Helping back pain sufferers to stay in work

Back pain is one of the main causes of absence from work in the UK. In 2004-5 approximately 34,000 people in the East Midlands suffered from musculoskeletal disorders affecting their backs, which they believed were caused or made worse by their current or past work.

Now medical research charity the Arthritis Research Campaign has awarded a three-year primary care fellowship of almost £132,000 to occupational therapist Carol Coole at The University of Nottingham, to develop more effective ways in which the NHS can work with employees with back pain — and their employers — to ensure that back pain doesn’t drive them away from the workplace.

In some areas of the UK, patients receive vocational rehabilitation to help them improve their ability to work. However, this service is patchy and ad hoc, and very few people with back pain have access to it.

Since 2000 the Nottingham Back Team — physiotherapists, occupational therapists, nurses, cognitive behavioural therapists and psychologists based at the City Hospital — has run regular group classes at local leisure centres. The programme, offered to some 700 people a year who have had back pain for more than three months, involves graded exercises and activities, relaxation techniques and educational packages.

Mrs Coole, who is based at The University of Nottingham’s division of rehabilitation and ageing, now aims to find out if extra support would also be of benefit, such as running more tailored, work-focused sessions with individual employees, and liaising much more closely with employers and job centres.

She said: “It can be difficult for employees who are worried that work might make their back pain worse, and also for employers who want the back pain to be cured and don’t understand that it’s a chronic condition that comes and goes. Some employers really want to help but don’t know who to ask for advice, while others think their staff are malingering, and the company can’t afford to keep them on. Closer links with local employers will increase their understanding of managing back pain at work.”

After interviewing 16 patients and asking local GPs about problems employees face in working with back pain, and what would make it easier, Mrs Coole will run a feasibility trial of 30 people with back pain. The aim will be to find out whether the Nottingham Back Team course, or a more work-focused rehab programme, is more effective.