Category Archives: HOME. Backache and chairs

Back pain and chairs. The biomechanical (ergonomic) factors resulting in backache (LBP) and the requirements for remediation.

Managing the Ergonomics

Managing the Ergonomics of Office Seating

 by John Jukes                       The Source Publishing Company Limited 

Ergonomics expert John Jukes asks is the Sit/Stand desk the answer to aches and pains in the office?

Research done by Dr Henry Sanford see, Orthopaedic Consultant at the Cromwell Hospital adds another dimension to the problem of ergonomic comfort in the office. Sitting in a semi reclined position at 45 degrees reduces the gravitational loading on the spine by 50%. This is similar to the astronaut position, which permits working under heavy G forces. A suitable headrest and positioning of keyboard and VDU screen makes this a perfectly practical working position without inducing sleep. Many programmers, CAD users, control room engineers and tall people are seen to adopt this position using an ordinary chair when  working for long periods – perching the tail on the front edge of the chair with their shoulder on the back and the legs out straight.

Sit/stand desks and pelvic support semi recline seating  in the UK have yet to become part of the normal office landscape. When they do there will be several million office workers that will be grateful to be free from daily debilitating pain.

 

He wrote

Dr Henry Sanford MA. MB. B Chir. (Cantab) D  Phys Med. (Lond) is a well known Consultant Orthopaedic Physician in London and Associate Consultant to the Department of Rheumatology, St Thomas’s Hospital, SE1.  Earlier he worked at St Thomas’s with Dr J H Cyriax who is regarded as the ‘Father’ of  Orthopaedic (or Musculo-skeletal) Medicine after following 2 years in the army finishing as a Captain in the RAMC.

He was a founder member of the Society of Orthopaedic Medicine (SOM), the British Society of Musculo-skeletal Medicine (BIMM) and was Chairman of the Cyriax Organisation..  He has run courses and lectured internationally                                                              John Jukes – 30/07/2001

 

HAS19.07.34HAS & M19.08.43                  

 

 

 

 

HAS in BAOR,1954

and with daughter, Marietta, in Cambridge, 2005.

Prevalence and economic cost of LBP.

 The increasing backache prevalence seems to be a genuine phenomenon of the 20th/21st centuries in Western societies at the same time as the increase in sedentary occupations and lack of exercise ..  The scale of mechanical  Low Back Pain (LBP) problems is confirmed by many studies from many countries.

Screen Shot 2018-06-11 at 21.35.22There has been a slight drop in prevalence in the last few years.  Perhaps it is presumptuous to suggest that this may be due to improved seating following my views put forward  in 1998 although a full 2T chair is not yet in the market.

LBP is the most common health problem for British workers. The Clinical Standards Advisory Group (Waddell), in 1994, in a study of the  backache prevalence and it’s cost  estimated that, since 1978 the  annual loss of working days due to low back pain had increased 200% to 150 million days.    A study in Manchester (Croft 1998) showed that 50% of women aged 45-50 claimed to have suffered from backache in the previous  month.  A prospective UK trial (Croft 1999) showed a 36% increase in prevalence of backache and incidence rate in 1 year.    Since then there has been a slight drop possibly due to better designed chairs, many of which are slowly approaching my views.

Back pain is also one of the most costly conditions for which an economic analysis has been carried out in the UK and this is in line with findings in other countries. It is estimated that the direct health care cost of back pain in 1998 to be £1632 million.  Approximately 35% of this cost is most likely paid for directly by patients. With respect to the distribution of cost across different providers, 37% relates to care provided by physiotherapists and allied specialists, 31% is incurred in the hospital sector, 14% relates to primary care, 7% to medication, 6% to community care and 5% to radiology and imaging used for investigation purposes. However, the direct cost of back pain is insignificant compared to the cost of informal care and the production losses related to it, which total £10668 million.  (Maniadakis N, Gray A. 2001)   (Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000 Jan;84(1):95-103.)

The Centre for Health Economics (CHE) showed a cost to the UK NHS of £265.3 billion – £382.7 billion in 1992-93.  https://www.york.ac.uk/che/pdf/DP129.pdf

The Work Foundation estimates that employees suffering from bone and joint pain cost the EU’s economies 240bn euros (£200bn) each year.  “Sitting is the new smoking,” explains Prof Steve Bevan, director of the Centre for Workforce Effectiveness at the Work Foundation.  “The more sedentary you are the worse it is for your health.”   The Lancet, published a study in 2012, which found that musculoskeletal conditions were the second greatest cause of disability in the world, affecting over 1.7 billion people worldwide.  “I describe suffering from musculoskeletal disorders as being like a Ferrari without wheels,” says Prof Woolf, who is also the chair of Bone and Joint Decade. “If you don’t have mobility and dexterity, it doesn’t matter how healthy the rest of your body is.”

In the United States About 100 million workdays are lost annually  (Johanning 2000).  Insurance figures show that 82% of US office workers complain of LBP (personal communication 2012 HAS),   Lower back pain’s economic impact is shown to be the number one reason for individuals under the age of 45 to limit their activity, second highest complaint seen in physician’s offices, fifth most common requirement for hospitalization, and the third leading cause for surgery.  (Health and Safety Executive‘s Better Backs campaign.https://en.wikipedia.org/wiki/Health_and_Safety_Executive).

The actual increase of mechanical spinal pathology and backache prevalence seems to be a genuine phenomenon of the 20th century and is rising exponentially (Hemingway 1997) with the increase in sedentary occupations.”Mankind has progressed from Homo sapiens to ‘Homo sedans” (Mandal).

(Prevalence = the number of existing cases overall.   Incidence = the number of new cases in a given time.)

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