEAS
Alliance Occupational Medicine
315 South Abbott Ave., Milpitas
2737 Walsh Ave., Santa Clara
1901 Monterey Rd. Ste., San Jose