We have a man with a mind; standing erect, with a spine and a back evolved by nature to function in a horizontal position. This support structure is a compromise between mobility and stability. The spinal column is made up of 24 pieces of bone tied together with ligaments, intervertebral discs and joints. It is freely mobile in any direction. Useful stability is achieved by a structure of checks and balances made up of muscles and ligaments under the control of the nervous system.
 

His back, with its supporting ligaments, discs, muscles, nerves and disks, is subject to a multitude of disease conditions which cause discomfort and disability (a sore back). He probably has an honest erroneous belief that most sore backs come from strains (injury). He doesn't know about all the other causes. He is usually working for someone besides himself. He sometimes does have damage to his back from acute or chronic injury.
 

What can we do about it?

We can't change the anatomy a person was born with or the diseases he may be heir to. We can learn to appreciate the nature of the sore back problem and how to live with it so that we do not antagonize employees with sore backs and thereby stimulate unjust claims. There is nothing to be gained by getting "teed off" and giving the impression you doubt a person's word, or that he is faking. He probably does have a sore back and resents any doubt of it.
 

We can give adequate medical and surgical care to the individual with a definite injury.
 

We can avoid some erroneous claims of back strains by having, as a matter of record; thorough accurate histories, examinations and investigations at the time of a reported accident, and by early x-rays which may show curvatures, Arthritis anomalies and convince the person he has an already existing condition which has caused his sore back.
 

We can carry on a program of education for our employees as to the true causes of most sore backs.
 

We can stop thinking and talking of sore backs in terms of strain (injury). Call them sore backs.
 

We can place the individual with a known vulnerable back in positions requiring a minimum use of the back so that he or she has little or no excuse to attribute their sore back to his work.
 

We can carry on an active program of health education, especially in adequate nutrition in order to improve over-all physical fitness and thereby diminish susceptibility to the inflammatory and arthritic conditions which are responsible for so many sore backs.

and finally,