A Case of Occupational Strain in a Middle-Aged Worker

Middle-aged Male with Occupational Strain

A Clinical Perspective on Work-Related Low Back Pain

low back pain scenario


Introduction

Work-related musculoskeletal disorders are among the most common causes of disability worldwide. Individuals in physically demanding jobs often experience pain due to repetitive movements, poor posture, and heavy lifting. This case study highlights a middle-aged male presenting with occupational strain-related low back pain, emphasizing its assessment, management, and preventive strategies.

Patient Profile

  • Age: 45 years

  • Gender: Male

  • Occupation: Warehouse worker

  • Chief Complaint: Persistent lower back pain for 3 months

History of Present Illness

The patient reported a gradual onset of dull aching pain in the lower back that worsens toward the end of his workday. The discomfort is aggravated by lifting heavy objects and prolonged standing. Temporary relief is achieved with rest and occasional over-the-counter pain medications. There is no history of trauma, systemic illness, or neurological symptoms such as numbness or tingling in the legs.

Clinical Examination

  • Posture: Slight forward-flexed lumbar posture observed.

  • Palpation: Tenderness noted over the lumbar paraspinal muscles.

  • Range of Motion: Pain-limited lumbar flexion and extension.

  • Muscle Strength: Mild weakness in abdominal and hip stabilizers.

  • Neurological Examination: Normal.

  • Special Tests: Straight Leg Raise negative, excluding nerve root compression.

Diagnosis

Based on the history and examination, the patient was diagnosed with:
Occupational Strain resulting in Mechanical Low Back Pain

Management Plan

1. Patient Education and Ergonomics

  • Instruction on safe lifting techniques (keeping load close to the body, bending knees instead of the back).

  • Incorporation of micro-breaks during long shifts to reduce fatigue.

  • Workstation adjustments such as proper shoe support and lumbar support belts.

2. Physiotherapy Interventions

  • Manual Therapy: Soft tissue mobilization for lumbar muscles to reduce stiffness.

  • Therapeutic Exercises:

    • Core strengthening (planks, bridging, pelvic tilts).

    • Flexibility training (hamstring stretches, hip flexor stretches).

    • Mobility exercises (cat-cow, lumbar rotations).

  • Postural Correction: Training in neutral spine alignment during daily activities.

3. Medical Management

  • Use of NSAIDs or muscle relaxants when pain interferes with daily functioning.

  • Heat therapy at the end of work shifts to relax muscles.

4. Lifestyle Modifications

  • Incorporating regular physical activity outside of work to maintain fitness.

  • Maintaining a healthy weight to reduce spinal load.

  • Adequate hydration and nutrition to support muscle health.

Prognosis

With early physiotherapy, ergonomic modifications, and patient compliance, recovery is expected within 6–12 weeks. Chronicity can be avoided if preventive strategies are consistently applied.

Preventive Strategies for Workers

  • Use mechanical aids (trolleys, forklifts) instead of manual lifting when possible.

  • Follow a structured stretching routine before and after shifts.

  • Employers should provide ergonomic training programs for their staff.

Key Takeaways

  • Occupational strain is a leading cause of low back pain in middle-aged workers.

  • Early intervention with physiotherapy prevents chronic disability.

  • Ergonomic awareness is crucial for long-term musculoskeletal health.

FAQs

Q1. What is occupational strain?
Occupational strain refers to musculoskeletal stress caused by repetitive work activities, poor posture, or heavy lifting that leads to pain or injury.

Q2. How is occupational strain different from an acute injury?
An acute injury occurs suddenly due to trauma, while occupational strain develops gradually from repetitive stress over time.

Q3. Can physiotherapy completely cure occupational back pain?
Yes, in most cases physiotherapy combined with lifestyle and ergonomic modifications leads to complete recovery.

Q4. When should I seek medical help for back pain?
Seek urgent medical care if pain is accompanied by numbness, weakness, difficulty walking, or loss of bladder/bowel control.

Q5. What exercises are best for occupational back pain?
Core strengthening (planks, bridges), stretching (hamstrings, hip flexors), and mobility drills (cat-cow, spinal rotations) are highly effective.

References

  1. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736–747.

  2. World Health Organization. Musculoskeletal health. WHO Fact Sheets, 2023.

  3. O’Sullivan P. Diagnosis and classification of chronic low back pain disorders. Manual Therapy. 2005;10(3):148–155.

  4. American Physical Therapy Association (APTA). Low back pain guidelines. 2022.


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