A new report released today highlights the need for all NHS staff to be given good advice about back pain. Musculoskeletal problems such as back pain account for 40% of sickness absence amongst NHS staff and costs approximately £400 million per year.
The Royal College of Physicians’ (RCP) National clinical audit of back pain management looked at how occupational health professionals cared for NHS staff who are experiencing back pain. It found that the care and management occupational health professionals give to staff suffering with back problems has improved in the three years since the previous audit in 2008.
However, in half of the 5,524 cases included in the audit, sufferers required clearer information about back pain. This included the fact that in most cases back pain is likely to get better spontaneously and that it is important to return to work as soon as possible. This advice applies even if they are experiencing some pain. If they do not, they risk developing chronic pain and disability.
Dr Julia Smedley, lead consultant on the audit said:
There has been a revolution in the way we manage back pain and there is now good evidence to show that what you do in the early stages is very important – in most cases, the sooner you get moving and doing your ordinary activities, the sooner you will get back to normal.
Occupational health professionals are ideally placed to spread this message amongst NHS staff and also to help those who are affected. I would urge any NHS employee who is suffering from a back problem to seek advice from their occupational health service.
Guidelines from the Faculty of Occupational Medicine recommend that occupational health professionals assess patients’ attitudes towards back pain, and ensure that they do not hold the mistaken belief that physical activity should be avoided.
The audit of 5,524 members of NHS staff, 53% of whom were nurses, also revealed that:
- 59% had taken time off sick due to their back pain
- 87% of the consultations encouraged patients, where appropriate, to stay at work despite residual pain
- 95% of the consultations resulted, where appropriate, in practical advice to managers about the adjustments they could make so that their staff could remain in or return to work.
The government’s 2009 Boorman review into NHS health and wellbeing recommended that there should be consistent access to early and effective interventions for common musculoskeletal problems such as back pain in all trusts, as this is one of the major causes of ill health among NHS staff. The audit suggested that occupational health teams in NHS trusts have responded to this.
90% of NHS staff in the audit had direct access to physiotherapist services, with 52% having a fast track service so that they could see physiotherapists quickly and 26% having access to a physiotherapist who was employed as a member of the occupational health team.
UNISON has estimated that around 3,600 nurses are forced to retire every year due to back injuries. Approximately 80% of the population develops back problems at some time in their lives.
Dr Sian Williams, clinical director for the RCP’s Health and Work Development Unit, said:
It is essential that NHS staff receive appropriate evidence-based advice so that they have the best possible chance of recovering swiftly from an episode of back pain. We are delighted that 86% of NHS occupational health services in England participated in this important audit of back pain management. This demonstrates the commitment amongst OH clinicians to improving their practice so that they can provide the best possible care to the NHS staff they look after.
Professor John Harrison, Director of NHS Plus who co-funded the study said:
Occupational health teams play a key role in improving the health and wellbeing of NHS staff so that they can provide the best possible patient care. This new report shows that NHS occupational health professionals have improved the way that they look after NHS staff who are experiencing back pain since the last 2008 audit. However, the NHS is the largest employer in the UK and its staff touch the lives of the whole population – if we can get rid of some of these mistaken beliefs about back pain amongst staff we can improve the wellbeing of the whole population.
- Download the full audit results from the Back pain management audit pages of the RCP site
- Back pain can range from a dull, constant ache to a sudden, sharp pain that makes it hard to move. It can start quickly if you fall or lift something too heavy, or it can get worse slowly. Discs that sit between the vertebrae of the spine can rupture or break down. Muscles can strain or tear.
- A higher proportion of nurses (53%) and a lower proportion of doctors (2%) were entered into this audit than would be expected from current demographics of the NHS workforce (nationally 29% of NHS staff are nurses and 10% are doctors).