THE WORKING BACK -- CONTENTS -- ACKNOWLEDGMENTS -- CHAPTER 1 INTRODUCTION -- 1.1 Audience for the Book -- 1.2 Apolitical Causality Assessment -- 1.3 A Systems View of Low Back Pain Causality -- 1.4 The Reality of Work -- 1.5 How Might the Different Aspects of Work Be Associated with Back Pain -- 1.6 Organization of the Book -- CHAPTER 2 BACK PAIN MAGNITUDE AND POTENTIAL RISK FACTORS -- 2.1 What is Back Pain? -- 2.2 How Common is Back Pain? -- 2.3 Back Pain at Work -- 2.4 Epidemiology of Work Risk Factors -- 2.5 Epidemiology of Physical Risk Factors -- 2.6 Epidemiology of Individual (Personal) Risk Factors -- 2.6.1 Age -- 2.6.2 Gender -- 2.6.3 Anthropometry -- 2.6.4 Fitness/Strength -- 2.6.5 Alcohol -- 2.6.6 Smoking -- 2.6.7 Heredity/Genetics -- 2.6.8 Social Class and Psychological Factors -- 2.7 Epidemiology of Work-Related Psychosocial/Organizational Factors -- 2.8 Potential Interaction of Physical and Psychosocial Factors -- Key Points -- CHAPTER 3 FUNCTION, STRUCTURE, AND SUPPORT OF THE BACK -- 3.1 Body Coordinates -- 3.2 Bony Structures of the Spine -- 3.3 The Disc (and the Spinal Joint) -- 3.4 Functional Spinal Unit -- 3.5 Spine Support -- 3.6 Ligaments -- 3.7 Muscles -- 3.8 Fascia -- 3.9 Nerves -- 3.10 Blood Vessels -- 3.11 End Plates and Nutrition -- 3.12 Facets -- 3.13 The System -- Key Points -- CHAPTER 4 THE PROCESS OF PAIN -- 4.1 What is Pain? -- 4.2 Origins of Pain -- 4.3 Pain Transmission -- 4.4 The Pain Process -- 4.5 The Inflammatory Process (Cytokines) -- 4.6 Peripheral Nervous System Sensitization -- 4.7 Neuropathic Pain: The Cytokine Cascade and Nerve Sensitization -- 4.8 Pain Mechanisms of the Central Nervous System -- 4.9 Role of the Environment in Central Sensitization -- 4.10 Implications for Low Back Pain -- 4.11 Nerves at Risk of Sensitization -- 4.12 Tissues at Risk of Sensitization -- 4.13 Disk and Nerve Roots.

4.14 Facet Joints -- 4.15 Muscular-Based Pain -- 4.16 Lumbar Nerve Roots -- 4.17 Relationship between Tissue Loading and Pain -- 4.18 Conclusions -- Key Points -- CHAPTER 5 POTENTIAL PATHWAYS TO BACK PAIN -- 5.1 Views of Back Pain Causality -- 5.2 A Unifying Model of Low Back Pain Pathways -- 5.3 The Support Structure Disruption Pathways -- 5.3.1 Support Structure Tolerance -- 5.4 Disc Tolerance Summary -- 5.5 Pain Tolerance -- 5.6 The Muscle Function Disruption Pathway -- 5.7 The Role of Individual Differences in the Pain Pathways -- 5.8 System Feedback -- 5.9 Summary -- Key Points -- CHAPTER 6 THE ASSESSMENT OF BIOMECHANICAL FORCES ACTING ON THE LOW BACK -- 6.1 Biomechanical Concepts Applicable to the Back -- 6.1.1 Load Tolerance -- 6.1.2 Moments and Levers -- 6.1.3 External Versus Internal Loading -- 6.2 How can we Modify Internal Spine Loads? -- 6.2.1 Biomechanical Arrangement of the Musculoskeletal Lever System -- 6.2.2 Length-Strength Relationship -- 6.2.3 The Impact of Velocity on Muscle Force -- 6.2.4 Temporal Relationships -- 6.3 Incorporating Spine Load Reductions into the Work System -- 6.4 Loading of the Lumbar Spine -- 6.5 Spine Load Assessments -- 6.6 Models of Spine Load -- 6.7 Biologically Driven Modeling of Spine Loading -- 6.8 Stability-Driven Spine Loading Models -- 6.8.1 Predictions of Muscle (Motor) Control within Torso -- 6.9 What Drives Motor Control? The Mental Model -- 6.10 Summary -- Key Points -- CHAPTER 7 THE INFLUENCE OF PHYSICAL WORK FACTORS ON MUSCLE ACTIVITIES AND SPINE LOADS -- 7.1 Introduction -- 7.2 Industrial Quantitative Surveillance of Physical Exposure -- 7.3 Strength Capacity Assessments of Work Load -- 7.3.1 Static Analyses of Work Load -- 7.4 Dynamic Analyses of Work Load -- 7.5 Surveillance Conclusions -- 7.6 Spine Loading and Task Performance -- 7.7 Spine Loading and Primary Physical Workplace Factors.

7.7.1 Moment Exposure -- 7.8 Role of Trunk Muscle Cocontraction in Spine Loading -- 7.9 Trunk Motion -- 7.10 Nonsagittal Plane Loading -- 7.10.1 Lateral Motion -- 7.10.2 Twisting Motion -- 7.10.3 Task Asymmetry -- 7.10.4 Lift Height -- 7.10.5 One-Handed Versus Two-Handed Lifting -- 7.11 Lifting Versus Lowering -- 7.11.1 Cumulative Exposure -- 7.12 Duration of Exposure to Lifting Tasks -- 7.13 Worker Experience, Task Frequency, and Moment Exposure -- 7.14 Spine Loading Associated with Modification of Physical Workplace Factors -- 7.14.1 Handles -- 7.15 Lifting While Supporting the Body -- 7.16 Team Lifting -- 7.17 Pushing and Pulling -- 7.18 Seated and Constrained Work Postures -- 7.19 Physical Work Factor Summary -- 7.20 Summary -- Key Points -- CHAPTER 8 PSYCHOSOCIAL AND ORGANIZATIONAL FACTOR INFLUENCE ON SPINE LOADING -- 8.1 Introduction -- 8.2 Psychosocial and Organizational Interactions -- 8.3 Biomechanical Responses to Psychosocial Environment -- 8.4 Biomechanical Responses to Mental Stress at Work -- 8.5 Expectation -- 8.6 Conclusions -- Key Points -- CHAPTER 9 INDIVIDUAL FACTORS ROLE IN SPINE LOADING -- 9.1 Introduction -- 9.2 Gender -- 9.2.1 Personality -- 9.3 Experience -- 9.4 Conclusions -- Key Points -- CHAPTER 10 PHYSICAL, INDIVIDUAL, AND PSYCHOSOCIAL/ORGANIZATIONAL RISK FACTOR INTERACTIONS -- 10.1 When Risk Factors Collide -- 10.2 The Magnitude of Influence of the Three Risk Factor Categories -- 10.3 Can Risk Factor Interactions be Predicted? -- 10.4 Conclusions -- Key Points -- CHAPTER 11 ENGINEERING CONTROLS TO MEDIATE BACK PAIN AT WORK: TOOLS FOR THE ASSESSMENT OF PHYSICAL FACTOR IMPACT ON SPINE LOADS AND INTERVENTION EFFECTIVENESS -- 11.1 Introduction -- 11.2 Static Strength Prediction Programs -- 11.3 Psychophysical Tolerance Limits -- 11.4 Job Demand Index -- 11.5 NIOSH Lifting Guide and Revised Equation.

11.5.1 The 1981 Lifting Guide -- 11.5.2 The 1993 Revised Equation -- 11.6 Video-Based Biomechanical Models -- 11.7 Lumbar Motion Monitor Risk Assessment -- 11.8 Lifting Threshold Limit Values (TLVs) -- 11.9 Workplace Assessment Comparisons -- 11.10 Conclusions -- Key Points -- CHAPTER 12 ADMINISTRATIVE CONTROLS FOR THE WORKPLACE: PSYCHOSOCIAL AND ORGANIZATIONAL INTERVENTIONS -- 12.1 Implementing Psychosocial and Organizational Change -- 12.2 Elements of the Process -- 12.3 Traditional Administrative Controls -- 12.3.1 Worker Selection -- 12.3.2 Worker Rotation -- 12.3.3 Training -- 12.3.4 Stretching Programs -- 12.3.5 Back Belts -- 12.4 Summary -- Key Points -- CHAPTER 13 INTEGRATING RISK INTERVENTIONS INTO THE WORKPLACE -- 13.1 Introduction -- 13.2 Systems Intervention -- 13.3 Examples of Intervention Effectiveness -- 13.3.1 Patient Handling Interventions -- 13.3.2 Types of Physical Interventions -- 13.4 Implementing Both Physical and Psychosocial Interventions -- 13.4.1 Distribution Center Interventions -- 13.5 Summary -- Key Points -- CHAPTER 14 UNDERSTANDING RECURRENT LOW BACK PAIN AND IMPLICATIONS FOR RETURN TO WORK -- 14.1 Introduction -- 14.2 The Natural History of Low Back Pain Recovery -- 14.3 How can One Quantify the Extent of Low Back Pain? -- 14.3.1 Impairment Assessment -- 14.3.2 Effort Sincerity -- 14.4 Spine Loading of those Experiencing Low Back Pain -- 14.5 Can Kinematic Impairment Assessments Predict Changes in Spine Loading? -- 14.6 Lifting Exposure Limits for Workers with LBP -- 14.7 Recurrence of LBP and Work -- 14.8 A Return-to-Work Strategy -- 14.9 Conclusions -- Key Points -- CHAPTER 15 CONCLUSIONS -- 15.1 Summary -- INDEX.