Debbie Gilbert, Anne Harriss and Siva Murugiah demonstrate how OH practitioners can assist employees with lower back pain to return to work
One of the most dramatic failures of healthcare in recent years in people of working age is the disability experienced from back pain.1 Almost 13 million working days are lost annually because of back pain, at a cost of £10bn and up to 12 million GP consultations a year.2 Lower back pain (LBP) will affect 70% of the working population at some time during their working lives.3 Sickness absence and the costs associated with back pain will, therefore, affect all employers and the productivity of the nation.
Occupational health practitioners will be involved in the assessment of fitness to work of people who have back pain either at the pre-employment stage or following a period of sickness absence.
There is strong epidemiological evidence that the physical demands of work can be associated with increased reports of back symptoms. However, disability owing to LBP depends more on the complex interplay between individual and work-related psychosocial factors, than on clinical features or on the physical demands of work.4
Although LBP is a symptom rather than a diagnosis, its presence is relevant when assessing fitness for work, along with other factors, including age, height, fitness, weight and sex.5
The impact of LBP caused by a protruding intervertebral disc with nerve root involvement with a view to assessing and facilitating the continued employment of a serving police officer, provides a good example of OH in action.
To place this in context, the pathology of a protruding intervertebral disc at L5/S1 with compression of the right S1 nerve root will be explored. Interventions available to promote the individual's return to work, the rehabilitation process while adhering to police force policies and procedures and compliance with health and safety legislation will be highlighted.
A police sergeant working in a large city force, officer Leo (not his real name) was 43 years old at the time of the management referral and had been off work for three weeks with LBP radiating down his right leg following an injury on duty. In line with the attendance management policy, advice on the expected recovery time and general rehabilitation was sought from the OHN.
Leo joined the police force when he was 18 and has 26 years' serv