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STAYING AT WORK WITH LOW BACK PAIN: WHO HELPS THE PATIENT?



Abstract

Background: Low back pain (LBP) can affect work ability. Retention of employment relies on appropriate management by employer and employee, and the healthcare that the employee may access. Healthcare in the UK has historically not been work-focused. The UK government has directed the NHS to play a greater role in enabling people with health conditions to remain in work.

Purpose: The aim of this study was to explore patients’ experiences of healthcare interventions regarding the management of work problems due to LBP.

Method: Individual semi-structured interviews were conducted with twenty-five LBP patients who had been referred for multidisciplinary back pain rehabilitation. All were in employment and concerned about their ability to work with LBP.

Findings: Although the participants had received a range of healthcare interventions, these had failed to alleviate their concerns about working with LBP. There was little evidence of work-related advice or interventions provided by any of the clinicians treating the participants. In a number of cases, patients had remained at work despite the recommendations they had received. Clinicians depended on the patient as an information channel rather than creating opportunities for ‘stakeholder’ dialogue and joint problem-solving.

Conclusions: Healthcare professionals need to improve their ability to explain the nature of persistent and recurrent LBP and to explore their patients’ concerns about working with pain. They should take more active steps to address those concerns, e.g. by communicating directly with employers where necessary, by advising patients how to address actual or perceived negative attitudes at work, and how to access modifications if required.

Conflicts of Interest: None

Source of Funding: Arthritis Research Campaign

Correspondence should be addressed to: SBPR at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.