I’m worried about my husband. He’s been in the construction business since he was 16. Now 30 years later (at age 46), he’s still expected to work another 20 years. Can his back hold up under this kind of strain?

Men involved in heavy manual labor worry they may end up with a herniated disc. How likely is this occurrence? Who is at risk and why? These are the questions asked by a group of researchers at the Copenhagen Male Study.

The Copenhagen Male Study was started over 30 years ago. Over 5,000 men participated in the study. They started by completing a survey with questions about the presence of back pain. Many other individual characteristics were also collected (e.g., age, social class, working conditions, height, weight, lifestyle).

By comparing men who reported back pain at the start of the study with men who did not have back pain, they were able to identify risk factors for disc herniation. It’s natural to assume that heavy lifting, carrying heavy objects, and sustained postures required by work conditions could contribute to low back problems.

It’s also logical that these kinds of problems should decline with age as men perform less strenuous work activities. But that may not be the case in situations like your husband finds himself. According to the Copenhagen Male Study, there seems to be a continued (cumulative) effect of heavy lifting, pulling, and pushing.

In other words, over time, the effects of these activities build up and influence disc health even after the man is no longer involved in those activities. Exposure will certainly change for most men over time. After 30 years in this study, many men were past retirement age and no longer engaged in heavy manual labor. Yet, their rate of disc herniation was higher than the younger men who were also involved in heavy physical activity.

More study on this topic is definitely required. And, in fact, efforts are being made to find ways to prevent problems such as back pain associated with disc herniation in manual laborers. The Copenhagen study is also looking for other risk factors that might be reduced or modified to offset the cumulative effects of workload.

Reducing psychosocial stress may help as dissatisfaction with work conditions or the job seems to also increase the risk of back pain. It’s possible that participation in leisure physical activity (even activities that involve heavy load on the spine) may reduce the risk of disc herniation.