Back pain: Don’t take it lying down!

Lower back pain is a burden but workers and employers are reluctant to raise the flag, Konekt Market 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.

While lower back pain is the second- greatest contributor of disability in Australia, employees and employers either take their time reporting injuries or ignore them until they become debilitating according to the latest figures from the Konekt Market Report.

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 productivity¹.

Last financial year saw an increase in the number of referrals to Konekt being made relating to back injuries. 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.

injury-treatments

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.

*Compensable claims – referrals where there is compensation claim arising (these referrals are typically made by insurers, scheme agents and self- insured employers.) Non-compensable – referrals where there is no compensation claim arising (these are typically made by employers).

References

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.