It’s not surprising that female workers are at increased risk of experiencing low back pain (LBP), given the stresses of work-family imbalance, on-the-job responsibilities and conditions that are exclusive to women and lead to spinal health problems. In fact, the CDC reports American women (40.6%) were more likely to experience back pain than men (37.2%). Some observers refer to this as the “gender pain bias”: the fact that women have a higher prevalence of back pain than men, with significantly higher prevalence for women who smoke, are overweight, have lower levels of social support or are less physically active.
For workforces that are dominated by women, the issues related to back pain can be most troublesome:
Source: US Department of Labor and Statistics
For Women Only: Conditions that Lead to Back Pain
Healthcare clinicians advise that there are several factors regarding back pain in the workspace that are exclusive to or more commonly seen among the female population.
In clinical practice, it is not uncommon for females to experience a spike in low back pain during their menstrual cycle or at the time of ovulation. The increase in intrabdominal pressure due to inflammation or uterine cramping can have a regional effect and cause a preexisting low back condition or what is normally a subclinical low back issue to flare up.
Considerations on the number of pregnancies, type of delivery such as C-section vs. vaginal delivery are important points in the treatment of the female with low back pain. One needs to appreciate that after pregnancy, a female’s core is weakened and this most often causes the pelvis to tip anteriorly. This pelvic position opens a huge opportunity for not only low back pain, but also gluteal amnesia, a “condition” where the individual is believed to have lost the ability to contract their gluteal muscles – generally the gluteus maximus. Additional issues include hip impingement, hip micro-instability, labral tears and premature hip osteoarthritis.
These and other conditions that are unique to women are appropriately treated with chiropractic care. Doctors of Chiropractic (DCs) are trained to initiate core retraining rehab, coupled with a custom flexible full length orthotic to stabilize the pelvis and lower kinetic chain. DCs as well as physical therapists are experts at providing pain relief that reduces the need for medications, including opioids. This level of care is critical for pregnant women who are advised to avoid drugs for pain relief.
An example of an organization making strides in patient-centered care is Kaizo Health. Chiropractic care has shown promise in addressing women’s back pain by targeting the underlying causes, such as misaligned vertebrae or muscular imbalances. Chiropractic is not only focused on alleviating women’s back pain but also empowering women to regain control of their health and well-being. This approach aligns with the mission to foster the health and happiness of patients and communities, emphasizing a holistic, non-invasive, and drug-free path to managing women’s back pain effectively.
Lastly and trending in the literature now is the realization that overall ligament laxity and fascial stability changes as the women undergoes hormonal fluctuations each month. While a painful neck or backache are attributed to tired muscles or stiff joints, these symptoms can also be caused by a part of the body called the fascia. Until recently, this network of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place received very little attention despite its major role in every move the body makes.
During the follicular phase of the female cycle, ligament laxity is increased, this causes instability of the pelvis as well as other joints of the body. This monthly flux in hormones although optimal for healthy females, creates an ebb and flow of unpredictability in low back pain.
Causes of Upper Back Pain in Females
Upper back pain in women usually results from:
- Poor posture, like slouching or pushing the head forward while sitting or standing, causing misalignment of the spine
- Muscle overuse or strain, usually due to repetitive motions or lifting items or children incorrectly
- Injury to discs, muscles and/or ligaments
- Myofascial pain
- Arthritis
Workplace Risk Factors for Back Pain
Sprains and strains for twisting or lifting something improperly, lifting something too heavy or over stretching are all common causes of lower back pain. Jobs that require heavy lifting, pushing, or pulling are more likely to lead to workplace injuries and back pain. For those who sit at a desk, poor ergonomics or posture can also result in back pain.
Back pain is also more common among women who are not physically fit, as weak back and abdominal muscles may not offer the spine enough support. Being overweight or obese, or quickly gaining a significant amount of weight, can also put stress on a woman’s back. The connection between back pain and emotional distress is also documented, as women can experience work-related stress in that takes a particular toll. One recent study found that heavy workloads, lack of control over one’s job, and lack of social support at work were all predictors of chronic low back pain.
Chronic back pain – pain that lasts for three months or longer – is more complex. In chronic lower back pain, the source of the pain is often unknown, or can’t be specifically identified. It may start with an injury but continue after the injury has healed.
Nerve pathways that carry pain signals from nerve endings through the spinal cord and to the brain may become sensitized, increasing the intensity or frequency of pain, even in response to stimuli – such as job-related responsibilities that were not previously painful.
Companies Step-Up Support for Addressing Women’s Back Pain
The economic and social impact of low and upper back pain among women can be measured in loss of productivity from missed days at work and a reliance on medication to alleviate pain. According to the Centers for Disease Control and Prevention (CDC), back pain costs employers $1,685 per employee every year. Across the nation, that equates to a loss to businesses of $225.8 billion.
Work-related performance issues have prompted employers to provide programs and services that introduce prevention and wellness strategies targeting risk factors of ergonomics, especially for a workforce dominated by women. In response, many businesses are already introducing innovative ideas and actions that include:
- On-site chiropractic care reduces workplace injuries and the high costs associated with those conditions, including absenteeism and potential opioid dependency. Proactive, preventive care brings down hospital stays, specialist visits and emergency room visits.
- An employee gym membership, also known as a corporate gym membership, makes it possible for women to receive free or heavily discounted memberships to the gym, personal training, health club, wellness center, yoga studio, or Zumba club.
- Ergonomic furniture and standing desks provide a friendly work station to help women reduce back pain. Employers increasingly consider using chairs with a backrest that supports the curve of a woman’s lower (lumbar) back.
- Employers are encouraging female employees to adopt some simple habits and routines during the workday and are providing “time-outs” for exercises that allow women to stretch their muscles in intervals and adjust their desk set-up so that they can try to work while standing up for short periods in between.
- Healthy work culture and food choices support women who want to maintain a healthy weight. A new study from School of Nutrition at Tufts and the Harvard T.H. Chan School of Public Health suggests that government and private sector cafeterias that comply with basic nutritional guidelines provided by the U.S. government for cafeterias can improve the health of the employees who eat lunch there—and save hundreds of millions in health care dollars, as well.
So many females are plagued by painful periods that in and of itself are disabling on a monthly basis. This makes it a challenge just getting to work and being productive. Additionally, for so many females, menstruation sets off the cascade of low back pain. For those females in jobs that require standing, bending, lifting, extended walking or sitting, it could be a difficult task to get through the day.
The multiple conditions that lead to back pain among women require greater employer understanding and sensitivity. As women enter the workforce in greater numbers, companies should consider programs that not only improve a woman’s health status, but also impact the bottom-line.
Dr. Christine Foss
Dr. Christine Foss. MD, DC, MS.Ed, ATC, DACBSP, ICSC has a Masters degree in Sports Medicine from Old Dominion University, a Doctorate in Chiropractic from New York Chiropractic College and a Doctor of Medicine degree from the University of Health Sciences. She is a Certified Athletic Trainer, Diplomate of the American Chiropractic Board of Sports Physicians and Internationally Certified Sports Chiropractor.
Dr. Foss has had many experiences treating and rehabilitating athletes as well as non-athletes. Co-owning and establishing Advanced Sports Medicine & Physical Therapy Center as well as Kidâs Therapy Center has been a passion. She worked in the Sports Medicine Department at the University of Notre Dame as well as volunteering at the Olympic Training Camps multiple times and locations. Dr. Foss has worked the World Games in Poland and the bobsleigh World Championships both for FICS. She additionally traveled with TEAM-USATF as medical staff. Dr. Foss has worked alongside prominent surgeons in the care and rehabilitation of athletic injuries.
Dr. Foss finds special interest in difficult cases and those patients that have had little success with conventional care as well as lecturing on a variety of aspects of sports injuries. She is currently director and lead instructor of the New York Chiropractic College âCertified Chiropractic Sports Physicianâ program and Education Chair for Federation Internationale de Chiropractique du Sport.
Jamie Greenawalt
Jamie Greenawalt, President of Foot Levelers, Inc., is a seasoned leader in healthcare and new business development. Under her guidance, Foot Levelers has introduced innovative products like Mother Nurture™, providing relief for pregnancy-related back and foot pain. Jamie has also overseen the launch of the 5th Avenue Collection, offering custom orthotics designed specifically for women's unique foot structure. Additionally, she has led the development of the InMotion+™ orthotic, combining premium performance and comfort. As the third-generation leader of Foot Levelers, Jamie continues her family's legacy of providing high-quality orthotics for a pain-free life.
