Lumbar sprain and work stoppage: All you need to know 

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THElumbar sprain, commonly called « kidney tower » ou « lumbago », is a fairly common condition characterized by the lesion of one or more ligaments located in the lower back.

In the vast majority of cases, the lumbar sprain is secondary to a Wrong move or the achievement of repetitive movements which is very frequently observed in the workplace.

Indeed, people exercising physical professions are particularly exposed to certain pathologies of the spine such as the herniated disc, theOsteoarthritis et thelumbar sprain.

In this article, we will focus on thelumbar sprain : what's this ? What are its impact on work ? Is it recognized as occupational disease ? Are we entitled to a work stopping in case of lumbar sprain?

What is a lumbar sprain?

As you know, our spine is made up of several vertebrae stacked on top of each other and separated by discs intervertebral.

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To unite all vertebrae between them and provide stability to the spine, there are many ligaments throughout the latter.

The ligaments are very strong fibrous structures which extend from one bone to another, unlike tendons which make the connection between a muscle and a bone.

When one of the ligaments in the lower back is overstretched, partially or totally broken, we are talking about a lumbar sprain.

The ligament most frequently affected in the event of a lumbar sprain is the iliolumbar ligament which extends from the last two vertebrae lumbar to the pelvic bones (iliac wings).

What are the causes of lumbar sprain?

THElumbar sprain is most often caused by:

  • Un Wrong move which causes severe acute stress on one of the ligaments in the lumbar region;
  • Personalized repetitive movements which cause microlesions (microscopic lesions) progressively weakening one or more ligaments until causing an anatomical lesion.
  • Un misalignment between the spine and the pelvis which predisposes to lumbar sprain, because certain ligaments are put under excessive tension. So they end up hurting themselves in the long run.
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The wrong moves and repetitive gestures are very common in many physical professions, hence the large number of spinal pathologies, including lumbar sprains, in the workplace.

How does a lumbar sprain manifest?

Lumbar sprain is mainly manifested by pain lumbar having the following characteristics:

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  • Location: the lower back (lumbar pain or lumbago) or the upper buttocks without giving radiation to the lower limb.
  • Mode of appearance: brutal, on the occasion of a trauma or false movement.
  • Aggravating factors: the pain worsens during movements of the spine (to lean forward, get up, turn around…).
  • Accompanying symptoms: stiffness, tension or contractures of the muscles of the lumbar region with lack of flexibility or even total blockage of the back.
  • Other signs: an increase in local heat and sometimes slight swelling are noticeable during the acute inflammatory phase.

For more details on lumbar sprain, its causes, symptoms and management, see the following article.

Lumbar sprain: work limitations

As mentioned above, the ligaments have the main function to ensure the stability of the spine, whether in a static position or during various movements.

When a vertebral ligament is damaged, it becomes unable to function properly and triggers sometimes very intense pain when it is solicited.

Thus, in the event of a lumbar sprain, certain movements of the spine become unachievable ou very painful, especially :

  • Prolonged standing or sitting;
  • Squat, climb or crawl;
  • Lifting heavy loads;
  • The lateral inclination of the trunk;
  • Twisting movements of the spine;
  • Anterior flexion (leaning forward);
  • Trunk extension;
  • The use of vibrating machines (low frequency)…

Of course, all these limitations can significantly interfere with work, or even prevent any professional activity that requires physical effort. This is why a work stopping may sometimes be necessary in the event of a lumbar sprain.

Indeed, whether it occurs in a professional environment or not, a lumbar sprain entitles you to a work stoppage.

The duration of the latter depends on many factors, including the severity of symptoms, severity of ligament injury, nature of work performed, the land (age, general physical condition, etc.), the response to medical treatment… In all cases, this duration must be fixed by a doctor after a accurate clinical assessment (+/— paraclinical).

In general, la duration of a work stoppage for lumbar sprain is a few days (5 days most often) a few weeks away. At the end of this period, a clinical reassessment is carried out by the doctor to extend the shutdown if necessary or allow a return to work in the event of recovery deemed sufficient.

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Lumbar sprain, recognized as an occupational disease?

THElumbar sprain, being an acute condition, is not considered an occupational disease. It may, however, be part of a work accident and be entitled to compensation.

In order not to lose your rights, the most important thing is:

  • That the diagnosis of lumbar sprain be made by a doctor (general practitioner or occupational physician).
  • Let a link be established between this lumbar sprain and a stain or a gesture performed during work (which caused the injury).

Moreover, in many cases, the diagnosis of lumbar sprain is made in a provisoire on the occasion of a acute episode of lower back pain, then, after carrying out imaging examinations (MRI or lumbar scanner), a more severe underlying pathology is highlighted as a hernia lumbar disc.

The latter is considered to be occupational disease when it meets a certain number of criteria listed in the tables:

  • No. 97 occupational diseases: who indemnize them chronic conditions of Lumbar spine, such as the sciatica L4-L5 or L5-S1 by herniated disc or radiculalgia crural L2-L3, L3-L4 or L4-L5 by herniated disc, caused by low or medium frequency vibrations transmitted to the whole body (driving construction machinery, using vibrating machines, etc.).
  • No. 98 occupational diseases: which compensates the chronic spinal conditions lumbar (sciatica or crural radiculalgia by herniated disc) caused by the manual handling of heavy loads (construction industry, garbage collection, moving, etc.).

A lumbar sprain can sometimes cause chronic pain and an inability to perform certain work-related tasks. A adaptation of working conditions, job change and reclassification professional can then be considered.

In the face of any back pain, whether work-related or not, it is strongly recommended to consult your doctor or occupational physician to benefit, in addition to adequate medical care, from precious advices.

Resources

References

[1] T.Flynn et al., “A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with spinal manipulation”, spine, flight. 27, no 24, p. 2835-2843, 2002.

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[2] MJ Alexander, “Biomechanical aspects of lumbar spine injuries in athletes: a review. », Canadian journal of applied sports sciences. Canadian Journal of Applied Sport Science, flight. 10, no 1, p. 1-20, 1985.

[3] T. Adam, “Sprains”, in Sports gynecology, Springer, 2012, p. 485-485.

[4] LH Yahia, G. Drouin, G. Mrais, and C.-H. Rivard, “Study of the microscopic structure of the posterior ligaments of the lumbar spine”, International orthopaedics, flight. 13, no 3, p. 207-216, 1989.

[5] Elsevier, "Lumbar pain: main reason for work stoppages", Elsevier Connect. https://www.elsevier.com/fr-fr/connect/aru/douleurs-lombaires-raison-principale-des-arrets-de-travail (consulted on October 25, 2022).

[6] “Treatment of back pain”. https://www.ameli.fr/assure/sante/themes/lombalgie-aigue/traitement-prevention (accessed October 29, 2022).

[7] M.-E. Charbonneau, “DID YOU KNOW THAT A LUMBAR SPRAIN DIAGNOSIS CAN BE QUITE ACCURATE? », Desroches Mongeon Lawyers, June 11, 2019. https://desrochesmongeonavocats.com/saviez-vous-quun-diagnostic-dentorse-lombaire-peut-etre-assez-precis/ (accessed October 28, 2022).

[8] "Lumbago: tables of occupational diseases". https://www.atousante.com/aptitude-inaptitude/aptitude-travail-pathologie/lombalgie-mal-dos/lombalgies-tableaux- Maladies-professionnelles/ (consulted on October 26, 2022).

[9] “Back pain: an occupational disease? laboutiquedudos.com”, The Back Shop – Blog, January 24, 2017. https://www.laboutiquedudos.com/blog/le-mal-de-dos-au-travail/mal-dos- Maladie-professionnelle/ (accessed October 27, 2022).

[10] AM Perron, “Work accident: Lumbar sprain”, Physio-Masso MP, December 2, 2019. https://www.physio-masso.com/accident-de-travail-entorse-lombaire/ (accessed October 29, 2022).

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