Back injuries in the workplace cause a great deal of pain, suffering, and expense. For many employers, back injuries account for 20 to 25 percent, or more, of their workers' compensation injuries. Employers, however, are often at a loss when it comes to getting a handle on preventing work-related back injuries and managing back injury claim costs.

While back injuries occur in virtually every work setting, there are some commonalities that can help employers direct their efforts toward reducing the occurrence and cost of these injuries. According to the University of British Columbia Back Study, the following risk factors have consistently been found to be related to back pain and back injuries:

• increasing age and length of job tenure


• working postures


• repeated lifting and heavy labor


• whole body vibration


• falls or other injury-causing events


• previous back pain


• work-related psychosocial factors, such as low job satisfaction, control, or support


• body condition and morphology, including being overweight, tall, or in poor physical condition


• smoking

Knowing these risk factors, employers can develop a prevention and management program that works best for their organization. Generally, to see real reductions in injury rates and costs, an employer needs to address a number of risk factors simultaneously; and while some of the risk factors may be difficult to target (for example, it is neither practical nor legal to eliminate workers from your workforce who are older or have been in jobs long term simply to reduce back injuries in your workplace), employers can certainly address others. Here are steps you can take:

Pay attention to how workers' comp claims are handled. An employer's attitude when an injured worker goes on temporary disability is a key factor in getting the employee back to work in a timely fashion, according to a study published in 2007 in the Journal of Occupational and Environmental Medicine. Workers who felt their employers handled their claims poorly were more likely to have lost-time claims and more than one period of joblessness. Employees are more likely to feel their claim is being handled well if 1) they understand the claim process, and 2) they can go to someone within their employer's organization if they are having difficulty with their claim. Employees also generally feel better about how their claims are handled if they remain connected to the organization throughout their recovery. For example, continue sending them company newsletters, memos, and bulletins; have a supervisor or co-worker call periodically to check up on them; and institute a return-to-work program that gets them back to work—if even only on light duty—as quickly as possible.

Establish a good working relationship with your workers' comp medical providers to help your employees get back to work more quickly. Recent research out of the Netherlands indicates that extensive patient education offered by healthcare providers that helps injured employees to better understand and manage their back pain allows employees to return to work more quickly. Medical providers often give little or no patient education when treating work-related injuries. By working with your medical professionals, you can encourage and assist them in providing that education. You can, for example, work with them to obtain educational materials and other resources and educate them on your workplace so that they more fully understand the environment the employees are exposed to.

Remove or reduce hazards that can cause slips, trips, and falls. Things as simple as using mats or rugs to provide nonslip walking surfaces in wet areas (including doorways and entrances) and ensuring that walking areas (both indoors and out) are kept clean and clear of debris and obstructions can help to prevent a painful—and expensive—slip and fall injury. Also, ensure that you have an effective fall protection program for employees who work at heights.

Whenever possible, remove heavy lifting from the equation. Instead, have employees use mechanical means, rather than only their bodies, to do the lifting.

Encourage overall health and wellness in the workforce. This includes encouraging and supporting exercise and weight management where appropriate.

Skip the back belts. A two-year study by the National Institute for Occupational Safety and Health indicates that back belts don't reduce the number of back injuries that occur in the workplace.

Don't just provide training, provide good training. An analysis recently published in the British Medical Journal which looked at studies on back injuries found that training did not have a significant impact on the number of back injuries that occurred among the workforce. The caveat to the analysis was that the training evaluated was not "engaging." Training provided to workers generally included simply stating to workers, "bend at the knees when lifting" and "no heavy lifting." Other studies (not included in the analysis) have found that training which engages the worker (e.g., having a trainer work with employees while they do their jobs to demonstrate proper postures and lifting) is effective in reducing back injuries.

Back injuries often are a large component of an employer's workers' comp costs. Even with that, many employers pay little attention to using a comprehensive approach for work-related back injuries. Establishing a multifaceted back injury prevention and management program takes time and effort; however, a good program can significantly reduce the number, severity, and cost of work-related back injuries.