I come from a long line of ranchers and farmers who work hard out doors. My own job is much easier as I do the bookkeeping, finances, and bill paying. Many of the ranch hands seem to get back pain of one kind or another. I'm wondering if there's any way we can screen our workers ahead of time to find who's at risk for back problems. It might save a lot of money in medical bills.

Since 80 percent of all adults will have back pain at one time or another, there's much interest in finding out who might be at risk. The idea of identifying risk factors and preventing this problem is very appealing. Cost savings and avoiding suffering are two of the top goals for this kind of research.

So far studies have not been able to target risk factors for prevention of low back pain. At best we know there are some psychosocial factors that might be linked with back pain. There's no firm evidence that the presence of these factors can predict who will or won't have back pain.

There is some data that suggests work rehab is a good idea before going back on the job. Identifying barriers to returning to work is also a good idea. For example if throwing 100-pound hay bales is part of the job, then the worker should spend time in a program that can monitor his or her activity and make sure this activity can be done safely.

Sometimes workers returning to manual labor need a transition period. During the first days to weeks back on the job they must restrict their activities to lighter duty. This helps them ease back into all the movements required on the job and hopefully avoid a recurrence of their back pain from reinjury.