Despite guidelines for clinical management of patients with low back pain encouraging health care practitioners to advise patients to stay active and return to work, researchers in the United Kingdom have found that most health care practitioners believe their role in returning patients to work is limited - and that at least some aspects of work are detrimental to recovery.
The study was recently published in Pain.
"Low back pain is consistently among the top most costly health problems," lead author Tamar Pincus, PhD, stated in a news release. "Back pain has been identified as the second main cause of absenteeism in the UK. Our findings suggest that, despite guidelines that encourage maintaining people at work during episodes of back pain, many clinicians hold a range of beliefs that contradict this advice, and these beliefs can influence their clinical decisions and behaviors."
The researchers examined the beliefs of chiropractors, osteopaths and physiotherapists to report clinical behaviors in reference to patients' work. They sent a questionnaire to 900 musculoskeletal practitioners. In all, 337 (37%) of those surveyed responded, with 80% saying they "sometimes" recommend work absence to patients with low back pain and 14% said they recommended absence "often" or "always."
Seventy percent of practitioners, according to the study abstract, never visit the patient's workplace but physiotherapists were more likely to visit and less likely to give sick leave certification.
For more information:
Pincus T, Greenwood L, McHarg E. Advising people with back pain to take time off work: A survey examining the role of private musculoskeletal practitioners in the UK. Pain. 2011. doi:10.1016/j.pain.2011.09.010