The longer a worker is out of work with a back problem, the lower the chance of a successful return to employment. There is a less than 5 per cent chance of work return for a person absent from work for a year or longer, the Irish Society of Occupational Medicine meeting has been told.
Dr Tim Carter, chairman of the British Faculty of Occupational Medicine working group on back pain guidelines, said it was an inevitable problem in the working population which was poorly managed in primary care. The issue of returning to work in particular was not well addressed.
The British guidelines, which last year won a BUPA Health care Foundation Award, were drawn up by a broad-based working group, including occupational health nurses, physiotherapists, osteopaths and doctors.
They address issues such as prevention, the assessment of a worker presenting with low back pain and the management of this condition in the crucial period when a person is off work for between four and 12 weeks.
Dr Carter outlined the key messages from the guidelines:
Physical work demands are only a small contributor to low back pain; early active mobilisation prevents disability and chronic problems; psychological aspects of back pain are important determinants of outcome; and there are limits to prevention and employee selection.
Back problems in work were a neglected area, which in Britain cost the economy £208 a year for each employee. Emphasising that fewer than 1 per cent of cases had a serious cause such as a tumour or slipped disc, he said the key to management was to get people back to work quickly.
Misperceptions such as "I'll never be right again" and the concept of a "broken back" to allow people to return to work earlier after an injury should be addressed.
Dr Carter added that workers should learn from sports people; how they exercised around and contained an injury so as to get back to fitness quickly.
Asked what impact these guidelines might have here, he said an EU-wide initiative involving both primary care and occupational health would be started in six months.
Mr Frank Power, an ergonomist with the Health and Safety Authority, told the meeting ergonomics needed to be integrated into the design of systems of work, work processes and equipment for a more proactive injury prevention strategy.