Billions of Dollars a Year Spent on Special Chairs, Braces and Treatment : ‘Oh, My Aching Back’ Is Music to Many in Medical Field

Bad backs are big business, causing billions of dollars in losses to employers and creating billions more in profits for doctors, chiropractors, physical therapists and makers of back-care products.

Hector Serber, a Sausalito, Calif., engineer who suffered chronic back pain for years, has come up with the latest invention to tap into the backache market.

He’s reinvented the office chair, which he says is one of the main culprits in low back problems.

The Ergomax Chair, an odd-looking and expensive product from Serber’s American Egonomics, is the first chair to support the worker while leaning forward.

Priced from $850 to $1,000, the Ergomax Chair has a variety of controls to change the seat and back support six ways to reduce lower back stress and combines some of the features of kneeling, backless chairs.

“It is unquestionably the most universal and most innovative of back chairs in the world today,” said Dr. Arthur White, the orthopedic surgeon who operated on San Francisco 49ers quarterback Joe Montana and who is medical director of St. Mary’s Spine Center in San Francisco.

Orthopedic supply stores and pharmacies are filled with dozens of other products designed to relieve lower lumbar stress while sitting or sleeping.

Nada-Chair of Minneapolis makes a brightly colored $30 sling worn around the back and over the knees to hold the lumbar area in correct sitting position. Numerous companies make pillows to reduce neck and back strain while lying down and wedge-shaped pads for chairs or leg rests.

Sell Hundreds of Corsets

Sacro-Ease, by McCarty’s of Coeur D’Alene, Idaho, is a popular lumbar support seat, costing up to $85, for cars, ballparks and airplanes that many doctors prescribe. Dr. Scholl’s, Spenco Medical Corp. of Waco, Tex., and other companies make gel-filled shoe inserts for up to $15 and orthotics costing up to $20 to reduce jarring vibrations on the spine while walking.

Braces and lumbar-sacral corsets costing up to $140 also are widely used, and some orthopedic stores individually design plastic body jackets from molds that reach from the chest to the base of the spine at costs up to $875.

“We fit about 50 body jackets a year and sell hundreds of corsets,” said Earl Kick of Palo Alto Orthopedic Co.

Back injuries cause more than $20 billion in annual losses due to absenteeism--the second leading cause of lost work in the United States after the common cold, according to the National Insurance Council. More than 100 million workdays are lost each year.

Billions more are paid out in disability claims, lawsuit awards and other settlements resulting from back injuries.

The American Academy of Orthopedic Surgeons conservatively estimates that more than $3 billion is spent annually in the United States on medical tests and treatment of lumbar disc disorders. Several billion dollars more go to an array of chiropractors, physical therapists, acupuncturists and a variety of self-styled gurus who promote more exotic cures.

The insurance council estimates the total bill for lost time, tests, treatment, pain-killing drugs, legal awards and back products runs well over $80 billion a year.

People Mostly Sit

The chief culprits, according to doctors and therapists, are prolonged poor seating at work and improper lifting. Sitting and lifting stress the lower back, often leading to ruptured discs and other problems.

“We sit at breakfast, we sit when we commute to work, we sit all day in the office, at lunch, when we drive home, have dinner and relax in front of the television,” said Howard Lieberman of the Woodside Physical Therapy & Spine Center in Redwood City, Calif. “All that sitting really compressively loads the joint structure of the lower spine.”

Lower back pain is largely a modern Western phenomenon, he added. By contrast, Asians have far fewer lower back problems, probably because they sit less on chairs and squat more often, thereby putting less strain on the lumbar discs.

It’s important to get up frequently from sitting and to shift positions in the chair, said Lieberman. That’s one of the key features of the Ergomax Chair.

“I designed the chair from the point of view of a mechanical engineer, looking at the forces that are put on the back and other parts of the body when we sit, and studying the ways a chair could be designed to reduce stress on the lower back,” Serber said.

“Most people are confined to one seating position all day, and have no support when they lean forward to do their work,” he said. “Most people develop bad backs as a result. The Ergomax Chair responds and supports the body’s need to change positions throughout the day.”