Active Rehabilitation:

Latest thinking on managing back pain - the leading cause of sickness absence in the UK - is unusual.

It encourages a speedy return to work, rather than the traditional prescription of complete rest.

Back Trouble UK believes that employees should not take long periods of time off work to recover from low back injuries, even if they are still suffering from the symptoms.

The most effective route to recovery is for employers to establish a program of active rehabilitation that encourages employees to get back to work as soon as possible.

Occupational health practitioners and managers are being encouraged to tackle the problem, by working closely together, with a common, consistent approach to agreed goals.

Improving Health

As well as affecting injured employees and their families, back pain has a major effect on industry through absenteeism and avoidable costs.

The Confederation of British Industries estimates that back pain costs £208 for every employee each year, while, at any one time, 430,000 people in the UK are receiving various social security benefits primarily for back pain.

There is strong evidence that physical activities at work, such as manual handling, account for only a small number of low back injuries among employees. Workers in heavy manual jobs report more low back pain symptoms, but people in lighter jobs have similar problems, related to normal everyday activities such as bending and lifting.

As a first step, health practitioners should raise awareness among employers and employees that work-related activities are not the only cause of lower back pain. But it should also be made clear that work activities can make the symptoms worse.

The next step is to carry out a pre-placement assessment to identify employees who may be more likely to develop lower back pain while carrying out particular work activities. This should include finding out whether employees have a previous history of pain. Care should also be taken when placing individuals with a strong history of lower back pain in physically demanding jobs.

The longer a worker is off work, the lower their chances are of ever returning to work. In fact, evidence shows that, whereas half those injured return to work after six months, only five per cent return after a year off work.

Employers are being encouraged to establish an active program of rehabilitation to help employees stay active and return to ordinary work activities as early as possible. This can lead to a faster recovery than traditional medical treatment, while the business benefits can include shorter periods of work loss and reduced sickness absence.

Occupational Issues

One way of promoting a quick return to work is for organisations to establish joint employer-worker initiatives to facilitate and support workers remaining at work or returning as soon as possible.

Back Trouble UK recommends that health practitioners should:

Initiate communication with the primary health care professional early in treatment and rehabilitation;
Advise the employee to continue as normally as possible and to provide support to achieve this;
Advise employers on the actions required, which may include sympathetic contact with the absent worker;
Consider how an employee's work tasks can be temporarily modified or how they can be given lighter work until they are fully recovered.

Guidelines suggest implementing rest pauses, work rotation, or using mechanical handling aids to carry out lifting operations to achieve this aim.

Other practical steps that can be taken to tackle the problem of low back pain include advising employees on current good working practices - for example, good lifting techniques - and issuing them with user-friendly information, such as HSE guidance publications.

Employers are also encouraged to:Consider joint employer-worker initiatives to identify and control occupational risks;

Monitor back problems and sickness absence due to Lower Back Pain;
Recognise that high job satisfaction can help to reduce disability and sickness absence rates attributed to Lower Back Pain.

Conventional tests such as X-rays and clinical examinations are of limited value when it comes to assessing and preventing lower back pain.

It is important to identify work-related factors. For example, dissatisfaction with work may get in the way of an employee's recovery and may cause symptoms to persist.

Please join us, we welcome your comments.

You can email us at: consultants@backtrouble.co.uk