A right pain in the back... and the bank balance
Farmers are feeling the impact of their gruelling workload - both physically and financially
Published 28/10/2015 | 02:30
The cost of treating common back pain in Ireland runs into hundreds of millions annually and farmers, because of the occupational risks associated with their jobs, suffer more than most.
Dr Kieran O'Sullivan of the University of Limerick Clinical Therapies department estimates that the annual cost of dealing with back injuries across all categories of patients is around ¤750m - more than the combined cost of treating cancer and diabetes.
Musculoskeletal Disorders (MSDs) are the most prevalent health problem among farmers and Lower Back Pain (LBP) is the most common of the MSDs, Dr Caitriona Cunningham, a lecturer in public health at UCD's Physiotherapy department, told Farming Independent.
Dr Cunningham, along with Dr Aoife Osborne of UCD's School of Agriculture, conducted a major health survey of farmers for Teagasc in 2009. They were also involved in the first ever survey of MSDs in farmers in Ireland as part of the ongoing National Farm survey.
The surveys showed farmers are at greater risk of suffering from lower back pain than any other working group and over half the farmers surveyed blamed a specific farm injury for their condition.
"General 'lifting, pushing and pulling' on the farm is the most common reported cause of work-related LBP problems, especially on the larger and more intensive farms," says Dr Cunningham.
"Longer hours also puts farmers at greater risk of LBP," she adds.
She says Irish farmers should take a "holistic'' approach to their day-to-day work, which takes into account their work environment and personal factors.
She also believes there is a need to generate a greater national awareness of the risks of these injuries, which the farming life inherently presents.
Most importantly, she says a modicum of common sense on the part of farmers is vital when undertaking farm work.
"Risk assessment is very important. When a farmer goes to do a farm task he or she needs to assess what risk it presents.
"They should sensibly consider whether the task should be carried out or should be avoided. They should ask themselves if the assistance of others is required to carry out the task or if mechanical assistance is required.
"They also need to plan lifting and other farm activities and they need to spread the workload.
"Pacing their farm activities is important and they should constantly review whether they might need to change farm practices," Dr Cunningham added.
She emphasised farmers should ttend manual-handling training courses which Teagasc provides.
The last National Farm Survey research into back pain and its effects on farmers covered 600 farmers and showed 49pc reported a significant LBP in their lifetime.
Most respondents attributed the episode to a specific farm injury or repeated farm activities.
Approximately 28pc did not know how their LBP injury arose.
Working on medium to large farms tended to increase the incidence of LBP due to more intensive activity levels and greater labour inputs.
Just under a sixth of the 600 respondents reported not being able to work at some time during the previous year because of back pain while some 46pc of respondents had sought some form of medical assistance from a doctor, chiropractor or physiotherapist the previous year.
Eight per cent of those surveyed said they had considered giving up farming because of their LBP injuries.
The survey showed these injuries were commonly attributed to general lifting, pulling and pushing activities.
Plagued by back pain
Limerick man Gerald Quain has been plagued by back pain for over 20 years now and for that duration, not a year has passed without the dairy farmer needing medical treatment.
"The back pain is at its worse during the winter and spring when the workload is heavy, but it is alright for the rest of the year. It's alright at the moment," Gerald told Farming Independent.
Gerald runs a 240ac mixed dairy, beef and liquid milk enterprise at Colmanswell near Charleville, right on the Limerick/Cork border. He can't remember what actually caused the back pain in the first place and just puts his condition down to the "wear and tear'' of farming life.
"I fell when filling a hay load about 20 years ago and that was a sore experience. I went into a hospital in Limerick to get treatment for the soreness from the fall but it cleared up quickly. It hardly helped but I wouldn't put the back pain down to the fall," he explains. "But pulling calves all the time and the pressure that involves hardly helps.
"I put it all down to the general wear and tear of working on the farm, especially at busy times like calving," he adds.
The pain affects his sleep patterns when the workload gets heavy.
"I suppose that too must have something to do with the physical stress," he adds.
Gerald says his son Colm, who is now working on the farm, is not affected by any sort of back trouble.
But Gerald puts that down to the modern farm machinery now available - none of which was available when he started farming.
He is resigned to his winter and spring time visits to the medics which, he says, don't come cheap.
"I usually get the back pain massaged, which works, or go on a course of pain killers for a few weeks. They seem to do the job."
USING COMMON SENSE TO AVOID BACK PAIN
Preventing lower back pain (LBP) for farmers and farm workers can often be just a matter of common sense and common precaution, according to Dr Kieran O'Sullivan of the Clinical Therapies department of the University of Limerick.
Dr O'Sullivan has a PhD in lower back pain and is currently working on a ¤1m research project about the problem. Here, along with his colleague Mary O'Keefe, a PhD student at the university, he gives a list of tips which will be useful to farmer and farm workers who are prone to LBP.
Take regular exercise
Farmers think they don't need exercise because of the on-the-go nature of their jobs. But farmers will benefit from moderately vigorous exercise like jogging and cycling. All types of exercise are good and while it can be hard to engage in when a farmer is suffering from LBP, it will not necessarily do further damage.
More sleep, less stress
Farming life can result in high stress levels, financial insecurity and poor sleeping patterns.
Many farmers do not realise that these factors negatively influence LBP. Therefore, decreasing stress levels and increasing sleep levels are important factors in staying pain free and healthy, as is keeping in contact with neighbours and the local community.
Don't avoid activities
Farmers with back pain often believe activities such as bending, lifting and twisting are dangerous and should be avoided. This is understandable as one of these activities may have lead to the LBP in the first place. Like an athlete who has sprained their ankle benefits from returning to track running, a farmer may benefit from returning to the activities which may have caused the problem.
Don't panic about back pain it is as natural as becoming sad or tired. Most acute pain is the result of simple strains and sprains and almost 85pc of LBP sufferers will recover within three months. Only a small percentage of sufferers will develop long-standing or disabling problems.
Some LBP is age-related
Farmers consider getting a scan in case there is something serious involved in their LBP. Scans often show up things that sound bad or get a report of bulging discs or arthritic changes. All these results are showing is harmless age-related conditions.
Avoid unnecessary surgery
There is no evidence back pain is caused by bones or joints being out of place or the pelvis being out of alignment. Farmers may think their back is worse than it actually is and lead to unnecessary surgery.