Worker's Compensation Light Duty

Worker's Compensation Light Duty

 

I have been treating a patient referred to me by Worker's Compensation.  This patient had a diagnosis of lower back pain.  His job consists of sitting at a desk for 8 hours straight with only two 15 minute breaks to get up to use the bathroom and an hour lunch.  Many propose that the time spent in sitting should be limited to 50 minutes before a short 'standing' break is taken.  

This patient states only the timed breaks described are allowed by the supervisor.  Therefore, I suggested that during this break, the employee perform the opposite movement/activity that they were performing while working.  Since sitting imposes flexion on the spine, which stresses the intervertebral disc's annulus fibrosis and may lead to disc posterior "creep," it is suggested that you stand up tall, raise the arms overhead, and push the hands toward the ceiling with a deep inhale.  This will fully extend the lower back, which reduces the annulus stresses.  I recommended that this patient stand as often as possible throughout the work day to go through the necessary work related paperwork.  Instead of sitting in a chair, bending forward to go through a bin of papers, place the bin on a higher surface and stand to do the same activity.  This will allow you to continue doing your job (so your supervisor can't complain), while at the same time 'sparing' your spine.  Your goal is to continually change positions so that the strain on your spine is not focused solely on one location, but shifts. It seems that patients who come to me with lower back pain are those who remain in the same position for extended periods of time.  If they were able to change positions frequently during their shift, their spine would be 'healthier.'  Unfortunately, once these patients are injured, they are usually placed on light duty, which consists of sitting in one position for even longer times during the work day, with minimal physical activity.