There are well-documented differences in the health and well-being of males and females, including several back pain issues and related conditions that women are more susceptible to developing. Notably, women report more low back pain from work, especially if they work 40-45 hours weekly.
For female employees, back pain is more likely to become chronic over time. This is a challenge that impacts a woman’s workplace performance and prompts employers to recognize opportunities for enhancing an employee’s overall health while improving on-the-job productivity, reducing disability and workers’ compensation claims and decreasing absenteeism.
Risk factors for low back pain (LBP) include work-related ergonomic factors, obesity, and smoking, with LBP more prevalent in women than men in all age groups. More precisely, a recent study showed that the associated factors for women’s back pain were occupational activities that involved heavy lifting, standing or sitting posture leaning forward and sitting at the computer three or more days per week.
These challenges are most compelling for positions that are dominated by women, in the labor force including:
- Registered Nurses
- Elementary and Middle School Teachers
- Secretaries and Administrative Assistants
- Customer Service Representatives
- First-Line Supervisors of Retail Sales Workers
- Accountants and Auditors
- Financial Managers
- Nursing Assistants
- Bookkeeping, Accounting and Auditing Clerks
Reality of Women’s Back Pain
Throughout their working lives, women face a number of health events that may result in back pain and related problems that become unmanageable at work.
A common cause of lower back pain in females is pregnancy, with pain attributed to pressure that the growing baby puts on the spine and muscles in the back. Additionally, hormonal changes during pregnancy can loosen the ligaments that support the spine, which can also contribute to back pain.
The American Pregnancy Association (APA) reports that the number of pregnant women who experience back pain is somewhere between 50 to 70 percent and over the last 40 years, the average age of women having their first child has risen from 21.4 to 25 years of age.
One important caveat is that most pain relievers aren’t safe to take during pregnancy–even over-the-counter ones. Prolonged use of acetaminophens (Tylenol) and NSAIDs (ibuprofen) are considered risky, and opioid pain killers increase the odds of birth defects, heart problems, premature birth or even stillbirth. For these reasons, female workers often turn to drug-free chiropractic care or physical therapy.
According to the Foundation 4 Chiropractic Progress, 94% of women report significant improvement while receiving chiropractic care. And there are no known contraindications to chiropractic care throughout pregnancy, says the American Chiropractic Association, noting that all Doctors of Chiropractic (DCs) chiropractors are trained to work with women who are pregnant.
DCs and other clinicians often prescribe custom-crafted, flexible orthotics (such as Mother Nurture™) which are designed to reduce or eliminate back or foot pain and discomfort during pregnancy and postpartum following delivery.
Benefits decision-makers should also be aware of the newly enacted Pregnant Workers Fairness Act, requiring employers to provide “reasonable accommodations” to pregnant workers. This rare bipartisan legislation aims to enhance protections for pregnant and nursing mothers in the workplace. Among the occupational health of pregnant workers are hazardous circumstances that involve doing jobs in which women must lift heavy objects or stand for long periods of time—requirements that may lead to back pain.
One of the most important contributions to a healthy pregnancy is good posture, especially for women who stand or sit in one position for long time periods. Proper alignment can decrease low back and neck pain and fatigue. Unfortunately, poor posture occurs naturally as the abdominal muscles become stretched as the baby grows. These muscles are less able to contract and keep the lower back in proper alignment, while hormone levels increase during pregnancy and cause joints and ligaments to loosen.
While many women are already working from home or choose this option during pregnancy, it is important to keep the body in alignment while sitting in an office or in a home-based office setting. Trying not to slump or slouch is key to avoiding back pain issues. Throughout the workday, and particularly while working on the computer, it is essential to use a sturdy chair with low-back support and tilt the pelvis forward to prevent the swayback position. Knees should be slightly lower than the hips and feet should touch the floor.
Poor posture puts unnecessary strain on the spine and muscles in the back, which can lead to pain and discomfort. Working women are especially susceptible to poor posture that results from wearing high heels or carrying heavy purses.
Healthcare analysts say that OA is not an equal-opportunity disorder since it appears to favor women. Among people with osteoarthritis, there are twice as many women as men, especially for those with arthritis in the knees and hands. Symptoms typically begin to appear in women in their 40’s and 50’s, and the disparity becomes even greater after age 55, after women enter menopause. The spine is a prime target for this common joint condition.
By far the most important risk factor for osteoarthritis in women is obesity. Women who go through menopause often gain weight, and the increased stress on the joints may explain the rise in osteoarthritis seen among women after age 55. By the time a woman reaches 65, she is twice as likely as a man to experience osteoarthritis symptoms.
Another possible explanation is anatomical as women’s hips are wider than men’s. The angle formed by the hip bones being wider than the knees puts more stress on the outside of the knees. The increased prevalence of osteoarthritis in women has also triggered studies to determine the role of hormones. While the roles of hormones such as estrogen and progesterone in osteoarthritis are unclear, the role of a hormone called relaxin, which is increased during pregnancy and makes joints more lax, causes potential instability.
Some of the common work restrictions given to women with osteoarthritis include: no typing or limited typing; no lifting anything over a certain weight limit, typically five pounds but possibly as little as two pounds. These limitations may be challenging since women are often called upon to perform these tasks.
Working women of all ages should take precautions to reduce the risk of developing OA, including:
- Achieving and maintaining a healthy weight
- Incorporating exercise into daily activities
- Staying strong and flexible to reduce your risk of injury
- Seeing your doctor to determine the best course of therapy if you are experiencing arthritis symptoms.
Endometriosis is a condition in which the tissue that lines the uterus grows outside of the uterus. This can cause pain and cramping, as well as lower back pain. Endometriosis is a common cause of chronic pelvic pain in women, which can radiate into the back and can be a difficult condition to manage. Surveys show that living with this disease may be characterized by physical limitations that disrupt health, work, and daily life.
This condition is shown to have a substantial negative impact on work performance, with with qualitative studies documenting patient-reported negative experiences at work. Many reported a noticeable decrease in the quality of their work and almost 20% reported being unable to work because of pain. 69% of the patients reported that they continue working despite feeling pain, a phenomenon called “presenteeism.”
Another common cause of pain in the lower back or a woman’s abdomen is menstrual cramps, caused by the uterus contracting to shed its lining. Menstrual cramps are most common in women of childbearing age, but they can occur at any age.
As a result, menstrual symptoms reduce workplace productivity, with 45.2% reporting that their symptoms require them to take days off, according to a new UVA Health survey. In other studies, significant majorities of women reported that menstrual symptoms had a moderate to severe effect on factors affecting their work.
Role of Employers
The societal and economic impact from low back pain among women is enormous and can be measured in loss of productivity from missed days at work and a reliance on medication to alleviate pain. Companies that introduce prevention strategies targeting risk factors of ergonomics, especially for a workforce dominated by women, can minimize the impact of this chronic health condition.
Today, employers can reduce back pain by making wellness programs a top priority for their female employees. The Society for Human Resource Management (SHRM) reports that LBP can cost $34,600 in lost productivity and under performance for every 100 workers. Many businesses are already leading the way with innovative ideas and actions that include:
- Employee On-site, Near-site Health Clinics, Including Chiropractic or Clinician Care
- Gym Discounts and Memberships
- Ergonomic Furniture and Standing Desks
- Healthy Work Culture and Food Choices
Thinking outside-the-box helps reduce back pain among female staff members—an investment that pays off in health savings and higher productivity in the long term.
Jamie Greenawalt is President at Foot Levelers.