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Improving Workplace Safety: The 10 Most Common Lost-time Injuries and Ways to Prevent Them

A review of approved workers' compensation claims in Ohio from 1996 to 2005 found that five of the 10 most common lost-time injuries involved the spine. Four of these are specifically back related and seven of the top 10 were sprains or strains. This article lists and explains these common injuries, and offers information about common causes leading to these injuries and how to prevent them. Note: This is not intended to be medical advice. Be sure to consult a physician for specific advice. Contact your State Workers’ Comp department for more information.

01 Sprain/strain, lumbar region of back

The lumbar region of the spine is the lower back. A sprain or strain occurs when there's extra pressure placed on a back that is already vulnerable. Lifting and/or bending at the waist can contribute to lumbar sprains or strains. Even a particularly violent sneeze can trigger these injuries. During the study period, 56,000 claims or 13% of all lost-time claims approved in Ohio included the diagnosis of a lumbar sprain or strain.

02 Sprain/strain, neck

Neck sprains and/or strains can occur when the head and neck wrench around violently, stretching the muscles or tearing the ligaments that hold the cervical vertebrae. Motor vehicle crashes, prolonged awkward posture and overhead work are common causes. Neck sprains or strains accounted for 34,700 lost-time workplace injuries in Ohio during the study period. Defensive driving and avoiding occupational risk factors are your best protection against this type of injury. Exercises that strengthen the neck muscles can help.

03 Sprain/strain, lumbosacral region of back

Lumbosacral strains or sprains result from excessive stretching of muscles or tearing of the ligaments supporting the lower back, including those supporting the sacral vertebra—the five fused bones at the base of the spine. Common causes include traumatic events—a fall, sudden movement —and overuse of the back muscles by lifting and other stresses. As with any sprain, the pain caused by the injury can irritate the surrounding muscles, causing them to contract and causing even more pain. With lumbosacral sprains particularly, the pain can severely limit everyday activities.

04 Sprain, shoulder and upper arm

Shoulder and upper arm sprains involve the partial tearing of the ligaments and tissues that surround and connect the bones of the shoulder. Falling on an outstretched arm, twisting or pulling of the shoulder or arm and one-handed lifting can cause these types of sprains.

05 Sprain, leg and knee

Leg and knee sprains involve the tearing of the ligaments supporting the knee. This can happen when the knee is forcefully twisted by stopping suddenly while running, stepping awkwardly while twisting, falling or being hit on either side of the knee or in the front of the knee while it is bent and the foot is planted on the ground.

06 Sprain/sprain, thoracic region

The 12 vertebrae between the neck and the lower back hold the ribs and make up the thoracic region of the spine. Pushing and pulling often cause a strain or sprain here, which affects the muscles and ligaments of the middle of the back. Sudden forceful trauma, such as being in a car crash, can cause severe cases.

07 Lumbar disc displacement

Between each pair of vertebrae is a disc of strong tissue that connects and cushions the vertebrae. The gelatinous center of the discs can dry out over time and become less effective. This can eventually cause the center to squeeze out through a crack in the outer layer. Also called a herniated disc, this usually occurs below the waist, in the bottom two discs of the lumbar region of the spine. Due to Ohio workers' compensation requirements, lumbar disc displacement is usually accompanied by an allowance of a lumbar sprain or strain. Patty Phillips, BWC's injury management services director, says the disc displacement was usually present in such cases all along. The preliminary diagnosis of a sprain or strain is appropriate until a subsequent examination confirms the disc displacement. Early treatments involve rest, punctuated with exercises to keep joint stiffness and muscle weakness from setting in. Treatment also includes anti-inflammatory medicines and drugs to control pain. Your caregiver may try a variety of other methods to reduce pain enough to allow you to start the exercises required to return to a more normal lifestyle.

08 Sprain, ankle

An ankle sprain is a tear of one or more of the ligaments that support the ankle. It can happen by falling or suddenly twisting the ankle.

09 Contusion, knee

Contusion means bruise. It's a swelling and discoloration of the skin caused when the underlying blood vessels are damaged in an injury and leak blood under the skin. Bruises generally do not pose a medical emergency; nonetheless, they should receive immediate care. Severe bruising can lead to extreme swelling and bleeding and may be a sign of underlying tissue damage, such as a broken bone.

10 Tear, medial meniscus

Menisci are shock-absorbing tissues between the bones in the knee. There are two in each knee, with the lateral meniscus on the outer side of the knee and the medial on the inner side. Most injuries to the meniscus are trauma related, a compression or twisting of the knee caused by sudden movements. The inner tissues of the menisci break down over time, so even minor events like squatting can injure the menisci in an older person.

Treating tears, sprains, and strains

Put injuries on RICE Many of these common workplace injuries will heal without surgery, but it's always a good idea to consult with a health-care practitioner. Even what looks like a simple bruise may overlay a broken bone or other tissue damage. But for most of these injuries, RICE is all you need to facilitate healing. RICE is an acronym for:

Rest—Take a break from the activities that contributed to the injury or aggravate the injured tissue;

Ice—Apply ice to reduce bleeding and swelling, control pain and muscle spasms. Apply ice for 20 to 30 minutes with a one- or two hour break between applications;

Compression—Use an elastic bandage to compress the injured area, reducing bleeding and swelling;

Elevation—Raise the injured body part above the heart. Gravity will help drain fluids and/or minimize swelling.

Over-the-counter medications to reduce inflammation and pain can also help during the healing process. Equipment is available to help speed recovery as well. Slings and braces immobilize an injured arm. Knee and ankle braces can support those joints while they heal. Cervical collars take weight off a sprained neck. Some people look to alternative medical practices—relaxation training, biofeedback. acupuncture and chiropractic or osteopathic manipulation—to reduce pain during recovery.

-- Ohio Bureau of Worker's Compensation, 2006