Work Foundation: back pain sufferers ‘need to work’

A new report by the Work Foundation has found controversial evidence to suggest that workers with common health problems may actually benefit from remaining at work. In ‘Fit for Work’, the authors argue that conditions such as back pain and arthritis can in fact be helped by employees returning to work early, or not having time off at all.

In the past, GPs and employers have been criticised for assuming that workers need to be 100% recovered before they go back to work.

Employers are now being encouraged to challenge GPs if sick notes are not providing a clear enough indication of the nature of an employee’s health problem, and its impact on their capacity to work. Employers should be much more prepared to ask for clarification of the GP’s assessment, the report argues, if only to help understand which tasks the employee can still perform, or what support they might need to return to work.

Senior researcher, Michelle Mahdon, said:

“Working may cause or aggravate symptoms, but evidence is amassing that with the right support arrangements, work can also be part of the recovery by contributing to a person's self-esteem and sense of being productive”.

Managers are in the front line of staff absence and are in a good position to spot the early warning signs of a problem and to help rehabilitate employees after a period away from work. Despite the current focus on ‘stress’, managers need to be aware that musculoskeletal disorders (MSDs) can be even more of a problem for their staff and for the whole organisation.

Back pain, is one of 200 MSDs affecting the spine, joints and tendons. It is the biggest cause of work-related sickness in the UK, often caused by bad posture at a workstation.

The report examined four conditions in detail. These are:

• Back pain: a non-specific condition (meaning no specific diagnosis is given) usually involving short episodes of pain. At any one time, 33 per cent of the UK population suffers with back pain.
• Work-related Upper Limb Disorders: Another non-specific set of conditions which affect over 375,000 people.
• Rheumatoid Arthritis: A specific condition which affects almost 400,000 people in the UK with 12,000 new cases each year. It is estimated that almost a quarter of RA sufferers stop work within five years of diagnosis.
• Ankylosing Spondylitis: a progressive and chronic rheumatic disorder that mainly affects the spine, but can also affect other joints, tendons and ligaments; it is most often diagnosed among men in their early twenties. Over 200,000 people visit their GP with AS every year.

Some of the suggestions made in the report should help employers to take a more pro-active stance over sickness and absence management. Recommendations for employers include:

• Imaginative job design will assist rehabilitation. Managers can change the way work is organised (including simple changes to working time arrangements) to help prevent MSDs getting worse and to help MSD sufferers to return to work. They need to do this in a way which preserves job quality, avoids excessive or damaging job demands and takes heed of ergonomic good practice.
• Intervene early. Employers should always take action sooner rather than later because caution and delay can only make matters worse. As long as they behave compassionately and make decisions based on evidence and on expert opinion, early intervention cannot be construed as harassment.
• Use occupational health advice. Vocational rehabilitation, when carefully organised and tailored to the individual, can make a real difference to return to work, productivity, morale and sustainability of performance.
• Focus on capacity not incapacity. Try to avoid a ‘risk management’ mentality when dealing with an employee with an MSD, most workers with MSDs can continue to make a great contribution at work if they are allowed to.

To help tackle the problem the Department for Work and Pensions (DWP) has set the HSE targets on reducing the number of reported MSDs between 2008 and 2010. The Department of Health (DH) has also developed a new national service framework on the treatment of MSDs (DH, 2006) and the DWP has announced a ‘Vocational Rehabilitation Taskforce’.

The full report, ‘Fit for Work: Musculoskeletal Disorders and Labour Market Participation’ , is available from the Work Foundation, and can be downloaded free of charge here .