New guidance for employers, patients and doctors on helping people with back pain return to work will be announced on Tuesday May 5 at the University of Leicester. It is estimated that it costs society in excess of £12 billion a year with people taking time off work because of back pain. Around 80% of these costs, were not associated with healthcare but due to lost work production and associated wage replacement benefits.
“These figures demonstrate the importance of maintaining people with chronic pain in useful employment,” says Professor Paul Watson of the University of Leicester Department of Health Sciences who was among a group of researchers investigating back pain and its impact in the workplace.
“The role of healthcare practitioners in sanctioning work absence has been investigated and this has demonstrated that the health service is currently ill equipped to manage work loss in people with chronic pain and may in itself contribute to the high societal costs.”
The reasons why people become disabled by chronic pain are not entirely explained by the severity of pain or the pathology but are better explained by the interaction of complex psychological and societal factors. Treatments which ignore these factors risk perpetuating the problem of chronic disability and work loss.
Professor Watson will present his report at the University of Leicester on Tuesday 5 May at 5.30pm. The lecture takes place in the Ken Edwards Building, Lecture Theatre 1 and is open to the public and free.
Key recommendations are:
- Assessment of the key, psychosocial barriers to successful rehabilitation
- Development of an action plan to provide comprehensive treatment to address these barriers.
- A co-ordinated approach involving of healthcare workers, employers and patients to prevent work loss
- A recognition that a return to full engagement in society, including work, is beneficial to health of those with chronic pain.
Following the lecture, an evidence based guide for clinicians, patients and employers on how to help people with chronic pain remain in work will be published. This was funded by a group including clinical interest groups, employers and health insurance companies. It will be made available as a free PDF.
Professor Watson said: “This work is extremely topical. The Chief Medical Officer has just released a report identifying the need to improve the management of pain. Dame Carol Black has launched an initiative to try and return people with chronic health problems to work – much of what she recommends is included in our evidence based review and underpins our previous research in this area over the last six years.
“The University of Leicester has been instrumental in performing key research on returning unemployed people with chronic pain to work and we have written a number of reports on the barriers and bridges to employment in this group.
“We are currently conducting research in how healthcare services can be made more effective in assisting people to remain in work by educating GPs on returning people with back pain to work – the results of this work will not be out until next year.”
Pain is a common experience, everyone has experienced it at sometime in their lives; it is usually self limiting and improves. For some pain will persist and most of us will experience chronic pain (lasting longer than 12 weeks) in our lifetime.
Pain is complex, significant damage may or may not result in pain, and moderate to severe pain can exist in the absence of significant damage or pathology. We now understand that pain is an interpretation of incoming stimuli some of which are associated with damage and some which are benign but interpreted in terms of threat and injury. Furthermore ethno-cultural differences exist in pain threshold in experimental studies, and in pain intensity and distribution in the clinical setting. Many people who have chronic pain do not become severely disabled by it, disability due to chronic pain is better explained by psychosocial rather than clinical factors.
The failure to adequately manage chronic pain has been called a modern healthcare disaster. The Chief Medical Officer’s recent report recognises the current poor service and the problem of helping people with pain remain in or return to work is highlighted in the report “Working for a healthier tomorrow”.
The cost to the public purse of musculoskeletal pain is greater than any other condition. The cost of low back pain alone in 1998 was estimated at £12.3 billion, the majority of these costs, around 80%, were not associated with healthcare but due to lost work production and associated wage replacement benefits. These figures demonstrate the importance of maintaining people with chronic pain in useful employment. The role of healthcare practitioners in sanctioning work absence has been investigated and this has demonstrated that the health service is currently ill equipped to manage work loss in people with chronic pain and may in itself contribute to the high societal costs.
Studies on the long-term unemployed have demonstrated that they can be successfully returned to work and this formed a base for the Pathways to Work initiative by the Government. Attention has now turned to helping people who experience pain in the workplace and an evidence based review informs how the psychosocial factors which lead to work absence should be managed through a coordinated approach involving patients, employers, health providers and funders. This evidence based approach will be made available free to all interested parties soon after this inaugural lecture.