28/05/2026
Ergonomics at the Workplace: Is Back Pain Occupational or Non-Occupational ?
One of the most common referrals to Occupational Health Doctors (OHDs) is back pain assessment. Employers and employees often ask whether the condition is truly work- related. However, before jumping to conclusions, several important questions must first be answered.
Has any Ergonomic Risk Assessment (ERA) been conducted at the workplace? Was an Initial ERA or Advanced ERA performed? Were the ergonomic risks significant enough to contribute to the employee's condition?
In some workplaces, proper ergonomic assessments and control measures are already implemented. Even if manual handling or awkward posture exists, the overall risk may not be significant because engineering controls, work modifications, and proper body mechanics have reduced exposure risk. Unfortunately, this is still uncommon in many workplaces.
Most cases are referred without any prior ergonomic assessment. Therefore, proper medical assessment becomes extremely important. Assessment of back pain requires detailed occupational and extra-occupational history taking. Employees may have side jobs, hobbies, sports activities, or home tasks that contribute significantly to their musculoskeletal (MSK) condition.
Clinical examination is essential, and referral to Orthopaedic Specialists together with investigations such as MRI or CT scan may help identify underlying MSK disorders.
An important fact often misunderstood is that most MSK diseases are not purely occupational diseases. Many are actually work-aggravated conditions. For example, long- standing spinal degeneration or degenerative slipped disc may already exist, but workplace activities may aggravate the condition further.
Globally, only around 10-20% of MSK diseases are considered strictly occupational, while the remaining 80– 90% are work-aggravated conditions.
This is why OHDs should not rely solely on clinic-based assessments. We must walk to the workplace, observe the work process, assess actual ergonomic risks, and evaluate non-work exposures as well.
Sometimes, home activities contribute more risk than the workplace itself.