Back pain: Don’t take it lying down!

Lower back pain a burden but workers
reluctant to raise the flag, new Konekt report shows.

Despite
Australians being infamous for “taking a sickie”, new research shows most are reluctant
to take action if they injure themselves – especially when it comes to
back pain.

The
Konekt Market Report, which is the largest of its kind in Australia, analysed
more than 113,000 cases of workers compensation and non-compensable* cases over
a six year period. It found that while lower back pain is the second-greatest
contributor of disability in Australia, employees either take their time
reporting injuries or ignore them until
they become debilitating.

Musculoskeletal
injuries represented the largest workplace injury category, with back injuries
accounting for almost one third. And in the compensable environment ‘back
strain’ injuries represented almost one in five serious injury claims over the
last decade.

Around three million AustraliansƗ (14% of the
population) suffer from low back pain, and according to the Australian
Institute of Health and Welfare, $5.7 billion was spent on arthritis and other
musculoskeletal conditions in 2008-2009, with $1.18 billion of that
specifically on back problems. A cost-of-illness study carried out in Australia estimated the indirect
costs associated with low back pain to be $8.15 billion due to loss of earnings
and productivity[1].

“Last
financial year saw an increase in the number of referrals being made relating
to back injuries,” says Nicholas Ward, Product Manager with Konekt. “While the
total number of claims is decreasing and the average time lost associated with
back strain injuries halved between 2000 and 2001 and 2010 and 2011, alarmingly
we noticed an increase in the average delay from when an injury occurs to when
it is reported and then referred for support and return to work services.”

Professor Chris
Maher, director of the University of Sydney
Medical School Musculoskeletal Division and one of the world’s top back pain
specialists, says there are numerous misconceptions about the causes and
treatment of back pain.

”We know that the worker with back pain, their
employer and the clinician managing the worker’s back pain may misunderstand
back pain, so we really need to think about educational programs targeting each
of those groups,” Professor Maher says.

The Konekt Market Report also showed males aged
between 30 and 39 had the highest incidence of back injuries, and were more
likely to report them (65%). Back injury claims made by women to
employers/healthcare professionals rose from 33% to 39% over the past decade.

Professor
Maher says in general back pain is more common in women than in men – and that
there’s a very strong genetic predisposition to getting back pain.

“Before we used to think
that back pain was mainly caused by injury and poor lifestyle, but I think
we’re now starting to realise that a person’s genes can also influence how much
back pain they experience,” he says.

SMEs shouldering the burden

Data showed
small and medium employers are shouldering the burden through higher rehabilitation
costs. Significantly, small employers are, on average, waiting 114 weeks to
refer employees for rehabilitation services.

“We
found that the return to work rate for small business is 85%, compared with 90%
for large businesses,” Nicholas Ward says. “Smaller businesses are less likely
to have internal expertise in relation to injury management [and] will be more
reliant on external providers.”

Professor
Maher says one of the most important things that employers/managers can do to
help workers with back pain is to become educated about the condition.

“Our understanding of how to best manage back pain has changed in
the last decade. For example, surgery really has a quite limited role for
workers with back pain,” he says. “Doctors are also now more cautious with
opioid medicines because if they are not used carefully they can cause harm. We know from Australian and overseas data that people
are unfortunately dying from taking prescription opioid medicines for their
back pain.”

Prevention and cure

While there is
often no obvious cause for a person’s back pain, Professor Maher says
there are some simple steps that could be taken to prevent it.

“Avoiding
smoking, having a healthy diet and a healthy amount of alcohol, undertaking
physical activity, and using your back sensibly,” he says.

And
while prevention is all very well, once the back pain is there it needs to be
dealt with. “There are several steps people can take to help themselves get
better,” Professor Maher says. “The contemporary approach is don’t go to bed.
Rather, try to stay physically active – you don’t need an x-ray and you should
try to remain at work.”

Tips
for helping address back pain:

– Speak
with your doctor or physio if the pain is not settling with simple self-care
measures

– During
an episode limit bed rest; try to stay active at home or work

– Use
your back wisely

– Adopt
a healthy lifestyle

– Be
physically active; avoid prolonged sitting

– Don’t
smoke; moderate alcohol intake

– Make
time to enjoy life– e.g. spending time with family or friends

[1]Walker B, Muller R, and Grant W,
Low back pain in Australian adults: the economic burden. Asia-Pacific Journal
of Public Health, 2003. 15(2): p. 79–87.

Images: http://www.forskningsradet.no/