Researchers at Royal Holloway, University of London are calling for more unified guidelines about returning back pain patients to work as currently the advice can be contradictory and confusing.
The work absence is often funded by income protection insurance, so insurers are very interested in the findings.
A study by researchers from the Department of Psychology at Royal Holloway reveals that the advice doctors give out can vary greatly and despite NICE (the National Institute for Health and Clinical Excellence) guidelines encouraging health care practitioners to advise patients to stay active and return to work, most practitioners believe work factors can cause or exacerbate lower back pain, and a recommendation for a short break from work to allow healing is common.
Lead author Professor Tamar Pincus, from Royal Holloway, explains: “Lower back pain is consistently among the top most costly health problems. Back pain has been identified as the second main cause of absenteeism and costs the economy billions of pounds each year. Our findings suggest that, despite guidelines that encourage an active recovery in relation to returning to work, many doctors hold a range of beliefs that contradict this advice, and these beliefs can influence their clinical decisions and behaviours. Everybody from employers, policy makers and doctors has their own agenda and patients get stuck in the middle with conflicting information. More needs to be done to understand each case and clinicians and employers need to find a way to start talking to each other to find a solution that works.”
Researchers measured work-related behaviours and beliefs related to lower back pain among osteopaths, physiotherapists, and chiropractors. After GPs these three groups most commonly treat back pain. They measured how frequently these practitioners visited a patient’s workplace; provided sick leave certificates; recommended a break from work for recovery; and prescribed exercises that could be incorporated into the patient’s work routine. They also examined practitioners’ beliefs about the benefit of work to health in general, and back pain specifically, and employers’ willingness to help patients.
Professor Pincus believes a more holistic and flexible approach needs to be taken and options such as working from home need to be considered: “This is an issue that affects so many people and everybody needs to be on board with this. Educating patients is an important priority that could reduce work absenteeism. If returning to work is beneficial to patients then bringing these practitioners on board is important because it has been suggested that cooperation, communication and agreed goals between workers, employers and practitioners reduce disability and related absence from work."