Thinking back: ongoing and reoccurring lower back pain problems inflict personal misery on individuals and financial penalties on businesses, but these can be eased through a more holistic approach, Zara Whysall explains.(LIFTING AND HANDLING)(musculoskeletal disorders)

Publication: The Safety & Health Practitioner

Publication Date: 01-JUN-06

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COPYRIGHT 2006 CMP Information Ltd.

THE LATEST HSE STATISTICS (2004/05) YET AGAIN identify musculoskeletal disorders (MSDs) as the most commonly reported type of work-related illness in Great Britain, extending the trend established by the previous six surveys. In 2004/05, an estimated 1,012,000 people in Great Britain suffered from an MSD caused or made worse by their current or past work, with each person taking an average 20.5 days off work each year as a result. (1) Of those reporting an MSD in 2004/05, 45 per cent (452,000) suffered from a disorder mainly affecting their back. With such statistics being so frequently cited, why do these problems remain so prevalent?

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One contributory factor is likely to be the complexity of such disorders. Back problems, for instance, cannot always be identified as specific types of disorder, or as relating to particular causes. In fact, it is thought that on average, 95 per cent of lower back disorders are labelled 'non-specific' or 'strain/sprain' because the biological source of the pain cannot be identified. (2) However, despite the inability to identify an organic cause in many cases, disability from back pain is common. Persons absent from work for longer than six months because of lower back pain have only a 50 per cent probability of ever returning to work. (3) Therefore, although the greatest impact of such problems is, of course, on the lives of those affected, they also have a major effect on industry. The direct health care cost of back pain in 1998 was estimated at [pounds sterling]1,632 million, of which approximately 35 per cent related to services provided in the private sector. (4) Despite being the preferred outcome, prevention of incidences (first-time onset), is difficult. Consequently, preventing back pain from becoming chronic is an important goal for employers and practitioners.

Evidence-based practice

The scale of the problem prompted the British Occupational Health Research Foundation (BOHRF) and the Faculty of Occupational Medicine (FOM) to establish new guidelines for the management of low back pain at work, based on a systematic review of the evidence. (5/6) One of the fundamental messages to emerge from this influential review was that although physical demands at work are influencing factors for lower back pain, they are...

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