Stress appears to be the leading risk factor for back pain and injuries, said Michael R. Bracko, Ed.D., FACSM today during an address at the American College of Sports Medicine (ACSM) 10th-annual Health & Fitness Summit & Exposition in Orlando. A properly designed and executed fitness program hastens recovery and often prevents back injuries.

Sixty to 80 percent of the population in North America will suffer from back pain or injuries at some point during their lives, with one to five percent of that group suffering chronic back pain that lasts six months or longer. Back pain is the most frequent cause of activity limitation among those under 45. Although 80 to 90 percent of individuals will recover from back pain within three to six days of their injury, statistics estimate $31 million is spent on office visits to physicians for back pain, but only three percent of that total cost goes to prevention of back pain.

Stress at home and in the workplace most often creates back problems. "Stress manifests itself to cause our muscles to go 'Boing!' and into a spasm to cause us to cry, not get out of bed, worry about coughing, worry about our jobs, and worry about not being able to work again, among other things," said Bracko. "Managing stress, knowing other risk factors and working it all out through exercise is a great way to keep back injuries at bay."

Individual Risk Factors

In addition to controlling stress in one's personal life, activities at home, recreation, exercise and family life can contribute to the potential of a back injury. Other factors include:

-- Lack of sleep/fatigue
-- Emotional instability
-- Family problems
-- Substance abuse
-- Lack of physical activity/too much physical activity
-- Poor muscle endurance and poor trunk muscle stabilization
-- Excessive weight

Occupational Risk Factors

The workplace is a unique contributor to opportunities for back pain and injuries. Truck drivers, nurses and young workers have the highest rates of back injury. In one study, only half of low-back injured workers, off work for six months or longer, returned their regular jobs. Several studies have documented an increased risk of disc herniation for those who perform sedentary jobs characterized by sitting.

Other risk factors include:

-- Heavy physical work
-- Static posture - sitting and standing
-- Repetitive work (bending, twisting, pushing, pulling and lifting)
-- Slipping, tripping or falling
-- Twisting while spine is loaded (carrying something)
-- Vibration while driving
-- Fatigue/poor muscle endurance (excessive overtime, work-to-rest ratio)
-- "Attitude" at work leading to accidents (poor or high-risk attitude)
-- Lack of work satisfaction and lack of motivation
-- Mental fatigue (forgetting to lift properly)

For office workers, Bracko noted the general rule is to be seated in an ergonomically-sound chair with the ankles, knees, hips, and elbows at approximately 90 - 100 degrees.

Exercise for Prevention

A variety of exercises can be performed in an attempt to prevent back injuries, but being active is key to disc health, says Bracko. Exercise is the best method of reducing the negative effects of stress, in addition to improving general health. Bracko specifically recommends training abdominal muscles to help strengthen and support the back.

"People tend to bend at the waist because it is less fatiguing," said Bracko. "But, pay close attention to posture while lifting or stretching. It is important to maintain the natural curves in spine to avoid a back injury."

The American College of Sports Medicine (ACSM) is the largest sports medicine and exercise science organization in the world. More than 20,000 International, National and Regional members are dedicated to promoting and integrating scientific research, education and practical applications of sports medicine and exercise science to maintain and enhance physical performance, fitness, health and quality of life.

American College of Sports Medicine (ACSM)